scholarly journals Pattern of Lymphadenopathy on Fine Needle Aspiration Cytology in a Tertiary Level Hospital in Kathmandu

2018 ◽  
Vol 1 (2) ◽  
pp. 97-99
Author(s):  
Amar Narayan Shrestha ◽  
Shova Kunwar ◽  
Barun Babu Aryal ◽  
Anurag Adhikari ◽  
Ayusha Poudel

Introduction: Fine Needle Aspiration Cytology is a relatively simple, inexpensive and rapid diagnostic procedure for identifying cause of lymphadenopathy without need for surgical procedures. This study aims to explain the pattern of lymphadenopathy seen on fine needle aspiration cytology in a tertiary level hospital in KathmanduMaterials and Methods: This study was conducted at Shree Birendra Hospital Nepal. Cases of lymph node FNAC done in the years 2073 and 2074 BS were included in the study. The cases were classified into reactive lymphadenitis, granulomatous lymphadenitis, tubercular lymphadenitis, lymphomas, leukemias, and metastases.Results: A total of 215 patients were included in the study, ranging in age from 2 to 84 years, out of which 98 were female and 117 were male. Reactive lymphadenitis was the most common diagnosis (n=126; 58.6%), followed by granulomatous lymphadenitis (n=34; 15.8%) and tubercular lymphadenitis (n=18; 8.4%). There were 18 cases of metastatic malignancies, 15 cases of suppurative lymphadenitis, and 2 cases of Hodgkin lymphoma and 2 cases of non-Hodgkin lymphoma.Conclusions: Reactive lymphadenitis is the most common type of lymphadenopathy encountered in FNAC, while in the elderly, metastases are more common.

Author(s):  
Nitin Sharma ◽  
Maya Singh ◽  
Pritosh Sharma ◽  
Rahul Nahar ◽  
V. P. Goyal

<p class="abstract"><strong>Background:</strong> Cervical lymphadenopathy is the sign of a disease process which involves lymph nodes that are anomalous in uniformity and dimensions. It is very vital to exercise fine-needle aspiration biopsy, histopathological investigation, and ultrasonography for the diagnosis of palpable lesions.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 12-month duration from January 2018 to December 2018 in 61 patients presenting with cervical lymphadenopathy admitted in the ENT Department at Geetanjali Medical College and Hospital, Udaipur.  </p><p class="abstract"><strong>Results:</strong> In biopsy, most common diagnosis was chronic granulomatous lymphadenitis i.e. in 62.3% of the patients. As compared to biopsy, fine-needle aspiration cytology (FNAC) showed chronic granulomatous lymphadenitis in 46% of the patients, with overall sensitivity of 91.1%, and specificity of 60.0%. and accuracy of 88.5%. Whereas ultrasonography (USG) reported, 64% cervical lymphadenopathy in patients, with overall sensitivity came out to be 91.1%, specificity to be 40.0%, accuracy was 86.9%.</p><p class="abstract"><strong>Conclusions:</strong> Present study showed that biopsy is the gold standard procedure for diagnosis of cervical lymphadenopathy lesions followed by FNAC, USG. Tuberculous lymphadenitis was most common diagnosis made by the diagnostic modalities.</p>


Author(s):  
Ashok Shreepaili ◽  
Sushil Dhakal

Background: Tuberculous lymphadenitis is the most common manifestation of extrapulmonary tuberculosis. Fine needle aspiration cytology (FNAC) is a valuable tool in diagnosis of tubercular lymphadenitis. The present study aims to determine the prevalence of different cytomorphological patterns in fine needle aspiration cytology of tubercular lymph nodes and their correlation with Acid Fast Bacilli (AFB) positivity on Ziehi-Neelsen (ZN) Staining.Methods: Fine needle aspiration cytology of 274 cases diagnosed as tubercular lymphadenitis over a period of a year were reviewed. Cytomorphological patterns were categorized into three patterns. Pattern I: Epithelioid granuloma without necrosis, Pattern II: Epithelioid granuloma with caseous necrosis and Pattern III: Caseous necrosis only. Fischer Exact test was applied to correlate cytomorphological pattern and AFB positivity.Results: Tuberculous lymphadenitis was most frequent in age group 21-30 years (24.81%). Cervical lymph nodes were the most frequent lymph nodes involved (84.67%). Pattern I was the most common cytomorphological pattern observed (49.3%). Overall AFB positivity was 28.10%. Maximum AFB positivity was seen in pattern III (73.3%).Conclusions: FNAC is the simple, cost effective and minimally invasive tool to diagnose tuberculous lymphadenitis. Study of both cytomorphological pattern and ZN staining for AFB can improve the diagnostic accuracy.


