Diagnostic Accuracy of Fine Needle Aspiration Cytology (FNAC) in Metastatic Lymphadenopathy

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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

Diagnostic Accuracy of Fine Needle Aspiration Cytology (FNAC) in Metastatic Lymphadenopathy

Zeeshan Mustafa*, Farhan Abbas Baloch** and Ahmareen Khalid*
* Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad
** Department of Pathology, Pak International Medical College, Peshawar

Objective: To determine the diagnostic accuracy of Fine needle aspiration cytology (FNAC) in metastatic lymphadenopathy, using histopathology of the same lymph node as a gold standard
Study Design: Cross sectional study
Setting: Department of Pathology, Pakistan Institute of Medical Sciences (PIMS), Islamabad
Duration of study: Samples were collected from 13th April, 2011 to 09th February, 2013
Methodology: After getting adequate clinical data, patients underwent FNAC. The slides were stained with Hematoxylin and Eosin (H&E), evaluated according to the set criteria and compared with histo-pathological slides
Results: All of the 54 cases were found to be lymph node lesions. Mean age was 45.17± 17.1 years. Male to female ratio was 1:1.08. Most of the smears were hypercellular. Most common metastatic tumor was Metastatic Squamous Cell Carcinoma (51.85%), followed by Metastatic Adenocarcinoma (7.41%). In 38 cases, the involved lymph node was found to be cervical, followed by supraclavicular lymph node which was involved in 9 cases. Axillary and inguinal lymph nodes comprised 4 and 3 cases respectively. A strong correlation was found between the diagnosis made by fine needle aspiration cytology and the final histopathological diagnosis. The sensitivity and specificity of FNAC came out to be 97.37% and 93.75% respectively with an overall diagnostic accuracy of 96.29%.
Conclusion: Fine needle aspiration cytology (FNAC) is a useful diagnostic test in metastatic lesions of lymph nodes because it is rapid, simple and inexpensive and has high diagnostic accuracy.
Key words: Fine needle aspiration cytology, FNAC, Lymph node, Lymphadenopathy, Metastasis.


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