Comparative Study of Fine Needle Aspiration Cytology and Cell Block Technique in Lymphadenopathy

Background: Lymphadenopathy is one of the commonest clinical presentation of all age groups attending out patient department. The aetiology can vary from an inflammatory process to a malignant condition. Fine needle aspiration cytology (FNAC) is an economical and reliable first line investigation in lymphadenopathy. Sometimes fine needle aspiration does not yield sufficient information for precise diagnosis. Hence to make the best possible use of aspirate, smear should be combined with cell block (CB) preparation that in turn gives a better morphological & histological diagnosis. Objective: This study was undertaken to assess the utility of cell block technique in diagnosing lymphadenopathies in correlation with FNAC findings. Material and methods: We carried out this study on 220 patients in Department of Pathology, JLN medical College, Ajmer (Rajasthan) from July 2018 to June 2020. After proper history taking, clinical examination and relevant investigations, we performed FNAC from lymph node swellings in cytology section of pathology department with approval from the institutional ethical committee. Results - Out of 220 cases, 144 cases of reactive lymphadenitis, 47 were of tubercular lymphadenitis, 18 of metastatic deposits of varied primaries, 4 cases of lymphomas and 7 cases were under category of non - diagnostic cases. The sensitivity and Specificity of cell block was 77.78% and 100% respectively and positive predictive value (PPV) and negative predictive value (NPP) was 100% and 92.98% respectively. Conclusion: The combined use of both the FNAC and Cell block techniques increases the diagnostic accuracy and helps the clinician in appropriate management of the patient.