1970 ◽  
Vol 7 (2) ◽  
pp. 139-142 ◽  
Author(s):  
S Hirachand ◽  
M Lakhey ◽  
J Akhter ◽  
B Thapa

Background: Fine Needle Aspiration Cytology (FNAC) is a simple and rapid diagnostic technique. Because of early availability of results, simplicity, minimal trauma and complications, the aspiration cytology is now considered a valuable diagnostic aid and is part and parcel of a pathologist's repertoire. Objectives: The aim of the study was to evaluate the results of fine needle aspiration cytology (FNAC) of lymph nodes in our institution in comparison to result of histopathology. Materials and methods: The present study on 130 patients of lymphadenopathy was conducted in the Department of Pathology Kathmandu Medical College Teaching hospital, Kathmandu from June 2006 to May 2008 (2 years). Results: In this series of FNAC cervical lymph nodes were 66 (50.76%), and axillary lymph nodes were 20 (15.38%). Male to female ratio of the patients was 1: 0.9. Th age of patients ranged from 3 to 85 years. FNAC diagnosis was found to be as follows : reactive hyperplasia 54( 41.55%), tubercular lymphadenitis 36 (28 %), metastatic carcinoma 16 (12.3%), granulomatous lymphadenitis 12 ( 9.2 % ), lymphoma 8 (6%) and suppurative lymphadenitis 4(3%). Out of 28 cases of FNAC 26 (92.85%) were consistent with histopathological diagnosis of tubercular lymphadenitis. In metastatic carcinoma to lymph nodes sensitivity and specificity of FNAC were 100% each. Conclusion: FNAC is useful and reliable in diagnosing neoplastic and non- neoplastic lesions of lymph nodes. It helps in planning surgery for malignant cases, where definitive operative intervention can be performed in one session. Key words: FNAC; lymphadenopathy. DOI: 10.3126/kumj.v7i2.2707 Kathmandu University Medical Journal (2009) Vol.7, No.2 Issue 26,139-142


1970 ◽  
Vol 7 (1) ◽  
pp. 54-58 ◽  
Author(s):  
M Maharjan ◽  
S Hirachan ◽  
PK Kafle ◽  
M Bista ◽  
S Shrestha ◽  
...  

Objectives: To determine the incidence of tuberculous lymphadenitis in enlarged neck nodes. Materials and methods: Continuous prospective study is carried out in the department of otorhinolaryngology head & neck surgery, Kathmandu Medical College, Kathmandu, during two years, from January 2006 to January 2008. The study included a group of 155 patients with cervical lymphadenopathy. Each patient underwent a detail clinical Ear, Nose and Throat (ENT) examination and a battery of investigations which included Fine Needle Aspiration Cytology (FNAC) of the nodes, Montoux's test, blood Erythrocyte Sedimentation Rate (ESR) and chest X-ray. Those patients with tubercular lymphadenitis were referred to Directly Observed Therapy System (DOTS) clinic for anti-tubercular therapy. Others with reactive lymphadenitis were treated with antibiotic and those with metastatic neck nodes were treated accordingly. Results: Of the 155 cases with enlarged neck nodes, 83 (54%) had tubercular lymphadenitis. Fifty two (33%) cases had reactive lymphadenitis and 17 (11%) cases were diagnosed with metastatic neck nodes. Fine needle aspiration cytology was found to be highly effective in the diagnosis of tubercular lymphadenitis with 94% accuracy. Majority of patients were otherwise healthy adults, aged between 8 - 71 years. No difference was observed between male and female in this study. Posterior triangle (PT) nodes were most commonly affected group of nodes accounting for 35 (42%) cases and preauricular region 1 (1%) case being the least commonly affected site. Fifteen (18%) cases presented with abscess formation. Only 42 (50%) cases had family history of tuberculosis but 8 (9%) patients had previous history of various forms of tuberculosis. Twelve (14%) patients had positive chest X-ray findings suggesting of concurrent pulmonary tuberculosis. All the patients were referred to DOTS clinic and were treated with category (CAT) - III anti tubercular therapy (ATT). Others with concurrent pulmonary tuberculosis were treated with CAT I regime. None of the patients required surgical treatment. Conclusion: There is high incidence of tubercular cervical lymphadenitis in patients with enlarged neck nodes in developing countries like Nepal. Involvement of cervical lymphnodes are the most commonly affected group of nodes. Therefore, it is important that otolaryngologists are aware of tuberculosis in the head and neck region. Key words: Tuberculosis, Lymph node, Fine needle aspiration cytology, Lymphadenitis    doi: 10.3126/kumj.v7i1.1766       Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 54-58         


