Diagnostic value of fine-needle aspiration in supraclavicular lymphadenopathy: a study of 106 patients and review of literature

Abstract

The simplicity and safety of the fine-needle aspiration (FNA) make it a useful procedure for the initial evaluation of supraclavicular lymphadenopathy. We analyzed data (106 patients) in combination with the data of three recently published studies (total 301 patients) to make the observations more meaningful. The usefulness of various ancillary techniques such as special histochemical stains (SHC), immunohistochemistry (IHC), and flow cytometry (FCM) in establishing specific diagnoses was also examined. Analysis of the combined data from 407 patients helps to reinforce certain trends observed by previous investigators such as the marked predominance of metastatic carcinoma (63%) over lymphoid malignancies (9%), reactive (19%) and infectious processes (2%), and the tendency of abdominal and pelvic primary carcinomas to metastasize to the left supraclavicular lymph node (SCLN) (88%). In addition, the current study confirms utility of performing IHC, FCM, and SHC on the aspirate material obtained from supraclavicular lymph nodes, because in 19 of the 22 cases (86%), these ancillary techniques provided supplemental diagnostic information critical to patient management.