Fine Needle aspiration of superficial Lymph node enlargement seen in Lagos, Nigeria: our experience over a six-year period

Abstract

Background: Lymphadenopathy is one of the common palpable superficial tumours in the body. The diagnosis of these masses can be challenging to physicians. Fine needle aspiration cytology (FNAC) is a cost effective investigation for the diagnosis especially in resource limited settings like ours.
Objectives: The aim of this study is to present the use of FNAC of lymph nodes, highlighting the benefits of this investigation.
Methods: This is a six year retrospective study of all lymph nodes FNAC performed in two laboratories in Ikeja, Lagos between January 2008 and December 2013. All cytological slides were retrieved and re-evaluated. Clinical details including age, gender, site of aspirations were retrieved from the request forms.
Results: A total of 128 cases were seen during the study period with an age range of 1 to 84 years and male to female ratio of 1:1.1. Cervical lymph node (90/128) was the commonest aspirated site. Tuberculous lymphadenitis accounted for 32.3% of cases. Diagnosis of malignancy accounted for 25% of cases comprising metastatic carcinoma (71.9%) and lymphoma (28.1%). All cases of lymphoma diagnosed were from cervical lymph node which also accounted for 60.9% metastatic carcinoma diagnosis.
Conclusion: Chronic granulomatous lymphadenitis is a very common cause of lymphadenopathy in our environment. Metastatic carcinoma is the most common cause of malignant lymphadenopathy. FNAC is a veritable tool for the diagnosis of lymphadenopathy and it can be performed on all age groups. Introduction of special technique such as immunohistochemistry and flow cytometry is advocated for definitive diagnosis of lymphomas.

Keywords: Lymphadenopathy, FNAC, tuberculous lymphadenitis, metastatic carcinoma, lymphoma.