Cytological Study of Cervical Lymphadenopathy in a Trtiary Care Institution from Kashmir Valley, India

Background: Cervical lymphadenopathy is a common clinical finding in all age-groups that ranges in etiology from inflammation to malignancy. Fine needle aspiration cytology (FNAC) is a standard first-line investigation in the evaluation of cervical lymphadenopathy. Objective: The study aimed to analyze the clinical profile and causes of cervical lymphadenopathy in different age-groups and the diagnostic utility of FNAC in our setup. Methods: This retrospective study included all the patients of cervical lymphadenopathy of more than 2-3 weeks duration, who underwent FNAC in our tertiary care institution in Kashmir valley, India during the two-year study period (January 2009-December 2011) in whom the aspirated material was adequate and satisfactory for evaluation. Results: A total of 790 patients were selected. Upper deep cervical lymph nodes were involved most frequently (38.9%); reactive lymphadenitis (39.4%) followed by metastasis (38.2%) were the commonest causes, in general. In addition, reactive lymphadenitis was the most common cause of lymphadenopathy in all age groups less than 40 years and at all topographic sites of cervical lymph node. However, in more than 40 years age-groups and at supraclavicular region, metastasis was the commonest cause of enlargement. Squamous cell carcinoma (36.4%) followed by adenocarcinoma, (25.8%) were the most common metastatic tumors. Conclusion: Enlargement of cervical lymph nodes, particularly in elderly patients involving supraclavicular nodes, should raise a suspicion of malignancy; and cervical lymphadenopathy can be effectively evaluated by FNAC without the need for surgical biopsy.