Role of fine-needle aspiration cytology in the diagnosis of metastatic cervical lymph nodes at a tertiary health-care center: A 5-year study

ABSTRACT Introduction: Fine-needle aspiration cytology (FNAC) is now a well-established diagnostic tool for evaluating enlarged lymph nodes. The procedure is minimally invasive, well tolerated by the patients with less complications and repeatability. FNAC not only confirms the presence of metastatic disease but also gives the clue regarding the origin of the primary tumor. Objective: To assess the usefulness of FNAC in diagnosing metastatic cervical lymph nodes. Materials and Methods: A cross-sectional study was conducted in all the metastatic cervical lymph nodes on FNAC samples reported in the department of pathology of our institute for a period of 5 years from June 2017 to May 2022. Cervical lymph nodes were aspirated, processed, and examined. Results: A total of 121 (33.9%) cases of metastatic cervical lymph nodes were studied. Metastatic adenocarcinoma was the most common finding, followed by metastatic squamous cell carcinoma (28.9%). Maximum number (50.4%) of the cases were seen in the sixth and the seventh decades of age. More than half (54.5%) of the cases metastasized to Level II, III, and IV cervical lymph nodes. Cases of known primary were 96%, whereas 4% were of unknown primary. Lungs and gastrointestinal tract were the main primary tumors (58%) that metastasized to the cervical lymph nodes. Conclusion: FNAC of the cervical lymph nodes is a reliable method to diagnose metastatic tumors where the tumor type gives us a clue about the primary site. It is now considered a routine outpatient department procedure and most convenient method for confirming metastatic lymph nodes.