FNAC in the diagnosis of lymph node malignancies: A simple and sensitive tool

Abstract

Context: Fine needle aspiration cytology (FNAC) of the lymph node is a simple diagnostic tool to diagnose suspected and unsuspected secondary and primary lymph node malignancy.

Aim: To study the utility of FNAC in the diagnosis of clinically suspected and unsuspected lymph node malignancy.

Design: A cross-sectional hospital based study on 50 patients diagnosed to have primary or secondary lymph node malignancy by cytology, and confirmed by histopathology.

Materials and methods: Lymph node aspirate smears reported as malignant were studied and the findings were correlated with histopathology. Clinical and radiological data were also noted.

Statistical analysis: The data were tabulated as per the involvement of the various lymph node groups and the types of secondary and primary lymph node malignancies involved.

Results: 45 cases of metastatic malignancy and five cases of lymphomas were diagnosed by FNAC of lymph nodes. Histopathological correlation was available in all cases. Malignancy was clinically unsuspected in nine cases (18%).

Conclusion: FNAC of lymph nodes is a very useful, simple and sometimes the only tool in the diagnosis of lymph node malignancies.

Keywords: Fine needle aspiration cytology; lymph node; malignancy.

Figure 1

Photomicrograph of smear of unsuspected melanoma, showing a pleomorphic population of tumor cells, some of which are binucleate and multinucleate. Pigment laden cell is also seen (Hematoxylin and Eosin stain, ×400)

Figure 2

Photomicrograph of smear of papillary carcinoma thyroid, showing a papillary fragment containing cells with large nuclei having intranuclear inclusion (Hematoxylin and Eosin stain, ×100)

Figure 3

Photomicrograph of smear of medullary carcinoma thyroid, showing round cells with acellular eosinophilic material, (amyloid) in the background (Hematoxylin and Eosin stain, ×100)