CLINICO-CYTOLOGICAL AND HISTOPATHOLOGICAL CORRELATION OF LYMPHADENOPATHY IN PEDIATRIC PATIENTS

RIYA MAHAJAN; POONAM SINGAL; SHIVANSHU KUNDAL; HARJINDER SINGH; RAMESH KUMAR KUNDAL; PRIYASI MONGA

doi:10.22159/ajpcr.2022.v15i3.43735

Authors

RIYA MAHAJAN Department of Pathology, Government Medical College, Patiala, Punjab, India. https://orcid.org/0000-0002-6502-9344
POONAM SINGAL Department of Pathology, Government Medical College, Patiala, Punjab, India. https://orcid.org/0000-0003-2499-0064
SHIVANSHU KUNDAL Department of Surgery, Government Medical College, Patiala, Punjab, India.
HARJINDER SINGH Department of Pediatrics, Government Medical College, Patiala, Punjab, India. https://orcid.org/0000-0001-7893-9163
RAMESH KUMAR KUNDAL Department of Pathology, Government Medical College, Patiala, Punjab, India. https://orcid.org/0000-0001-6688-6981
PRIYASI MONGA Department of ???, Government Medical College, Amritsar, Punjab, India.

DOI:

https://doi.org/10.22159/ajpcr.2022.v15i3.43735

Keywords:

Fine needle aspiration cytology, Paediatric lymphadenopathy, Lymphadenitis

Abstract

Objective: The aim of the present study was to evaluate the cytomorphological and histopathological (wherever possible) patterns of lymph node (LN) lesions along with clinical correlation in the pediatric population.

Methods: This was a prospective study conducted on 100 pediatric patients (aged <12 years) who presented with lymphadenopathy (LAP). Fine-needle aspiration cytology (FNAC) was performed on all cases out of which only 22 underwent surgical excision and histopathological examination. Aspirated material was stained with May-Grunwald Giemsa, Papanicolaou, Z-N stain (wherever required) and for histopathology, Hematoxylin and eosin stain was used.

Results: Majority number of patients was in the age group of 5–8 years (44%). Cervical LN s were most commonly involved (71%). Out of the total 100 cases, 91% were benign, 3% were malignant and 6% were inadequate. Most common cytologically diagnosed entity was non-specific reactive lymphadenitis (68%). There was one case of reactive lymphadenitis on cytology that proved to be Hodgkin lymphoma on histopathology. Two cases of generalized LAP given as atypical lymphoproliferative lesion on cytopathology proved to be acute lymphoblastic leukemia/lymphoma on further investigation. The cytomorphological findings were found to be concordant with histopathology in 21 cases out of 22 with a diagnostic accuracy rate of 95.45%.

Conclusion: FNAC is especially helpful as LN biopsy is a difficult and invasive procedure in children. Although excision biopsy is the gold standard, FNAC is preferred as first-line investigation. Along with cell block analysis and ancillary techniques, it provides an excellent diagnostic accuracy.

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