A Study Of Pattern Of Lymphadenopathy On Fine Needle Aspiration Cytology In And Around Meerut, U.P (India)

摘要

Background and objectives : The present study was undertaken to study non-neoplastic and neoplastic lesions of enlarged lymph nodes by FNAC in patients presenting with lymphadenopathy in the Pathology Department of L.L.R.M. Medical College, Meerut, attached to SVBP Hospital, Meerut, to determine the pattern of disease affecting lymph nodes in this region.Methodology : The study was conducted on 957 patients with lymphadenopathy. Routine investigations which included complete blood counts, X-ray chest (PA view), ultrasound / CT scan (if indicated).Fine Needle Aspiration Cytology was done and the slides were stained with routine stains plus special stains as and when required.Results & Conclusion : In the present study ,the commonest site of involvement was cervical region 897 (93.73%). Overall benign lesions were 853 (89.13%) and malignant lesions 104 (10.87%). In benign lesions, Tubercular lymphadenitis was the most frequently encountered lesion 501 (52.35%). FNAC proved to be a safe, inexpensive, repeatable and rapid procedure in which no hospitalization or anaesthesia is required. INTRODUCTION Lymphadenopathy is one of the commonest clinical presentation of patients attending the outdoor clinics in most hospitals. The etiology varies from an inflammatory process to a malignant condition.1 Enlarged lymph nodes are easily accessible for fine needle aspiration and hence fine needle aspiration cytology (FNAC) is a very simple and important diagnostic tool for lymph node lesions.2 FNAC of lymph node has become an integral part of the initial diagnosis and management of the patients with lymphadenopathy due to early availability of results, simplicity and minimal trauma with less complications.3 FNAC has also been advocated as a useful method in comparison to more expensive surgical excision biopsies in developing countries with limited financial and health care resources.4 The present study was undertaken to study non-neoplastic and neoplastic lesions of enlarged lymph nodes by FNAC in patients presenting with lymphadenopathy in the Pathology Department of our institute, to determine the pattern of disease affecting lymph nodes in this region. MATERIAL AND METHODS This work was carried out in Department of pathology in collaboration with department of surgery, L.L.R.M Medical College, Meerut attached to S.V.B.P Hospital, Meerut. The study was conducted on 957 patients with lymphadenopathy. Patients of all age groups and both sexes were included.In all patients, a thorough clinical examination along with detailed clinical history i.e. age, sex, duration of involvement, past history, family history, history of tubercular contact and prior anti tubercular treatment etc. was taken. Physical examination included whether lymph node involvement was single or multiple, unilateral or bilateral, generalized or localized etc. Routine investigations which included complete blood counts, X-ray chest (PA view), ultrasound / CT scan (if indicated). FNAC was performed using a 23G needle. Several smears were prepared in each case, both air dried and alcohol fixed. Stains used were Leishman, Geimsa and Ziehl-Neelsen stains. OBSERVATIONS In this study total 1018 cases of lymphadenopathy were received, out of which 61 cases were excluded from the study due to inadequate aspirate. Therefore the present study was conducted on 957 patients. The maximum number of patients 379 (39.60%) were in the age group of 0-10 years followed by 193 (20.17%) patients in 11-20 years age group, 137 (14.32%) patients in 21-30 years age group, 91 (9.51%) patients in 31-40 years age group, 74 (7.73%) patients in 41-50 years age group and 45 (4.70%) patients in 51-60 years age group. (Table 1)