Divya Radhakrishnan, Rajan Gopalan Nair, Sathi P. P, K. Rajasree Varma
BACKGROUND Lymphadenopathy especially in the supraclavicular region is often associated with an underlying pathology. Fine needle aspiration cytology of lymph nodes is a cost effective and simple procedure that can be carried out in the outpatient department itself which helps in deciding the management. MATERIALS AND METHODS The study was done in Department of Pathology, Govt. Medical College, Kozhikode. Data of past 3 years (January 2014 - December 2016) was retrieved from records of the pathology department and reviewed. Relevant history, clinical examination findings and investigations were documented. Aspiration was done routinely using 23 gauge needle and smears wet fixed in isopropyl alcohol and Papanicolaou staining was done. Cases in which aspirate was inadequate were excluded from the study. The cases were broadly divided into following groups, viz., reactive lymphoid hyperplasia, acute suppurative lymphadenitis, granulomatous lymphadenitis, metastatic malignancy, lymphoma and miscellaneous cases. RESULTS A total number of 724 cases were included in the study, males constituted 66% and females 34%. Metastatic malignancy constituting 65% was the commonest cause of lymph node enlargement, followed by reactive hyperplasia 22%. Granulomatous lymphadenitis was diagnosed in 64 cases (8.8%). Rest of the causes like lymphoma, suppurative and non-specific causes constituted only a minor category. Most common site of lymphadenopathy was left side, constituting 59.4%. Metastatic malignancy was the commonest cause of supraclavicular enlargement in the age group of 40-80 yrs. On analyzing histopathology adenocarcinoma was the most common type in this study constituting 55% followed by squamous cell carcinoma in 27%. Approximately 11% were metastasis from small cell carcinoma and 5% from poorly differentiated carcinoma. In metastatic adenocarcinoma, the most common primary site was lung, constituting 54.2%. CONCLUSION Supraclavicular lymphadenopathy is most often associated with an underlying pathology and it has to be evaluated especially in the elderly. FNAC is a cheap and reliable diagnostic tool in the initial evaluation as well as follow up of patients attending outpatient department and provides valuable information that helps in treating patients.
