Accuracy of fine needle aspiration biopsy to diagnose lymphadenopathy in Dr.Sardjito General Hospital, Yogyakarta, Indonesia

https://doi.org/10.19106/JMedSci005201202006

Ery Kus Dwianingsih(1*), Claudia Priska Adelin(2), Andre Stefanus Panggabean(3), Linda Pratiwi(4), Naomi Yoshuantari(5), Mardiah Suci Hardianti(6), I Indrawati(7)

(1) Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
(2) Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
(3) Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
(4) Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
(5) Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
(6) Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
(7) Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
(*) Corresponding Author

Abstract


Lymphadenopathy is a non-specific enlargement of lymph nodes which may be caused by infection, cancer, or autoimmune disease. To date, only a few studies reported the diagnostic value of fine-needle aspiration biopsy (FNAB) in lymphadenopathy. This study was performed to evaluate diagnostic reliability of FNAB for benign and malignant lymphadenopathy. This was a retrospective cross-sectional study. The obtained data were statistically analyzed for its sensitivity, specificity, and accuracy. Out of 126 collected FNAB cases with histopathological confirmed results in Dr. Sardjito General Hospital, Yogyakarta, 85 (67.4%) were malignant lymphadenopathy, consisting of 42 metastatic tumor cases, 38 non-Hodgkin lymphoma (NHL) cases, and 4 Hodgkin lymphoma (HL) cases.The overall diagnostic sensitivity, specificity, and accuracy of FNAB in lymphadenopathy was 85.88, 70.73, and 80.95%, respectively. In diagnosing metastatic tumors, FNAB had sensitivity of 83.33%; specificity of 89.28%; and accuracy of 87.3%. The sensitivity, specificity, and accuracy of FNAB in diagnosing NHL was 60.52, 94.31, and 84.12%, respectively. FNAB had a sensitivity of 25%, specificity of 95,90%, and accuracy of 93.65% to diagnose HL. Meanwhile, the accuracy of FNAB in diagnosing malignancies in generalized lymphadenopathy, head-neck lymphadenopathy, and inguinal lymphadenopathy was 90.90; 81.39 and 44.44%, respectively. In conclusion,FNAB has moderate diagnostic value in diagnosing overall malignant lymphadenopathy, including metastatic tumors. FNAB also has some limitations in diagnosing NHL and HL, with sensitivity less than 70% for both diseases. However, it has high accuracy to diagnose generalized lymphadenopathy.


Keywords


FNAB; malignant lymphadenopathy; Non-Hodgkin lymphoma; Hodgkin lymphoma;

