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The role of fine needle aspiration cytology (FNAC) in the investigation of superficial lymphadenopathy; uses and limitations of the technique
Author(s) -
Lioe T. F.,
Elliott H.,
Allen D. C.,
Spence R. A. J.
Publication year - 1999
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1046/j.1365-2303.1999.00183.x
Subject(s) - medicine , fine needle aspiration cytology , radiology , malignancy , lymphoma , metastatic carcinoma , fine needle aspiration , differential diagnosis , lymphoid hyperplasia , cytology , diagnostic accuracy , biopsy , surgery , carcinoma , pathology
The role of fine needle aspiration cytology (FNAC) in the investigation of superficial lymphadenopathy; uses and limitations of the technique Aspirates (n = 163) from 157 patients with enlarged superficial lymph nodes were obtained over a 5‐year period in a combined surgical/FNAC clinic. A definitive diagnosis was achieved in over 77% of the cases: benign 52.7%, malignant 25.1%. The diagnostic accuracy was 94.4%, sensitivity 85.4% and specificity 100%. The false‐negative rate was 12.5% but decreased to 3.5% when lymphoma cases were excluded. There were 36 cases of metastatic disease, the majority of which were from a primary breast carcinoma. The main diagnostic difficulty was in distinguishing low‐grade lymphoma from reactive hyperplasia. An added advantage was that aspirated material could be used in ancillary tests to help with the differential diagnosis. FNAC has a well‐defined role in the investigation of superficial lymphadenopathy. Used in the proper setting it will provide a definitive diagnosis in the majority of cases, especially relating to recurrent malignancy or metastatic disease. Patients with a reactive cytological picture and no clinically suspicious symptoms could be spared unnecessary surgery and reviewed through follow up. This technique is cost‐effective, of high diagnostic accuracy, and results in considerable resource savings.