الفهرس 
TitleOnly 14 pages are availabe for public view
 |  | from | 104 |  |  |
| | | from | 104 | | |
Abstract
The problem of lymphadenopathy is frequently encountered in surgical and
medical outpatient clinics. Meanwhile, it is not uncommon to find enlarged lymph
nodes in patients who are admitted for other clinical issue. Fine needle aspiration
cytology (FNAC) is considered a rapid screening method in patients presenting with
lymph node enlargement. Cell blocks and subsequent application of immunostaining
are of promising benefits.
The aim of the present work was to determine the reliability and accuracy of
FNAC, cell blocks and immunostaining in rapid diagnosis of lymph node enlargement.
Materials and methods: After taking brief history and performing physical
examination, fine needle aspirates were taken directly or under ultrasound guidance and
examined from 50 patients presenting with lymphadenopathy in the outpatient clinic of
the Medical Research Institute, Alexandria University. Cell blocks and immunostaining
have been performed whenever possible.
Results: In 46% of cases the lymphadenopathy was due to benign etiology,
while 54% of cases were malignant. Benign cases were affecting females mainly
(78.3%) and the malignant cases had nearly equal distribution, with only slight male
predominance. Roughly, 30% of malignancies were lymphomatous and the remaining
70% were metastatic deposits. The most common benign etiology was reactive
lymphadenitis (82.6%). The most common lymph node group involved was the axillary
group for both benign and malignant groups. The most common malignant etiology in
males was the large B cell non-Hodgkin lymphoma (29%), while in females it was
metastatic ductal carcinoma of the breast (85% of cases). Cell blocks were available in
31 cases in the other 19 cases the aspirate was inadequate or hemorrhagic devoid of
cells. The available cell blocks allowed immunocytochemistry to be done where they
were used to confirm suspicious diagnosis, determine the origin of a metastatic tumour,
classify lymphoma, determine the histopathologic type of a tumour or determine
immune markers of relevance in prognosis and treatment. In 2 cases immunostaining
was done on FNAC slides to confirm the diagnosis of Hodgkin’s lymphoma.
Diagnostic accuracy of cytology (FNAC & Cell block) was found to be 82%.
Conclusion: Cell block method allows the recovery and processing of minute
amounts of cellular material and facilitates the better classification of tumors especially
if accompanied with immunostaning
FNAC, cell block and immuno-staining are very helpful methods in rapid
diagnosis of lymphadenopathy. These methods have yielded the diagnosis in all cases
without the need of excision biopsy with a fairly high diagnostic accuracy.