Superficial Lymphadenopathy (LAP) is a common clinical presentation seen in pediatric patients attending the outpatient department. The etiology of Superficial LAP varies from a benign process to malignancy. Fine needle aspiration cytology (FNAC) is a very rapid and easy to perform diagnostic test. Majority of cases can be diagnosed and managed on FNAC without need of histopathology. The aim of this study was to evaluate the role of FNAC in diagnosis of superficial LAP in pediatric population.
Methods: This retrospective study was carried out over a period of two year from June 2019 to May 2021 in the department of Pathology, B.J. Medical college, Civil Hospital Ahmedabad, Gujarat, India. Aspirated material was stained with Giemsa, Papanicolaou and Ziehl- Neelsen stain (whenever required). Distribution of cases in different age groups and sex was analyzed. lesions were categorized into benign and malignant conditions. All cases of superficial LAP seen in pediatric population where FNAC was performed were included in the study.
Results: A total of 122 lymph nodes were aspirated in pediatric population during the study period. Majority of cases (94%) were benign. The results were categorized into two broad categories as benign- reactive lymphadenitis (67; 55%), Granulomatous lymphadenitis (47; 39%) and malignancy (08; 06%). The eight cases of malignancies identified in this population comprised of four cases, one of Hodgkin’s Lymphoma (HL) and three of Non-Hodgkin’s Lymphoma (NHL). In this study, maximum number of patients were in the age group of 10-14 years (46%) followed by <5 years age group (37%). Cervical lymphadenopathy is the main group of superficial lymphadenopathy in pediatric population constituting (96/122; 79%) of all superficial LAP followed by Axillary Lymphadenopathy.
Conclusion: FNAC should be considered as a first line investigation for evaluating the peripheral superficial LAP in pediatric population. Reactive Lymphadenitis is recognised as most common cytological finding of superficial LAP examination. Majority of these cases can be diagnosed and managed on FNAC alone.