A prospective study on clinicopathological study of cervical lymphadenopathy
Author(s): Dr. Kondal Reddy J and Dr. Aleemullah Khan
Abstract: Cervical lymphadenopathy is a common clinical presentation in various departments of clinical practice. This study was done to know the correlation between clinical presentation of FNAC and histopathology of cervical lymphadenopathy, to emphasize the role of fine needle aspiration cytology (FNAC) in etiologic workup in cervical lymphadenopathy. 50 patients with cervical lymphadenopathy were assessed clinically, by laboratory and by FNAC study over a period of two years. In the present study, results revealed that tuberculous lymphadenopathy is the commonest cause of cervical lymphadenopathy with 68% followed by chronic non-specific lymphadenopathy with 32. Of the 35 patients whose fine needle aspiration cytology (FNAC) showed granulomatous changes, 50 had subsequent surgery and histological confirmation of the cytological appearance. 34 had TBLN (Tuberculous Lymphadenopathy), thus the specificity of FNAC was 94 per cent in diagnosing tuberculosis related granulomatous lymphadenopathy. One false positive FNAC was reported histologically to be non specificity. Present study had cervical lymph node swelling. Other common presenting symptoms were loss of weight and loss of appetite (20%), fever (30%), axillary and inguinal swellings (4%), cold abscesses (8%), pain (6%), sore throat, cough, discharging sinus, old sinus scars, caries tooth (2%). there was only unilateral involvement of node in 72% of cases right side was affected in 32% and left side was affected in 40% of cases bilateral involvement was seen in 14% of the cases. The lymph nodes were associated with other groups of lymph nodes in 10% of cases. In our study the sensitivity and specificity of FNAC of tuberculous cervical lymphadenopathy is 77 and 94 respectively. The results concluded that tuberculosis is the most common cause of cervical lymphadenopathy in the Indian population followed by reactive lymphadenitis and metastatic deposits. Reactive lymphadenitis is the commonest cause of cervical lymph node enlargement in different age group, infective in 11-40 yrs. age group including tuberculous and suppurative lymphadenitis, neoplastic lesions in more than 40 age group including metastatic disease and nonhodgkins lymphomas. FNAC is an important diagnostic modality for the etiologic workup in significant cervical lymphadenopathy and is almost as sensitive and specific as excision lymph node biopsy when an adequate aspirate is examined by expert eyes.