title: Spectrum of cytological findings in patients with neck lymphadenopathy--experience in a tertiary care hospital in Pakistan.
abstract: BACKGROUND
  Lymph adenopathy is of great clinical significance as underlying diseases may range from a treatable infectious etiology to malignant neoplasms. In fact it is also essential to establish that the swelling in question is a lymph node. Fine needle aspiration cytology (FNAC) plays a vital role in solving these issues, nowadays being recognized as a rapid diagnostic technique because of its simplicity, cost effectiveness, early availability of results, accuracy and minimal invasion. FNAC is particularly helpful in the work-up of cervical masses and nodules because biopsy of cervical adenopathy should be avoided unless all other diagnostic modalities have failed to establish a diagnosis.
  
  
  OBJECTIVE
  To determine the epidemiological and cytomorphological patterns of enlarged neck nodes.
  
  
  METHODS
  This retrospective observational study was performed at the Section of Histopathology, Aga Khan University Hospital (AKUH), Karachi, Pakistan.
  
  
  METHODS
  Three Hundred and seventy seven (377) neck swelling specimens obtained over a period of two and a half years registered from different regions of Pakistan were selected. Data were analyzed using SPSS 17.
  
  
  RESULTS
  Of a total of 377 cases of FNAC performed on neck nodes, the most frequent cause of lymphadenopathy was found to be tuberculosis with 199 cases (52.7%), followed by reactive lymphoid hyperplasia with 61 cases (16.1%). Metastatic carcinoma was found to be the third most common cause with 33 cases (8.7%). A diagnosis of lymphoproliferative disorder was rendered in 21 cases (5.5%). Acute and chronic non-specific inflammation was seen in 16 cases (4.2%). In 47 cases (12%) FNAC was inconclusive.
  
  
  CONCLUSIONS
  In our study, the predominant cause of enlarged neck nodes was tuberculous lymphadenitis, followed by reactive lymphadenitis and malignant neoplasm, especially metastatic carcinoma and lymphoma. FNAC was helpful in establishing the diagnosis in approximately 98% of the cases.
authors: Department of Pathology and Microbiology, Aga Khan University Hospital, Karachi, Pakistan. saira.fatima@aku.edu.com
authors: Saira
authors: S
authors: Fatima
authors: Sidra
authors: S
authors: Arshad
authors: Zubair
authors: Z
authors: Ahmed
authors: Sheema H
authors: SH
authors: Hasan
mesh_terms: D000328:Adult; D044963:Biopsy, Fine-Needle; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D009333:Neck; D009369:Neoplasms / Q000175:diagnosis / Q000473:pathology; D010154:Pakistan; D012189:Retrospective Studies; D014376:Tuberculosis / Q000175:diagnosis / Q000473:pathology; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis / Q000473:pathology; D002577:Uterine Cervical Diseases / Q000175:diagnosis / Q000473:pathology