Cytopathological Spectrum of Lesions in the Axilla - A Population Based Study from a Tertiary Care Centre in North-East India

2021 ◽  
Vol 8 (32) ◽  
pp. 2988-2992
Author(s):  
Soram Gayatri Gatphoh ◽  
Badrinath Venkatesh ◽  
Khagokpam Ambala Devi

BACKGROUND The axilla is a triangular space between the lateral wall of thorax and the upper part of arm. The component of axilla can give rise to different diseases ranging from developmental and reactive to neoplastic. Various mesenchymal tissues present in the axilla can give rise to different lesions. Fine needle aspiration cytology (FNAC) is a safe, quick, easy, and a cheap diagnostic tool to decipher the benign or the malignant nature of the swelling. Imaging techniques and FNAC, both used individually or coupled, improve the accuracy of diagnosis and help in avoiding unnecessary invasive procedures. The most common lymph node lesion in axilla is benign reactive lymph node hyperplasia. It is caused by inflammation of the lymph nodes or the adjacent organs, such as the breast or lung. METHODS The present study is a retrospective review of swellings aspirated from axillary region. FNAC was performed following strict aseptic precautions. Inadequate aspirates were excluded from the study. The aspirated sample was blown on clean glass slides and smears were made using squash preparation. Smears were fixed using air dried and alcohol fixation method. Smears were stained with Giemsa stain, and the alcohol - fixed smears were stained with haematoxylin and eosin and Papanicolaou stains. Cytological smears were evaluated for adequacy, cellularity, type of cells, arrangement of cells and nuclear as well as cytoplasmic features. RESULTS A total of 191 axillary swelling were aspirated during the study period. Out of which 148 (77.5 %) cases were females and 43 (22.5 %) cases were males. Most common lesion was lipoma followed by axillary tail of breast. CONCLUSIONS Various pathological processes may affect the axilla. There is overlap in the imaging findings of these diseases. FNAC is a diagnostic tool which is required for conformation of diagnosis of axillary lesions. KEYWORDS Axillary Swelling, Fine Needle Aspiration, Lipoma

2021 ◽  
Vol 8 (17) ◽  
pp. 1090-1094
Author(s):  
Badrinath Venkatesh ◽  
Khagokpam Ambala Devi ◽  
Soram Gayatri Gatphoh

BACKGROUND Lymph nodes (LN) are an integral component of the immune system. Enlarged lymph nodes are a prime target for fine needle aspiration (FNA). Lymph nodes greater than 1 to 2 cm are an immediate source of concern. Lymphadenopathy is a common presenting symptom in various diseases. Fine needle aspiration cytology (FNAC) confirms the presence of metastatic disease and gives a clue regarding its nature and origin of primary malignancy. In many metastatic malignancies, FNAC may be the only tool for diagnosis and further management of the patients. We intend to assess the cytomorphological patterns of both primary tumour and metastatic tumour in a lymph node. METHODS A retrospective study was conducted in the Department of Pathology, RIMS, Imphal, over a period of one year from January 1, 2018 to December 31, 2018. Five hundred and fifty-five lymph nodes were aspirated, out of which 99 cases turned out to be malignant lesions. Giemsa and PAP stained FNAC slides were collected and reviewed. Data entry and analysis were done by using SPSS version 21. RESULTS Out of 99 cases, 88.9 % were metastatic tumours and 11.1 % were of primary lymphoproliferative disorders. Thirty three percent of malignant lymphadenopathy were found in fifth decade. Undifferentiated carcinoma constituted around 32.3 % of all the cases of malignant lymphadenopathy. Cervical group of lymph nodes were involved in 46.5 % of cases. CONCLUSIONS FNAC has proved to be a useful tool in diagnosing malignancy with good certainty. FNAC of lymph nodes prevents complications associated with lymph node biopsy. KEYWORDS FNAC, Lymph Node, Undifferentiated Carcinoma, Squamous Cell Carcinoma


2015 ◽  
Vol 26 (2) ◽  
pp. 49-54
Author(s):  
Mohammad Rafiqul Islam ◽  
Md Azizul Hoque ◽  
ARM Saifuddin Ekram

Background: Lymphadenopathy is a common clinical problem in our country among all age groups and in both sexes. In this study an attempt has been made to evaluate the clinical presentation and diagnosis of peripheral lymphadenopathy, which is commonly encountered in medical wards and diagnostic value of FNAC has been evaluated.Methodology: This hospital-based descriptive study was done in thirty adult cases, of clinically apparent peripheral lymphadenopathy of at least more than two weeks of duration. Study was conducted over a period of 6 months from July, 2005 to December, 2005 in inpatients and outpatients of Rajshahi Medical College Hospital. After thorough examination, fine needle aspiration from several accessible enlarged lymph node groups were taken and sent for cytopathological examination and later biopsy of the significantly enlarged lymph node from the same anatomical region was performed and was sent for histopathological examination.Results: Cytopathological study was successful in correctly identifying 84.6% of tubercular case, 85.7% of non-Hodgkin’s lymphoma, 66.7% of Hodgkin’s lymphoma, 83.3% of mitotic nodes and 100% of reactive nodes. Statistical correlation between aetiology of lymphadenopathy and cytopathological diagnosis with Spearman’s rank correlation coefficient revealed a strong positive statistically significant correlation of cytopathology with aetiology, i.e. histopathology. Calculation of sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for a positive test result and likelihood ratio for a negative test result confirms the diagnostic value of cytopathology in peripheral lymphadenopathy by demonstrating high values for different aetiology.Conclusion: The result of this study may not exactly reflect that of similar studies conducted home or abroad, probably due to smaller sample size and limited scope, but its strength remains in the fact that it attempted to address a widely prevalent condition in a practical way.Bangladesh J Medicine Jul 2015; 26 (2) : 49-54


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