Comparison of fine needle aspiration cytology and histopathology in diagnosing cervical lymphadenopathies

Background: Lymphadenopathies are the most common form of extrapulmonary tuberculosis and tuberculous lymphadenitis is the most common cause of peripheral lymphadenopathy in a developing country like Nepal. The objective of this study is to compare the findings of fine needle aspiration cytology to histopathology in diagnosing cervical lymphadenopathies. Method: This is a prospective, longitudinal, comparative study was performed in the Department of ENT and Head and Neck Surgery, TU Teaching Hospital, Kathmandu between August 2007 and January 2009. Patients 13 years of age or older were included. There were 55 patients with cervical lymphadenopathies subjected to both fine needle aspiration cytology (FNAC) and histopathology (HPE). The sensitivity, specificity, false positive, false negative, positive predictive value and negative predictive value were calculated. Results: Of 55 patients, 48 patients had lymphadenopathies of infective origin while 7 patients had metastatic disease. Majority of patients (n=20) were in age group 23-32 years and males outnumbered females. The sensitivity, specificity, false positive, false negative, positive predictive value and negative predictive value of FNAC of lymphadenopathies to diagnose tubercular lymphadenopathies were 80.0%, 100.0%, 0.0%, 20.0%, 100.0% and 82.14% respectively. Similarly, sensitivity, specificity of FNAC of lymphadenopathies to differentiate benign and malignant lesion were 100% each. False positive, false negative, positive predictive value and negative predictive value were 0.0%, 0.0%, 100.0% and 100.0% respectively. Overall correlation of FNAC and HPE was 90.9%. Conclusion: FNAC can distinguish tubercular lymphadenitis from reactive and granulomatous lymphadenitis in majority of cases. Similarly, it can distinguish well between benign and malignant lymphadenopathies. It can be used as an initial investigation for routine screening of cervical lymphadenopathies where facilities of histopathology are not available.