Fine Needle Aspiration Cytology in Evaluation of Lymph Node Lesions

Background: Lymphadenopathy is a common clinical presentation with causes ranging from reactive and infectious processes to primary and metastatic malignancies. Fine needle aspiration cytology (FNAC) provides a rapid and minimally invasive method for initial evaluation of lymph node lesions. The aim is to study the cytomorphological spectrum of lymph node lesions diagnosed by FNAC and to assess cytohistopathological correlation wherever biopsy findings were available. Material and Methods: This prospective study included 208 patients who underwent FNAC of palpable lymph node lesions in the Department of Pathology from January 2020 to December 2021. Smears were examined using routine cytological stains and special stains wherever indicated. Histopathological correlation was available in 22 cases. Results: Of the 208 patients, 114 (54.8%) were males and 94 (45.2%) were females. The 21–30-year age group was most commonly affected. Cervical lymph nodes were the predominant site, accounting for 172 (82.7%) cases. Non-neoplastic lesions constituted 169 (81.3%) cases, while 39 (18.8%) were malignant. Reactive lymphadenitis was the most frequent diagnosis with 86 (41.3%) cases, followed by granulomatous lymphadenitis in 40 (19.2%) and tuberculous lymphadenitis in 33 (15.9%) cases. Among malignant lesions, metastatic carcinoma accounted for 33 (84.6%) cases and primary lymphoma for 6 (15.4%). Squamous cell carcinoma was the most common metastatic tumor, comprising 22 of 33 metastatic lesions. Histopathological correlation was available in 22 cases, and all demonstrated concordant cytological and histological diagnoses. Conclusion: FNAC is an effective first-line diagnostic modality for lymphadenopathy and provides useful differentiation between non-neoplastic and malignant lesions. It is particularly valuable in diagnosing reactive, tuberculous, and metastatic lesions. Histopathological examination and ancillary techniques remain essential in selected cases, especially for lymphoma subclassification and cytologically indeterminate lesions.

Keywords: Fine needle aspiration cytology, lymphadenopathy, lymph node, reactive lymphadenitis, tuberculous lymphadenitis, metastatic carcinoma, lymphoma cytopathology.