Fine Needle Aspiration Cytology of Metastatic Neck Lymph Nodes: A review of 100 cases
FNAC of Metastatic Neck Lymph Nodes
Keywords:
metastatic nodes, lymph node, FNACAbstract
Background: FNAC of neck nodes is very cost effective, simple, free of complications & well tolerated by the patients, done on an outpatient basis and repeatable. India is eminently suited for this procedure. Increased exposure and routine audits have improved the sensitivity and accuracy of FNAC in all anatomical sites, particularly so, in head and neck masses. The false positive rate of lymph node metastasis is quite low. Enlarged lymph nodes were the first organ to be biopsied by FNA. Today, they are one of the most frequently sampled tissues. FNAC not only confirms the presence of metastasis but also gives clues regarding the nature and origin of the primary tumour. The diagnostic accuracy of FNAC in neck node malignancy is high. Methods: The material was obtained from outdoor and indoor patients, having suspected neck nodes, over a period of 2 years, more than 18 years of age, attending the cytology laboratory in the Department of Pathology, S.N.Medical College, Agra. Cervical lymph nodes were aspirated, and smears were prepared & processed following standard techniques. Cytologically diagnosed metastatic lymph nodes were included in the study. Relevant clinical data was collected. Findings were correlated with previous studies. A total number of 100 cases were examined. Results: A total of 100 cases of metastatic enlarged cervical lymph nodes were studied. Most number of cases was seen in males, in the age group of 51-60 years. Higher number of patients had known primary sites, seen in oral cavity. Confirmatory cytological diagnosis could be made in maximum number of cases. Conclusion: Fine needle aspiration cytology is a quick, convenient and safe method for diagnosis of suspected / unsuspected metastatic neck nodes. Presence of cystic change, extensive necrosis and inflammatory cells led to diagnostic difficulty which was largely overcome through careful clinical correlation followed by meticulous examination of the aspirates.
References
2. Chan MK, McGuire LJ, Lee JC; The cytological features of fine needle aspiration samples of 40 metastatic nasopharyngeal carcinoma in cervical lymph nodes. Acta Cytol. 1989 May-June; 33(3): 344-50.
3. Gulhrie CG. Gland Puncture as a diagnostic measure. Bulletin John Hopkins Hosp. 1921; 32: 266-269.
4. Mehrotra et al : Trends of prevalence and Pathological Spectrum of head & neck cancers in North India: Indian Journal of cancer 2005; 42: 89-93
5. Engzell U et al : Aspiration biopsy of metastatic carcinoma in lymph node of neck : A review of 1101 cases. Acta Otolaryngol 1971; 72: 138-147.
6. Ustun et al cystic lymph node aspiration. Diagn. Cytopathol 2002; 27: 387-392
7. Izhar N. Bagwan, Shubadha V. Kane, Roshni F. chinoy : Cytologic evaluaiton of the enlarged neck nodes. FNAC utility in metastatic neck disease. The internet journal of pathology, 2007, Vol. 6, No. 2
8. Karabi Kohar et al : Pitfalls in the cytodiagnosis of metastatic squamous cell carcinoma in the head and neck 2008; Vol. 25 (4) : 119-122
9. Malika Afroz et al : Metastatic necknodes – a clinical study of 60 cases. Bangladesh Journal of Otorhinolaryngology 2009; 15(1) : 26-30.
10. Chih Hsu C et. al : Efficacy of FNA & sampling of lymph node in 1484 Chinese patient. Diagn Cytopathol 1990;6: 154-159
11. Kiran Alam et al : Fine needle aspiration cytology, a handy tool for metastatic lymphadenopathy, 2010. Internet Journal of Pathology
12. Burgers, Hartwic, Bedaed : Metastatic squamous cell carcinoma presenting as neck cyst : Acta Cytol 1993; 37, 4: 494-498.
13. Thompson et al : Metastatic squamous cell carcinoma of the tonsil; Presenting a cystic neck masses. Acto Cytol 1994; 38: 605-607.
14. Mohanty et al : Metastatic nasopharyngeal carcinomas. Diagn. Cytopathol. 2002; 27: 340-342.
15. Jayram et al; Metastatic nasopharyngeal carcinomas. Diagn. Cytopathol 1998; 19: 168-172.
16. Md Atiqur Rahman et al : Scenario of Fine Needle Aspiration Cytology of Neck Masses in a Tertiary Care Hospital. J Enam Med Col 2011; 1(1) : 8-14.
17. Ghartimagar D et al. Utility of fine needle aspiration cytology in metastatic lymph nodes. J Path Nepal, 2011;1:92-5.
