Vol. 8, Issue 1, Part A (2025)

Background: Lymph node enlargement requires thorough evaluation. Fine-needle aspiration cytology (FNAC) is a primary diagnostic tool, particularly for infectious conditions and distinguishing benign from malignant lesions. To address this, the Sydney system for reporting of lymph node cytology was established to promote standardized reporting and optimal patient care.
Aims & Objectives: The present study aims to assess the applicability and accuracy of the system in the diagnosis of lymph node cytology.
Materials and Method: This study included 135 patients who presented to the Cytopathology Department at B.J. Medical College, Civil Hospital, Ahmedabad, between April 2024 and June 2024. The cytological features were evaluated and the cases were classified according to Sydney System.
Result: Total 135 cases were evaluated cytologically. The distribution of cases into different categories was as follows L1-Inadequate/Non-Diagnostic (2.96%), L2- Benign (82.22%), L3- Atypical: ALUS/AUS (5.92%), L4- suspicious for malignancy (2.96%), L5-Malignant (5.92%). The ROM for non-diagnostic, Benign, ALUS/AUS, Suspicious for malignancy, Malignant were 0%, 4.76%, 50%, 100%, and 100%, respectively. 
Conclusion: The Sydney system for reporting of lymph node cytology is an essential tool for standardizing reporting and preoperatively stratifying cases. The findings of this study reinforce the value of Sydney system in enhancing diagnostic accuracy, stratifying malignancy risk, and facilitating collaborative patient management between cytopathologists and clinicians, highlighting the need for ongoing refinement and widespread adoption.