Efficacy of fine needle aspiration cytology (FNAC) as diagnostic tool in case of cervical lymphadenopathy
Keywords:
Fine needle aspiration cytology, malignant lymphoma, cervical lymph node enlargement.Abstract
Objective: Cervical lymphadenopathy is one of the commonest presentations in clinical practice. Fine Needle Aspiration Cytology (FNAC) is one of the simple technique used for establishing the etiology of cervical lymphadenopathy. This study aims to determine the efficacy of fine-needle aspiration cytology (FNAC) as a diagnostic tool of cervical lymph node enlargement and identify clinical parameters related to malignant condition for excisional lymph node biopsy.
Materials: and Methods: A retrospective study was conducted in 98 patients with cervical lymph node enlargement who underwent preoperative FNAC and lymph node biopsy at Hua Hin Hospital during January 2015 - December 2020. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of FNAC were calculated with assessment of clinical parameters. The continuous data were analyzed using T-test or Mann-Whitney U test. Whereas, chi-square or Fisher-exact test was used for the category data analysis.
Results: A total of 98 patients were included in this study. The accuracy of 70.41%, with 54.55% sensitivity, 90.79% specificity, 63.16% PPV and 87.34% NPV. In metastasis disease, the accuracy of FNAC result was 100%, in contrast with lymphoma. The clinical parameter was evaluated between lymphoma and non-lymphoma group. Age and size of lymph node were significantly higher in lymphoma group than in non-lymphoma group. The lymphoma group was significantly noted in male, cervical lymph node area 1, 2, 3 and more bilateral lymph node enlargement than in non-lymphoma group. The most significant clinical parameter related to lymphoma was size of cervical lymph node with adjusted odd ratio at 3.93.
Conclusion: Fine needle aspiration cytology is an accurate and effective diagnostic tool in patient with cervical lymph node enlargement for excisional lymph node biopsy.
Keywords: Fine needle aspiration cytology, Lymphoma, Cervical lymph node enlargement.
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