2015 ◽  
Vol 5 (10) ◽  
pp. 814-816
Author(s):  
N Mainali ◽  
RB Suwal

BACKGROUND: Lymphadenopathy is a commonly encountered clinical problem. Fine needle aspiration cytology offers the alternative of an immediate, preliminary, although not always specific diagnosis with little trauma and cost, thus providing ample information for further management and reduce the amount of open biopsy.MATERIAL AND METHODS:  FNAC was performed using 21 gauge needle attached with 10ml disposable needle. Slides were prepared, two were air dried and stained with field stain where as two were fixed in ethanol and was stained with PAP stain. One slide was stained with Ziehl-Neelson stain. Field and PAP stained slide were reviewed and diagnosed by Pathologist.RESULT: Out of the 225 patients, reactive lymphadenitis was the most common diagnosis (54.2%), followed by tubercular lymphadenitis (33.44%). Among the age group percentage of tubercular lymphadenitis was more in 210-30 years of age.  Majority of the metastatic carcinoma was in cervical region, comprising mainly squamous cell carcinoma.CONCLUSION: Reactive lymphadenitis was the most common cause of lymphadenopathy especially in case of children. In case of older population, definite pathology for lymph node enlargement was found in most of the cases. Hence FNAC is warranted in lymphadenopathy, as it is simple yet of great diagnostic value.


Author(s):  
Bhavna G. Gamit ◽  
Mubin I. Patel ◽  
Mandakini M. Patel ◽  
Sharmistha M. Patel

Background: Fine needle aspiration cytology (FNAC) is a first line investigation in cervical swellings. The etiology varies from an inflammatory process to a malignant condition.Methods: The study was carried out in department of Pathology, Government Medical College, affiliated with government hospital in Gujarat. There were 470 patients with cervical swelling in a period from January 2017 to December 2017. Patients with thyroid swelling (swelling moves with deglutition) were excluded from the study. FNAC procedure was performed, smears prepared, stained with haematoxylin and eosin (H and E), May Grunwald Giemsa (MGG) and Pap stain. Zeihl Neelsen stain was carried out when required. Patient history, local examination findings and microscopic findings were recorded.Results: Total 470 patients, age ranged from 2 months to 90 years were studied. There were 286 males and 184 females. There were 449 cases in which conclusive opinion given. 111 cases were neoplastic and 338 cases were non-neoplastic. Various cytological diagnosis were; 207 cases of granulomatous lymphadenitis (tuberculosis), 1 case of filarial lymphadenitis, 72 cases of chronic reactive hyperplasia, 25 cases of acute suppurative inflammation, 1 case of sialadenitis, 10 cases of keratinous cyst, 6 cases of benign cystic lesion, 12 cases of lipoma, 4 cases of lymphoproliferative lesion, 1 cases of benign appendage tumor, 2 cases of mucoepidermoid carcinoma, 103 cases of metastasis and 5 cases of non Hodgkin lymphoma.Conclusions: FNAC is a simple, quick, inexpensive and minimally invasive technique to diagnose cervical swellings. It can differentiate the infective process from neoplastic one and avoids unnecessary surgeries.


Sign in / Sign up

Export Citation Format

Share Document