Adhikari P, Sinha Bk, Baskota Dk
Department of ENT and Head and Neck Surgery, GMS Memorial Academy of ENT and Head and Neck Studies, TU Teaching Hospital, Kathmandu, Nepal.
Australas Med J. 2011;4(2):97-9. doi: 10.4066/AMJ.2011.559. Epub 2011 Feb 28.
Lymphadenopathies are the most common form of extrapulmonary tuberculosis and tuberculous lymphadenitis is the most common cause of peripheral lymphadenopathy in a developing country like Nepal. The objective of this study is to compare the findings of fine needle aspiration cytology to histopathology in diagnosing cervical lymphadenopathies.
This is a prospective, longitudinal, comparative study was performed in the Department of ENT and Head and Neck Surgery, TU Teaching Hospital, Kathmandu between August 2007 and January 2009. Patients 13 years of age or older were included. There were 55 patients with cervical lymphadenopathies subjected to both fine needle aspiration cytology (FNAC) and histopathology (HPE). The sensitivity, specificity, false positive, false negative, positive predictive value and negative predictive value were calculated.
Of 55 patients, 48 patients had lymphadenopathies of infective origin while 7 patients had metastatic disease. Majority of patients (n=20) were in age group 23-32 years and males outnumbered females. The sensitivity, specificity, false positive, false negative, positive predictive value and negative predictive value of FNAC of lymphadenopathies to diagnose tubercular lymphadenopathies were 80.0%, 100.0%, 0.0%, 20.0%, 100.0% and 82.14% respectively. Similarly, sensitivity, specificity of FNAC of lymphadenopathies to differentiate benign and malignant lesion were 100% each. False positive, false negative, positive predictive value and negative predictive value were 0.0%, 0.0%, 100.0% and 100.0% respectively. Overall correlation of FNAC and HPE was 90.9%.
FNAC can distinguish tubercular lymphadenitis from reactive and granulomatous lymphadenitis in majority of cases. Similarly, it can distinguish well between benign and malignant lymphadenopathies. It can be used as an initial investigation for routine screening of cervical lymphadenopathies where facilities of histopathology are not available.
淋巴结病是肺外结核病最常见的形式，在尼泊尔这样的发展中国家，结核性淋巴结炎是周围淋巴结病最常见的病因。本研究的目的是比较细针穿刺细胞学检查与组织病理学检查在诊断颈部淋巴结病中的结果。
这是一项前瞻性、纵向、对比研究，于2007年8月至2009年1月在加德满都TU教学医院的耳鼻喉科及头颈外科进行。纳入13岁及以上的患者。55例颈部淋巴结病患者同时接受了细针穿刺细胞学检查（FNAC）和组织病理学检查（HPE）。计算了敏感性、特异性、假阳性、假阴性、阳性预测值和阴性预测值。
55例患者中，48例为感染性起源的淋巴结病，7例为转移性疾病。大多数患者（n=20）年龄在23-32岁之间，男性多于女性。淋巴结病的FNAC诊断结核性淋巴结病的敏感性、特异性、假阳性、假阴性、阳性预测值和阴性预测值分别为80.0%、100.0%、0.0%、20.0%、100.0%和82.14%。同样，淋巴结病的FNAC鉴别良性和恶性病变的敏感性、特异性均为100%。假阳性、假阴性、阳性预测值和阴性预测值分别为0.0%、0.0%、100.0%和100.0%。FNAC与HPE的总体相关性为90.9%。
在大多数情况下，FNAC可以区分结核性淋巴结炎与反应性和肉芽肿性淋巴结炎。同样，它可以很好地区分良性和恶性淋巴结病。在没有组织病理学检查设施的情况下，它可以作为颈部淋巴结病常规筛查的初步检查方法。
