Lymph nodes are a site for organized collections of lymphoreticular tissue and are pink gray bean shaped encapsulated organs. They are located at anatomically constant points along the course of lymphatic vessels. The common sites of distribution are cervical, axillary, mediastinal, retroperitoneal, iliac, and inguinal regions. Their enlargement is noted in a wide spectrum of diseases, including infections and malignancy, they are a common finding in clinical practice. Therefore, peripheral lymphadenopathy is common in all age groups and management of cases depends on lymph node pathology, which can be studied by collecting material through fine-needle aspiration or excision biopsy [1].

Fine needle aspiration (FNA) [Fine Needle Aspiration Cytology (FNAC)] technique was first introduced by Greig and Grey [2]. Since the 1960’s, it has been used extensively as a diagnostic tool for rapid evaluation of mainly superficial lesions, especially of lymph nodes. It is cost effective, relatively less traumatic, and enables the pathologist to provide the clinician with a diagnosis in a very short time, and hence is ideal especially for OP patients [3].

Lymphadenopathy is one of the most common clinical presentations with variable etiologies and one of the major causes of morbidity [4]. In developing countries, infective lymphadenopathy is quite common, mostly due to high prevalence of tuberculosis. However, still a large percentage of lymphadenopathies in adults turn out to be malignant [5]. The diagnosis of the cause underlying the enlarged lymph node (s) enables the clinician to plan appropriate management for each patient. Enlarged superficial lymph nodes are easily amenable to evaluation by FNA technique and hence FNAC forms an important diagnostic tool in the armamentarium of the pathologist [6].

1. To study the age and sex distribution of the patients of FNAC of peripheral lymph node .
2. To study the spectrum of diseases diagnosed on FNAC of peripheral lymph nodes.

Study Type: Cross-sectional hospital based Observational study.

In the present study FNAC was performed in 50 patients who had superficial lymphadenopathy. Table 1 showing distribution of age.

Most of the patients were in the age group of 21 to 30 years followed by the age group of 11 to 20 years. Means 32% patients were in the age group of 21 to 30 years and 22% were in the age group of 11 to 20 years (fig 1).

Fig-1: Showing Age and Sex distribution

Fig-2: Showing spectrum of Diseases diagnosed in FNAC of superficial lymph nodes.

Table-2: Showing distribution of sex of FNAC patients of superficial lymph nodes.

Number of female patients was more than that of male patients (table 2). Number of female patients was 29 and that of male patients was 21 i. e. female patients were 58% and male patients were 42% (Fig 1)

Table-3: Showing different cases found in FNAC of lymph node.

In the present study it was observed that most of the patients (50%) were in the age group of 11 to 30 years and small number of patients were seen in the age group 0-10 years (8%) & 51 years and above (8%). Similar observation was seen in studies done by Pandit AA et al and Gupta et al. Pandit AA, et al. found 146(51.05%) patients were in the age group of 0-20years [7]. And Gupta et al also found most of the patients 532(52.26%) were in the age group of 0-20years [8].

In the present study female (58%) patients approxi-mately 1.5 times higher than male (42%) patients. Duraiswami R et al also found a preponderance of female patients (61%) which is similar to the present study [9].

Authors have diagnosed various diseases in the FNAC of different lymph nodes like reactive hyperplasia of lymph node, granulomatous lymphadenitis, Suppurative lesion, metastasis, lymphoproliferative disorder, histiocytosis, necrotic lesion and descriptive or non-conclusive. Among these reactive hyperplasia of lymph node was the most common (46%) cytological diagnosis in the present study which is comparable to the study done by Duraiswami R et al, Shrivastav A et al, Mohanty R et al and Pandey P et al. Duraiswami R et al found reactive lymph node hyperplasia was the predominant diagnosis in their series (49.8 %; 126 cases out of 253 FNA evaluations) [9].

Shrivastav A et al observed that in pediatric and adolescents' age group the most common cause of lymphadenopathy was reactive hyperplasia 198 cases out of total 378 cases (52.38%) [10].

Reactive lymphadenopathy was observed to be the most frequent diagnosis with 122/355 cases (34.36%) in the study done by Mohanty R et al [11]. Pandey P et al found that of the 395 patients they studied with palpable lymphadenopathy, among 277 cases of benign lesions, reactive hyperplasia 121 (30.63%) ranked on top [12]. But tuberculous lymphadenitis (n = 102) was found to be the most common pathologic lesion accounting for 47.67% in the study of Kumar H et al [13].

In the present study Granulomatous lymphadenitis was the second most common (28%) cytological diagnosis. Duraiswami R et al found Granulomatous lymphadenitis was the second most common diagnosis (37.15%; 94 out of 253 FNA evaluations) in their study [9].

Benign and malignant diseases were easily diagnosed by this simple diagnostic procedure.

This test can be performed in very young age group to very old individuals in a minimally equipped outdoor setting. In the present study most common age group is 21 to 40 years with predominance of female patients. Reactive hyperplasia of lymph node was the most common diagnosis followed by Granulomatous lymphadenitis.

Limitations- Small numbers of patients were included in the study.

1. Dr Prasenjit Gayen- Concept designing and conducting the study & performing and reporting the FNAC.
2. Saswata Ghosh and - Conducting the study and writing the manuscript.
3. Subhrajyoti Naskar- Guiding the study procedure and preparing the manuscript suitable for publication.

Acknowledgement: Mr. Dipak Das, Mr. Rajib Manna, Mr. Manabesh Pramanik and Ms Jaya Ghosh have helped me performing the FNAC, staining and conducting the study.