Fine-needle aspiration in the management of peripheral lymphadenopathy in a developing country

Fine-needle aspiration (FNA) is a simple, cheap, and well-tolerated procedu re that is well-established as a method of definitive diagnosis of palpable masses. This review reports the role of FNA in the investigation of periph eral lymphadenopathy as an alternative to expensive surgical excision biops y in developing countries, where there are limited funds and facilities. Al l lymph node aspirates done in the FNA clinic at the Department of Patholog y, University College Hospital, Ibadan, between 1995-1997 were reviewed. Th e aspirates were obtained using 21- or 22-gauge needle with a 5- or 10-ml d isposable plastic syringe, smeared on standard microscopic slides and stain ed with Giemsa and/or Papanicolou stains. The most common diagnosis was reactive change/nonspecific inflammation, con stituting 33.4%; tuberculosis and metastatic lesions made up 25.7% and 22.4 %, respectively while lymphoma constituted 16.9% of cases. The commonly asp irated nodes were cervical. Tuberculosis was the most frequent diagnosis in these nodes and was the most commonly diagnosed infective condition, parti cularly in those under age 20 years. The sensitivity and specificity of lym ph lymph node FNA in the diagnosis of tuberculosis were 79.5% and 100%, res pectively. The overall accuracy rate of lymph node aspiration was 89.5%. Ou r study showed that FNA is a simple, cost-effective procedure which offers a reliable method of diagnosis in distinguishing reactive lymphadenopathy, tuberculosis, and malignant conditions. Diagn. Cytopathol. 1999;21:159-162. (C) 1999 Wiley-Liss,Inc.