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References

  1. Bazemore AW, Smucker DR. Lymphadenopathy and malignancy. Am Fam Physician 2002; 66(11):2103-10.
  2. 2. Malhotra AS, Lahori M, Nigam A, Khajuria A. Profile of lymphadenopathy: an institutional based cytomorphological study. Int J Appl Basic Med Res 2017; 7(2):100-3. https://doi.org/10.4103/2229-516X.205812
  3. Sattar A, Shamim SH, Wahab S, Javed A. Yield and safety profile of ultrasound guided fine needle aspiration cytology (FNAC) of lymph nodes. J Coll Physicians Surg Pak 2016; 26(5):357-60.
  4. Goret CC, Goret NE, Ozdemir ZT, Ozkan EA, Dogan M, Yanik S, et al. Diagnostic value of fine needle aspiration biopsy in non-thyroidal head and neck lesions: a retrospective study of 866 aspiration materials. Int J Clin Exp Pathol 2015; 8(8):8709-16.
  5. Yu YH, Wei W, Liu JL. Diagnostic value of fine-needle aspiration biopsy for breast mass: a systematic review and meta-analysis. BMC Cancer 2012; 12:41. https://doi.org/10.1186/1471-2407-12-41
  6. Sengupta A, Pal R, Kar S, Zaman FA, Sengupta S, Pal S. Fine needle aspiration cytology as the primary diagnostic tool in thyroid enlargement. J Nat Sci Biol Med 2011; 2(1):113-8. https://doi.org/10.4103/0976-9668.82308
  7. Gupta R, Naran S, Lallu S,Fauck R. The diagnostic value of fine needle aspiration cytology (FNAC) in the assessment of palpable supraclavicular lymph nodes: a study of 218 cases. Cytopathology 2003; 14(4):201-7. https://doi.org/10.1046/j.1365-2303.2003.00057.x
  8. Gupta R, Naran S, Lallu S, Fauck R. Diagnostic value of needle aspiration cytology (NAC) in the assessment of palpable inguinal lymph nodes: a study of 210 cases. Diagn Cytopathol 2003; 28(4):175-80. https://doi.org/10.1002/dc.10244
  9. Jeffers MD, Milton J, Herriot R, McKean M. Fine needle aspiration cytology in the investigation on non-Hodgkin’s lymphoma. J Clin Pathol 1998; 51(3):189-96. https://doi.org/10.1136/jcp.51.3.189
  10. Srinivasamurthy BC, Saha K, Senapati S, Saha A. Fine needle aspiration cytology of dermatopathic lymphadenitis in an asymptomatic female: A case report. J Cytol 2016; 33(1):49-51. https://doi.org/10.4103/0970-9371.175523
  11. Saikia UN, Dey P, Jindal B, Saikia B. Fine needle aspiration cytology in lymphadenopathy of HIV-positive cases. Acta Cytol 2001; 45(4):589-92.https://doi.org/10.1159/000327869
  12. Singh P, Rohilla M, Dey P. Comparison of liquid-based preparation and conventional smear of fine-needle aspiration cytology of lymph node. J Cytol 2016; 33(4):187-91. https://doi.org/10.4103/0970-9371.190444
  13. Daskalopoulou D, Rapidis AD, Maounis N,Markidou S. Fine-needle aspiration cytology in tumors and tumor-like conditions of the oral and maxillofacial region: diagnostic reliability and limitaions. Cancer 1997; 81(4):238-52. https://doi.org/10.1002/(sici)1097-0142(19970825)81:4<238::aid-cncr6>3.0.co;2-l
  14. Qadri SK, Hamdani NH, Shah P, Lone MI, Baba KM. Profile of lymphadenopathy in Kashmir valley: a cytological study. Asian Pac J Cancer Prev 2012; 13(8):3621-5. https://doi.org/10.7314/apjcp.2012.13.8.3621
  15. Dorak MK, KapuzogluE. Gender differences in cancer susceptibility: an inadequately addresed issue. Front Genet 2012; 3:286. https://doi.org/10.3389/fgene.2012.00268
  16. Shrivastav A, Shah, HA, Agarwal, NM, Santwani, PM & Srivasta, G Evaluation of peripheral lymphadenopathy by fine needle aspiration cytology: A three year study at tertiary center. Journal of DrNTR University of Health Sciences 2014; 3(2):86-91. https://doi.org/10.4103/2277-8632.134834
  17. Ferrer R. Lymphadenopathy: Differential diagnosis and evaluation. American Family Physician 1998; 1313-20.
  18. Abba AK. Clinical approach to lymphadenopathy. JK-Practitioner 2011; 16(1-2):1-8.
  19. Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A. Peripheral lymphadenopathy: approach and diagnostic tools. Iran J Med Sci 2014; 39(2):158-70
  20. Reddy D, Venter WD, Pahter S. Patterns of lymph node pathology; Fine needle aspiration biopsy as an evaluation tool for lymphadenopathy: A retrospective descriptive study conducted at the largest hospital in Africa. PLoS ONE 2015; 10(6):0130148. https://doi.org/10.1371/journal.pone.0130148
  21. Mostafa MG, Chiemchanya S, Srivannaboon S,Nitiyanant P. Accuracy of fine needle aspiration cytology in the evaluation of peripheral lymphadenopathy. J Med Assoc Thai 1997; 80(Suppl 1):155-61.
  22. Haque MT, Talukder SI. Evaluation of fine needle aspiration cytology (FNAC) of lymph node in Mymensingh. Myemensingh Med J 2003; 12(1):33-5.
  23. Ho FC, Tham IW, Earnest A, Lee KM, Lu JJ. Patterns of regional lymph node metastasis of nasopharyngeal carcinoma: a meta-analysis of clinical evidence. BMC Cancer 2012; 12:98. https://doi.org/10.1186/1471-2407-12-98
  24. Goret CC, Goret NE, Ozdemir ZT, Ozkan EA, Dogan M, Yanik S, et al. Diagnostic value of fine needle aspiration biopsy in non-thyroideal head and neck lesions: a retrospective study of 866 aspiration materials. Int J Clin Exp Pathol 2015; 8(8):8709-16.
  25. Prasad R, Narasimhan R, Sankaran V, Veliath AJ. Fine-needle aspiration cytology in the diagnosis of superficial lymphadenopathy: an analysis of 2,418 cases. Diagn Cytopathol 1996; 15(5):382-6. httpa://doi.org/10.1002/(SICI)1097-0339(199612)15:5<382::AID-DC5>3.0.CO;2-E
  26. Yazdi AK, Langroudi MM, Saedi B, Ensani F, Amali A, Memari F, et al. Diagnostic value of fine-needle aspiration in head and neck lymphoma: a cross-sectional study. Indian J Otolaryngol Head Neck Surg 2014; 66(Suppl1):277-80. https://doi.org/10.1007/s12070-012-0484-y
  27. Kumari RR.Fine needle aspiration cytology in the diagnosis of Hodgkin lymphoma: Hits and misses. J Cytol 2008; 25:10-2. https://doi.org/10.4103/0970-9371.40651
  28. Wakely PE Jr. The diagnosis of non-Hodgkin lymphoma using fine-needle aspiration cytopathology. Cancer Cytopathol 2010; 118(5):238-43. https://doi.org/10.1002/cncy.20106
  29. Babu G, Ramesh G, Kashyap B, Suneela S, Hiremath SS, Murgud S. Cytohistopathological evaluation of the cervical lymph nodes by fine needle aspiration cytology. J CranioMax Dis 2014; 3:101-5. https://doi.org/10.4103/2278-9588.138222
  30. Alam K, Maheswari V, Haider N, Siddiqui F, Jain A,Khan A. Fine needle aspiration cytology (FNAC), a handy tool for metastatic lymphadenopathy. The Internet Journal of Pathology 2009; 10(2). https://doi.org/10.5580/1df3
  31. Hall B, Schmidt RL, Sharma RR, Layfield LJ. Fine neede aspiration cytology for the diagnosis of metastatic melanoma. Am J Clin Pathol 2013; 140(5):635-42. https://doi.org/10.1309/AJCPWSDDHLLW40WI
  32. Hu X, Zhou X, Yang H, Wei W, Jiang Y, Liu J. Axillary ultrasound and fine needle aspiration biopsy in the preoperative diagnosis of axillary metastases in early-stage breast cancer. Oncol Lett 2018; 15(6):8477-83. https://doi.org/10.3892/ol.2018.8445
  33. Tambunan G. Penuntun biopsi aspirasi jarum halus: aspek klinis dan sitologi neoplasma. Jakarta: Hipokrates; 1990.



DOI: https://doi.org/10.19106/JMedSci005201202006

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