Spectrum Of Cytological Findings In Patients With Lymphadenopathy In Rural Population Of Southern Haryana, India - Experience In A Tertiary Care Hospital

摘要

Lymphadenopathy is of great clinical significance as underlying diseases may range from a treatable infectious etiology to malignant neoplasms. In fact, it is also essential to establish that the swelling in question is a lymph node. Fine Needle Aspiration Cytology (FNAC) plays a vital role in solving these issues, nowadays being recognized as a rapid diagnostic technique because of its simplicity, cost effectiveness, early availability of results, accuracy and minimal invasion. This study was conducted to evaluate the usefulness of FNAC as a diagnostic tool in the management of patients with superficial lymphadenopathy. The study was also carried out to know the distribution of various lesions among the different age groups. The present randomized study was undertaken to study cytological features of non-neoplastic and neoplastic lesions of enlarged lymph nodes by FNAC in 182 patients presenting with lymphadenopathy in the Maharaja Agrasen Medical College, Agroha village over a period of one year from January to December 2011. There were 100 male and 82 female patients with an age range of 1–70 years. Tuberculous lymphadenitis, reactive hyperplasia, metastatic carcinoma, suppurative lymphadenitis and lymphomas were seen in 35.7%, 31.3%, 20.3%, 9.9% and 2.7% respectively. Reactive hyperplasia was seen most often (60%) in first two decades of life, 58.9% tuberculous lymphadenitis in the second and third decades (66%) and incidence of metastatic carcinoma are high during and after 40 years of age. Cervical lymph nodes were involved in all types of lymphadenopathy. Metastatic lesions of lymph nodes were seen to be more common in males. Squamous cell carcinoma is the most common metastatic lesion. Introduction Lymphadenopathy is one of the most common clinical presentations of patients attending the outdoor department. Fine Needle Aspiration Cytology (FNAC) is a reliable, simple, safe, rapid and inexpensive method of establishing the diagnosis of lesions and masses at various sites and organs1. Lymph node aspiration is of great value for the diagnosis of lymphadenitis, lymphomas and metastatic carcinoma(6,7). The present randomized study was undertaken to study non-neoplastic and neoplastic lesions of enlarged lymph nodes by FNAC in patients presenting with lymphadenopathy referred to cytology section of pathology department from the OPD/IPD of Maharaja Agresen Medical College, Agroha, (Hisar) over a period of one year. A study was carried out to know the overall prevalence of various causes responsible for cervical lymphadenopathy. The study was also carried out to know the distribution of various lesions among the different age groups. The present study also tried to evaluate the FNAC as a diagnostic tool in our clinical setup. FNAC is also done for confirmation of peripheral lymph node metastasis of a known and occult primary lesion and it can help the clinician to know about the primary site. Material And Method A total of 182 patients presenting with superficial palpable lymph nodes, who were referred to cytology section of pathology department from the OPD/IPD of Maharaja Agrasen Medical College situated in Agroha village covering the rural population of southern Haryana, were studied over a period of one year. In each instance, a brief history and physical examination along with evaluation of relevant investigations, if available, was carried out. FNAC procedure performed by pathologist using 22-24 G needle attached to 10 - 20 mL syringe. Aspirated material was smeared on the slides in each case. Slides were immediately put into the fixative solution and air-dried. Alcohol-fixed smears were stained by Haematoxylin and eosin and Papanicolaou method. The air-dried smears were stained with May-Grunwald-Giemsa (MGG) stain. Special stains like Ziehl Neelson (ZN) stain for acid-fast bacilli and Periodic Acid Schiff (PAS) stain were used whenever required. Results The study included 182 patients with lymphadenopathy swellings. Out