Md Hamed Altaf Mali1, Arpitha K.2, Radha Angadi3, Girish Ronad4, Sanjeev Navadagi5
BACKGROUND
Lymphadenopathy is a commonly encountered clinical entity and its study by
cytological procedure is safe and minimally invasive technique, which helps in early
detection and direction of appropriate investigations. Further the use of
immunohistochemistry in inconclusive cases has markedly improved the final
diagnosis. The purpose of this study was to evaluate the cytological and
histomorphological patterns of lymphadenopathies in various age groups.
METHODS
The study was descriptive type of observational study that included 104 cases of
suspected lymphadenopathies. Fine needle aspiration cytology (FNAC) was done
and cytological smears were stained with standard cytological and special stains.
Excisional biopsy was carried out in suspected neoplastic lesions. Biopsy sections
were stained with routine haematoxylin and eosin, special stains, and
immunohistochemistry (IHC) markers according to the histopathological features.
RESULTS
A total of 104 cases were studied during one year. Fine needle aspiration cytology
was carried out for lymphadenopathies. Cervical lymph nodes were the most
common group of lymph nodes involved with 77 cases (74.04 %). 86 cases were
non-neoplastic, and 18 cases were neoplastic. In non-neoplastic lesions, maximum
28 (26.93 %) cases were of granulomatous lymphadenitis. In neoplastic lesions,
maximum of 09 cases were metastasis to lymph node. Lymph node biopsy was
carried out in all the suspected neoplastic cases, out of which 04 cases were
reported as suspicious of neoplasia, 02 cases each were reported as metastatic
adenocarcinoma and metastatic poorly differentiated carcinoma on biopsy, 05
cases of lymphomas, 03 cases of Hodgkin’s lymphoma and 02 cases of non-
Hodgkin’s lymphoma were reported respectively.
CONCLUSIONS
Immunohistochemistry on biopsies and histopathological specimens was effective
where the diagnosis was inconclusive on cytology. FNAC is a simple and costeffective
procedure in developing countries like India. FNAC has its own limitations
while evaluating cases of suspected neoplasms and in sub-typing of lymphomas.
To overcome these limitations, we can use lymph node biopsy to know the
complete architecture and morphology of the lymph node, and to do additional
studies like immunohistochemistry and immunophenotyping. Finally, this study
also showed how the diagnostic efficacy is improved when cytology is combined
with histopathology in the diagnosis of lymphadenopathies.
