STUDY OF CYTODIAGNOSIS OF LYMPHNODE NEOPLASTIC LESIONS AND COMPARISION WITH HISTOPATHOLOGY

Background: The development of aspiration cytology is one of the biggest advances in anatomic pathology. Cancer has become one of the ten leading causes of death in India. The advantages of FNAC are : it is safe, gives a rapid report, is sensitive and specific for the diagnosis of malignancy, requires little equipment, causes minimal discomfort to the patient, is an outpatient procedure, avoids the use of frozen section, reduces the rate of exploratory procedures, allows a definitive diagnosis of inoperable cases, is repeatable and cost effective. Fine needle aspiration cytology is of particular relevance in lymphnodelesions because of easy assessibility, excellent patient compliance, minimally invasive nature of procedure and helping to avoid surgery in non-neoplastic lesions, inflammatory conditions and also some tumors. Aims and Objectives: To test the utility of FNAC, to establish the diagnostic accuracy of cytology by comparison with histopathology diagnosis and to establish the sensitivity and specificity of this technique in lymphnode neoplastic lesion. Materials and Methods: The present study was undertaken in the Department of Pathology, Government medical college and hospital, Nashik between January 2008 – June 2009. All cases were studied with initial clinical evaluation, followed by fine needle aspiration cytology and subsequent histopathology wherever needed. Results: In the present study, total of 584 aspirates from lymphnode lesions were studied for cytopathological examination and correlated with histopathology where needed. Out of the total 584 cases of thyroid lesions, 367 cases (62.84%) were non-neoplastic and 217 cases (37.16%) were neoplastic. Of the total 217 cases with neoplastic lymphnode lesions, 169 cases (77.88%) were male and 48 cases (22.12%) were female. Males were more commonly affected. The male to female ratio was 3.5:1. Most common neoplastic lesion of the lymphnode on cytologic diagnosis was found to be metastatic lesions (81.57%). Out of total 177 cases of metastatic deposits, 148 cases (83.60%) were of squamous cell carcinoma. Most common age group affected was found to be more than 60 years age group (37.33%) and metastatic deposit was found most commonly in this age group (40.68%). Summary and Conclusion : Excisional biopsy remains the gold standard for diagnosis of lymphnode neoplastic lesion, cytological study can establish the diagnosis of the majority of lymphanode neoplasm and can be recommended as an adjunct to histopathology. As the age increases, the chance for lymphnode malignancy is also increases.