Fine needle aspiration cytology and histopathological correlation in diagnosing lymph node lesions

Introduction: A lymph node is an oval or kidney-shaped organ of the lymphatic system, present widely throughout the body. Lymph nodes lie along the course of lymphatic vessels. Most lymphadenopathy is due to a benign self-limited disease such as viral infections, and adenopathy is secondary to an increase in normal lymphocytes and macrophages in response to an antigen. Other less common mechanisms responsible for adenopathy include lymphadenitis, neoplasia or storage diseases. Tubercular lymphadenitis is one of the commonest causes in developing countries. FNAC allows the pathologist to see the cells aspirated from the lesion. In contrast to large bore needle biopsy techniques, FNAC does not allow evaluation of the morphology. In some instances, aspirated cells can be evaluated by flow cytometry or with immunologic markers. Methods: This study was conducted at the Sher-i-kashmir Institute of Medical Sciences (SKIMS) Srinagar, Kashmir (India) in the Department of Pathology. The study was a prospective study of 2 years i.e. from June 2016 to May 2018. Cases presenting with lymphadenopathy where FNAC was done and underwent subsequent biopsy were studied. Results: This study included total of 120 patients who presented with lymphadenopathy. Out of 120 patients, there were 76(63.3%) males and 44 (36.7%) females. Male: Female ratio was 1.73:1. For Non-Hodgkin's Lymphoma FNAC showed sensitivity of 97.22%, specificity of 96.55%, positive predictive value of 92.11% and accuracy of 89.74%. For Hodgkin's Lymphoma FNAC showed sensitivity of 85.71%, specificity of 98.84%, positive predictive value of 92.31% and accuracy of 97%. For Metastatic tumors, FNAC showed sensitivity of 91.67%, specificity of 98.81%, positive predictive value of 97.06% and accuracy of 96.67%. For Benign Lesions, FNAC showed sensitivity of 93.94%, specificity of 97.73%, positive predictive value of 93.94% and accuracy of 96.69%. Conclusion: FNAC proved to be a safe, accurate, inexpensive and patient friendly in the effort to establish diagnosis in patients with lymphadenopathy.