Mitra Sumit, Ray Suchandra, Mitra Pradip K
Department of Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India.
J Cytol. 2011 Jul;28(3):108-10. doi: 10.4103/0970-9371.83465.
This study was taken up with the aim to investigate the pattern of supraclavicular lymphadenopathy among patients presenting to our tertiary care institution, evaluate the diagnostic efficacy of fine needle aspiration cytology (FNAC), and analyze the diagnostic pitfalls.
A total of 215 patients were subjected to FNAC of supraclavicular lymph nodes over a three-year period (August 2006 to July 2009). Since in 18 patients as either the aspirate was inadequate or the opinion was equivocal, we analyzed the remaining 197 cases.
Malignant pathology accounted for 79.7% (157/197) of the cases. These were mostly cases of metastatic squamous cell carcinoma (79/197, 40.1%), adenocarcinoma (47/197, 23.9%), small cell carcinoma (12/197, 6.1%) and lymphoma (10/197, 5%). There were 28 (14.2%) cases of tuberculosis. Out of these 197 patients, 92 patients were biopsied. The opinion based on FNAC was erroneous in 6 cases but corroborated with the final histopathology findings in the remaining 86 cases.
FNAC is an excellent first line of investigation; and when used with a proper combination of experience and diligence, it can greatly reduce the number of errors.
本研究旨在调查到我们三级医疗机构就诊的患者锁骨上淋巴结病的模式,评估细针穿刺细胞学检查(FNAC)的诊断效能,并分析诊断中的陷阱。
在三年期间(2006年8月至2009年7月),共有215例患者接受了锁骨上淋巴结的FNAC检查。由于18例患者的抽吸物不足或诊断意见不明确,我们分析了其余197例病例。
恶性病变占病例的79.7%(157/197)。这些主要是转移性鳞状细胞癌(79/197,40.1%)、腺癌(47/197,23.9%)、小细胞癌(12/197,6.1%)和淋巴瘤(10/197,5%)的病例。有28例(14.2%)结核病病例。在这197例患者中,92例进行了活检。基于FNAC的诊断意见在6例中错误,但在其余86例中与最终组织病理学结果相符。
FNAC是一种出色的一线检查方法;当与适当的经验和勤勉相结合使用时,它可以大大减少错误数量。