Cytological Study of Abdominal Lymph Nodes by Fine Needle Aspiration under Image Guidance
Published: December 1, 2018 | DOI: https://doi.org/10.7860/JCDR/2018/37873.12329
Rajeev Ranjan, Umesh Kumar Paliwal, Abhishek Anand
1. Assistant Professor, Department of Pathology, Government Medical College, Kannauj, Uttar Pradesh, India.
2. Associate Professor, Rama Medical College, Kanpur, Uttar Pradesh, India.
3. Consultant pathologist, Lal Pathlabs, Kanpur, Uttar Pradesh, India.
Correspondence
Dr. Rajeev Ranjan,
Assistant Professor, Department of Pathology, Government Medical College, Kannauj, Uttar Pradesh, India.
E-mail: aryanranjanpgi@gmail.com
Introduction: Fine Needle Aspiration Cytology (FNAC) has become simple, safe, speedy, cost-effective, accurate and more diagnostic after advancement in imaging techniques. Sensitivity of image guided FNAC of intra-abdominal lymph nodes is relatively high. Ancillary techniques on FNAC material may increase the accuracy of diagnosis.
Aim: To evaluate adequacy of material, cytologic assessment of samples obtained by image-guided aspiration and side effect/complication on account of the procedure.
Materials and Methods: Image guided FNAC were performed on 60 patients which include retroperitoneal and abdominal nodes. A sterile 3.5/5-MHz micro convex sector probe was used for localisation of the node. FNAC was performed using a 0.7-0.9 mm needle with stylet removed and attached to a 20ml syringe and FNAC handle after the needle was visualised in the lesion. For each case a minimum of 4-5 smears were made and two observers without bias interpreted the smears.
Results: A total of 60 patients were aspirated, of which adequate material for cytologic diagnosis was obtained in 58(96.6%) patients with a similar diagnostic accuracy. The 6th and 7th decade accounted for approximately half of the cases. Male to female ratio in our study was 2.16:1 (41:19). Most common cytologic diagnosis was metastasis 22(37%) followed by Non-Hodgkin lymphoma 17(28%) and followed by tubercular etiology seen in 16(27%) cases. All patients were followed by six monthly period for five years to further validate the study.
Conclusion: Image-guided FNAC has a pivotal role, and is a cost-effective tool for establishing tissue diagnosis as a primary investigative modality. It is also helpful and accurate in follow-up of patients with a known malignant disease, thereby avoiding surgical intervention.
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