Efficacy of Ultrasound-guided Fine Needle Aspiration Cytology (FNAC) of Abdominal, Pelvic and Retroperitoneal Lymph Nodes

Abstract

Objective: To evaluate the efficacy of ultrasound-guided FNAC of abdominal, pelvic and retroperitoneal lymph nodes. Study Design: Cross sectional analytical (comparative study).Setting:
Department of Histopathology, Sheikh Zayed Hospital, Lahore. Study period: One year.
Material & Methods:Atotal of 36 lymph nodes including 12 abdominal, 10 pelvic and 14 retroperitoneal were submitted to FNAC from January 2001 to December 2001. Adequate aspirates
were obtained in all these cases. The smears were stained with Haematoxylin and Eosin (H & E),
papanicolaou staining (PAP) and May-Grunwald Giemsa stain (MCG). Results of FNAC were
categorized as malignant (group-I) and non-neoplastic/ inflammatory (group-II). Excision
biopsies from the same 36 cases were also obtained, processed and stained with routine H & E
staining. Histology was taken as the gold standard.
Results: On histological examination 24 of the total 36 cases were categorized as malignant,
and 12 as non-neoplastic/ inflammatory lesions. FNAC picked up 20 cases as malignant with 4
false negative diagnoses, including 2 cases of Hodgkin's lymphoma and 2 cases of non-Hodgkins
lymphoma. No false positive diagnosis was obtained. The most common malignancy was diffuse
non-Hodgkin's lymphoma, while granulomatous lymphadenitis was the commonest inflammatory
lesion. Malignant tumours revealed 83.3% sensitivity and 88.89% diagnostic accuracy, while
non-neoplastic/ inflammatory lesions showed a 100% sensitivity and diagnostic accuracy.
Conclusion: Majority of the malignant tumours can be categorized on FNAC with a high degree
of accuracy while lymphomas, specially of the mixed large and small cell type and Hodgkin's
lymphomas pose maximum diagnostic problems. Non-neoplastic/ inflammatory lesions can be
correctly diagnosed on FNAC