Original Research Article
Year: 2023 | Month: September | Volume: 13 | Issue: 9 | Pages: 180-185
DOI: https://doi.org/10.52403/ijhsr.20230926
Reliability of Fine Needle Aspiration Cytology (FNAC) as a Diagnostic Tool for Cervical Lymphadenopathy: A Comparative Analysis with Biopsy
Dr. Preethi. S1, Dr. Nithya Narayanan 2
1ENT Head & Neck Surgery, 2ENT Head & Neck Surgery,
Apollo Hospitals, Chennai
Corresponding Author: Dr. Preethi. S
ABSTRACT
BACKGROUND: Cervical lymphadenopathy, characterized by neck lymph node enlargement, demands accurate diagnostic methods due to its varied etiology, ranging from benign to malignant conditions. Fine Needle Aspiration Cytology (FNAC) and biopsy are vital diagnostic tools, each with distinct attributes. This study explores the reliability of FNAC compared to biopsy in evaluating cervical lymphadenopathy, aiming to inform clinical decision-making for improved patient care outcomes.
METHODOLOGY: This retrospective, comparative study was conducted in the Department of ENT and Head and Neck Surgery, Apollo Hospital, Chennai, between June 2022 and June 2023. Patients aged 18 years or older were included. There were 70 patients with cervical lymphadenopathies who underwent both fine needle aspiration cytology (FNAC) and histopathology (HPE). The sensitivity, specificity, and Cohen’s kappa coefficient were calculated.
RESULTS: Of the 70 patients, 49 had a benign etiology, with Tuberculosis being the most common, while 21 had a malignant etiology, with Hodgkin's Lymphoma being the most common. The majority of patients were in the age group of 35-60 years, and gender distribution was equal. In our study, it was observed that the sensitivity and specificity of FNAC in detecting TB were 76.2% and 98%, respectively; for Lymphomas, it was 68.75% and 100%, respectively; for metastatic secondaries, it was 80% and 100%, respectively; and for reactive lymphadenitis, it was 79% and 87%, respectively (see Table 1). The overall sensitivity of FNAC in our study is 70.6% (95% confidence interval: 68.5-72.7). Cohen's Kappa coefficient for comparing FNAC with biopsy is approximately 0.6016, indicating moderate agreement.
CONCLUSION: Fine Needle Aspiration Cytology (FNAC) is a valuable initial investigation for cervical lymphadenopathy. It is a simple outpatient procedure that offers a rapid and specific diagnosis with minimal discomfort and is cost-effective. One of its primary advantages is the early detection of malignant diseases, enabling timely treatment initiation. However, the success of FNAC relies on two crucial factors: the representativeness of the sample and the high quality of the preparation. Achieving these can be challenging, so the most reliable diagnostic method is still histopathological examination.
Key words: FNAC, Biopsy, cervical lymphadenopathy, tuberculosis, lymphoma