Evaluation of Lymph Node Fine Needle Aspiration Cytology in Pediatric Age Group

Background: Lymphadenopathy is a common clinical presentation in paediatric practice and may result from diverse disease processes. Fine Needle Aspiration Cytology (FNAC) has proven to be a rapid, minimally invasive, and reliable diagnostic tool with low morbidity. The aim of this study is to determine the utility of FNAC in diagnosing the cause of lymphadenopathy, to identify the spectrum of cytological findings in paediatric lymph nodes, and to correlate cytological findings with clinical, histopathological, and Acid-Fast Bacilli (AFB) staining results. Materials and Methods: This retrospective study was conducted from January 2011 to December 2013 and included 293 cases of paediatric lymph nodes in the age range of 0-12 years. Results: A total of 293 lymph nodes were aspirated. The cases were classified as: Benign 277 (94.54%): Reactive 183 (62.46%) [Reactive 166 (56.66%), Florid reactive 17 (5.80%)], Tuberculous lymphadenitis 86 (29.36%), BCG lymphadenitis 3 (1.02%), Non-specific lymphadenitis 4 (1.36%) [Resolving inflammation 3 (1.02%), Suppurative 1 (0.34%)], Dermatopathic 1 (0.34%). Malignant 16 (5.46%): Hodgkin lymphoma (HL) 8 (2.73%), Non-Hodgkin lymphoma (NHL) 7 (2.39%), Metastasis 1 (0.34%), The distribution of cases according to gender, anatomic location of lymph nodes, associated organomegaly, and clinical presentation was also analyzed. Out of the 26 cases with histopathological follow-up, results were concordant in 12 benign and 11 malignant lesions, while discordant in two benign and one malignant lesion. Conclusion: The calculated sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FNAC were high for malignant lesions in paediatric lymphadenopathies.