title: Analysis of FNAC of cervical lymph nodes: experience over a three-year period.
abstract: This study was taken up with the aim to investigate the pattern of cervical lymphadenopathy among patients presenting to IPGME&R, Kolkata, a tertiary care institution in Eastern India to evaluate the diagnostic efficacy of FNAC, and to dissect the diagnostic pitfalls. A total of 509 patients were subjected FNAC of cervical lymph nodes over a three-year period (August 2006-July, 2009). Since in 34 patients, as either the aspirate was inadequate or the opinion equivocal, the remaining 475 cases were analysed. Overall tuberculous lymphadenitis was the most common finding (222/475; 46.7%), while reactive hyperplasia was the commonest presentation (45%) in patients less than 20 years of age. Malignant pathology accounted for 13.7% (65/475) of cervical lymph node enlargement, most of which was due to metastatic squamous cell carcinoma (44/65; 67.7%). Histopathology reports were available for comparison in 220 cases. Twelve cases of tuberculosis were missed in FNAC and were reported as either reactive hyperplasia (n = 9) or acute non-specific lymphadenitis (n = 3). Among the 3 cases of metastatic squamous cell carcinoma that were missed in FNAC, one was reported as tuberculous lymphadenitis (due to granuloma formation) and the other 2 as reactive hyperplasia due to sampling error. FNAC is an excellent first line of investigation and when used with a proper combination of experience and diligence, it can greatly reduce the number of errors.
authors: Sumit
authors: S
authors: Mitra
authors: Suchandra
authors: S
authors: Ray
authors: Pradip K
authors: PK
authors: Mitra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000473:pathology* / Q000556:secondary; D002648:Child; D002675:Child, Preschool; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007223:Infant; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009333:Neck; D014388:Tuberculosis, Lymph Node / Q000473:pathology*; D055815:Young Adult