IP Archives of Cytology and Histopathology Research

Print ISSN: 2581-5725

Online ISSN: 2456-9267

CODEN : IACHCL

IP Archives of Cytology and Histopathology Research (ACHR) open access, peer-reviewed quarterly journal publishing since 2016 and is published under the Khyati Education and Research Foundation (KERF), is registered as a non-profit society (under the society registration act, 1860), Government of India with the vision of various accredited vocational courses in healthcare, education, paramedical, yoga, publication, teaching and research activity, with the aim of faster and better dissemination more...


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Majithia, Algotar, Chokshi, Mori, and Ghelani: Cytomorphological study of lymph node lesions


Introduction

Lymph nodes are essential part of immune system. Their enlargement is noted in various diseases, including infections and malignancy. Lymphadenopathy is defined as an abnormality in size, number, and consistency of one or more than one lymph nodes.1 The differential diagnosis for cervical lymph node swelling in patient ≤18 years is broad, including both common benign etiologies and much more rare malignant causes. FNAC can play a major role as first line screening method as it allows us to obtain a cytological specimen directly from the swelling.2

Most represented cases are benign and selflimiting in nature.3

Objective

  1. To study lymph node lesions in patient ≤18 years.

  2. To study demographic characteristics in lymph node lesions.

Materials and Methods

In this study, the data were taken from 100 patients of age ≤18 years having lymph node lesion. They are presented at central clinical laboratory for Fine Needle Aspiration Cytology examination. They are undergone to FNAC examination. Cytomorphological study of collected sample were done. On basis of this, diagnosis were given.

Inclusion criteria

  1. Age group ≤18 years

  2. Patients having lymph node lesion.

Ethical issues

Study was conducted on retrospective data. No any ethical issues were there.

Results

Table 1

Disease specific distribution

Diagnosis given by cytology study

Number of cases (Out of 100 case)

Granulomatous inflammation

44

Reactive lymphadenopathy

37

Acute inflammation

06

Abscess formation

05

Cystic lesion

03

Insufficient material

03

Leukemic infiltration

02

Thus from 100 patients 44% patient were having granulomatous inflammatory lesion of lymph nodes, 39% patient were having Reactive lymph node lesion. These are the diagnosis in maximum patients. Other includes Acute inflammation (06%), Abscess formation (05%), Cystic lesion (03%), Leukemic infiltration (02%) and undiagnosed due to insufficient material (03%).

Table 2

Age & Gender specific distribution

Age (Years)

Male

Female

Total

0-5

12

08

20

6-10

26

07

33

11-15

11

18

29

16-18

08

10

18

57

43

100

Mean age group which is highest affected is 6 to 10 years (33%).

Discussion

Lymph node lesion is a common problem with a broad differential diagnosis. Symptomatic or asymptomatic inflammation is the commonest cause of lymphadenopathy. Treatment of lymph node lesion is totally different in various etiology. So, the diagnostic part of lymph node lesion is the core of treatment. FNAC is very safe and inexpensive method for diagnosis,4 as little information is available on the value of fine needle aspiration biopsy in routine practice in resource limited setting.5 A clinician can get idea about further management, whether drug therapy is sufficient or surgical procedure will be needed. Fine needle aspiration cytology has been found to be much simpler than the lymph node biopsy and patient is free from the scar of operation.6 Cervical lymph node enlargement is a very common complain in the patient ≤18 years of age.7

In this study data obtained from 100 patients demonstrates that granulomatous inflammation is the commonest cause of lymphadenopathy8 by presence of epitheloid cells, granuloma formation and necrosis according to the immune status of patient. As the granuloma formation is the protective response by body to suppress the infective agent spread. Second most common cause is Reactive lymph node. In developing country like India Tuberculosis is commonest cause of granulomatous inflammation. But, this diagnosis cannot be confirmed by FNAC study. AFB demonstration is must to stamp tubercular lesion. Other benign conditions like acute inflammation, Abscess formation and cystic lesion can also be rule out by smear prepared from aspirated material.

Any malignant lesion like metastasis or leukemic infiltration can also be rule out by aspirated material, which can be followed by histopathology and immunohistochemistry for confirmation.9

More than 90% of lymph node metastasis are diagnosed by initial aspiration.10 But primary site for metastasis of malignancy cannot be confirmed by aspirated material study.

Source of Funding

No financial support was received for the work within this manuscript.

Conflict of Interest

The authors declare they have no conflict of interest.

References

1 

S B Sarsu B K Sahin A retrospective evaluation of lymphadenopathy in children in a single center’s experienceJ Pak Med Assoc2016666547

2 

F. De Corti G. Cecchetto R. Vendraminelli G. Mognato Fine-needle aspiration cytology in children with superficial lymphadenopathyPediatr Med Chir201436280210.4081/pmc.2014.15

3 

B Sawaimul B Iqbal T Kambale H Kumar WITHDRAWN: Fine needle aspiration cytology: A diagnostic tool in evaluation of lymphadenopathy in pediatric ageAnn Diagn Pathol2017

4 

M-L Fanny N Beyam J C Gody G Zandanga F Yango A Manirakiza Fine-needle aspiration for diagnosis of tuberculous lymphadenitis in children in Bangui, Central African RepublicBMC Pediatr201212119110.1186/1471-2431-12-191

5 

C. A. Wright J. P. Pienaar B. J. Marais Fine needle aspiration biopsy: diagnostic utility in resource-limited settingsAnn Trop Paediatr2008281657010.1179/146532808x270707

6 

C F P Panditaa S R Khubchandani Fine needle aspiration cytology of lymph nodesJ Postgrad Med198733134

7 

V Annam MH Kulkarni RB Puranik Clinicopathologic Profile of Significant Cervical Lymphadenopathy in Children Aged 1–12 YearsActa Cytol2009532174810.1159/000325120

8 

M P Reddy N Moorchung A Chaudhary Clinico-pathological profile of pediatric lymphadenopathyIndian J Pediatr2002691210475110.1007/bf02724385

9 

AR Wilkinson SA Maimoon SD Mahore FNAC in the diagnosis of lymph node malignancies: A simple and sensitive toolIndian J Med Paediatr Oncol20123312110.4103/0971-5851.96964

10 

I N Bhagwan S V Kane R F Chinoy Cytologic evaluation of the enlarged neck node: FNAC utility in metastatic neck diseaseInternet J Pathol200762



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Article type

Original Article


Article page

280-282


Authors Details

Hiral J Majithia, Chandrika Algotar, Tejas Chokshi, Neelaba K Mori, Siddharth Ghelani


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