Study of Cytopathological Spectrum of Lymphadenopathy at Tertiary Care Hospital, Gujarat, India

Abstract

Lymph nodes are most widely distributed and easily accessible component of lymphoid tissue. Lymphadenopathy is a commonly encountered clinical problem which has multitude of causes varying from non-neoplastic to neoplastic conditions like inflammation, infection, primary or metastatic tumors. Fine needle aspiration cytology (FNAC) is a very simple, quick, and cost-effective method of sampling of superficial masses. This technique is an outpatient department (OPD) procedure and causes minimal trauma to the patient and carries virtually no risk of complication. The main goal of FNA is to determine the presence or absence of neoplasm, assure the clinical benign impression of the mass, and if malignant, to determine the type of malignancy. Aim: To evaluate and diagnose the causes of lymph node swelling for early and prompt treatment as FNAC is the minimally invasive procedure and report can be issued within 2 to 3 hours. Materials and method: Total 110 cases of FNAC of lymph node was studied at the Department of Pathology, GAIMS, Bhuj during period from July 2022 to March 2023. Patients were explained about the procedure and consent was taken. FNAC was done, smears were prepared and subsequently stained using H&E, PAP, Giemsa satin and ZN stain for AFB. Observation and Result: Out of total 110 cases, 61 (55.45%) were male and 49 (44.54%) were female patient. Age ranges from first year of life to 78 years of life, with maximum cases 32 (29.09%) were in age group of >40 years. Based on anatomical site, cervical lymphadenopathy was found to be more common, seen in 85(77.27%) cases out of 110 cases. The non-neoplastic lesions were predominated, diagnosed in 85 (77.27%) patients as compared to neoplastic lesions diagnosed in 25 (22.73%) cases. In non-neoplastic lesions, non-specific reactive lymphadenitis was the most frequent diagnosis with 43 (39.09%) cases followed by tuberculous lymphadenitis diagnosed in 22 (20.00%) case. In neoplastic lesions, metastatic squamous cell carcinoma was common in 18(16.36%) cases, whereas, the primary neoplastic lesions of lymph node (lymphoproliferative disease) constituted only about 07(6.36%) cases. Conclusion: FNAC is less invasive and less time consuming procedure yielding result in 1 to 3 hours of procedure. That’s why FNAC must be first line of investigation in lymphadenopathy to differentiate neoplastic from non-neoplastic lesion and guide the surgeon for line of treatment.