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New Indian Journal of Surgery

Volume  6, Issue 4, October-December 2015, Pages 109-123

 

Original Article

Correlation of Clinical, Sonographical, Fine Needle Aspiration Cytological and Excisional Biopsy Findings in Lymphadenopathy
S.I. Bagasrawala*, S.N. Jajoo**
*Resident, General Surgery **M.S. General Surgery, M.Ch. Plastic Surgery, Professor, Jawaharlal Nehru Medical College & Acharya Vinoba Bhave Rural Hospital Datta Meghe Institute of Medical Sciences Sawangi (Meghe), Wardha
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DOI : https://dx.doi.org/10.21088/nijs.0976.4747.6415.2

Abstract

 Aim: To find out the correlation of Clinical Diagnosis and Investigative Techniques, to determine the diagnostic accuracy of Clinical diagnosis, ultrasonography and fine needle aspiration cytology (FNAC) in lymphadenopathy using histopathologic examination of the excised lymph node as gold standard. Study: Cross sectional study. Department of Surgery along with Department of Pathology and Department of Radiodiagnostics at Acharya Vinobha Bhave Rural Hospital (AVBRH) attached to Jawaharlal Nehru Medical College (JNMC) which come under Datta Meghe Institute of Medical Sciences (DMIMS) Deemed University.From October 2013 to October 2015. Material and Methods: A total of 102 patients suffering from lymphadenopathy were selected. After taking informed consent,the patients were then subject to Ultrasonography and FNAC. Thereafter the same lymph node was removed under local anesthesia for histopathology. All Specimens were sent separately to Cytology and Histopathology units at. Data was analyzed using SPSS version 10. Result: 102 patients with a mean age of 35.87 (±17.33) years was sampled, Commonest age group was 41-50 years. the neck was the most common site of lymphadenopathy. The most common cause found for lymphadenopathy was reactive lymphadenopathy followed by tubercular lymphadenitis. clinically size of the lymph node more than 2 cm, duration of more than 2 weeks, consistency and matting were indicators for a neoplastic aetiology. onsonological examination, Longitudinal to transverse ratio, internal echoes and presence of hilum were important finding on ultrasonography to reach at a specific diagnosis. In our study we found that FNAC had a high Specificity (100%) and positive predictive (100%) value in diagnosing secondary metastatic conditions and lymphomas. However in diagnosis of Tubercular lymphadenitis the specificity of FNAC was 81.82% . Conclusion: Clinical evaluation of the patient is imperative. Ultrasonography proves to be an important investigative tool that aids in the diagnostic accuracy. Ultrasonography is also important where extent and severity of the disease needs to be identified. FNAC has a high sensitivity and specificity for diagnosis of malignant condition and is useful in those conditions where tissuediagnosis is not required. Where diagnosis is questionable, early excisional biopsy is recommended.


Corresponding Author : S.I. Bagasrawala*