Misdiagnosis of cervical lymph node lesions by fine-needle aspiration cytology / 医学研究生学报

ABSTRACT

Objective Cervical lymph node enlargement may be attributed to inflammation or tumors .This study was to analyze the pitfalls in fine-needle aspiration cytology ( FNAC) of cervical lymph nodes and the measures for avoiding misdiagnosis of cervical lymph node lesions . Methods We retrospectively analyzed the data about 435 cases of FNAC in comparison with the results of corre-sponding tissue biopsies in cervical lymph nodes . Results Among the 435 cases, 7 showed disagreement between the results of cytolog-ic and histologic diagnoses, which included 5 males and 2 females, at the age of 41 to 71 (58.4 ±8.9) years.Six of the cases presented with local lymph node enlargement and 1 with generalized lymphadenopathy, all with enlarged lymph nodes palpable 1-4 cm in diameter . Based on the results of FNAC, 1 case of malignant lymphoma was misdiagnosed as lowly differentiated adenocarcinoma, 1 case of lympho-ma misdiagnosed as poorly differentiated metastatic carcinoma, 2 cases of lymphoma diagnosed as lymphoproliferation and recommended for biopsy, 1 case suggestive of malignant tumor without further classification, and 2 cases microscopically characterized and recommended for lymph node biopsy.Compared with the results of the biopsy, FNAC achieved a 99.3%coincidence rate of qualitative diagnosis (432/425), with a misdiagnosis rate of 1.6%(7/435). Conclusion FNAC plays a very important role in the initial identification of the nature of lymph node lesions and the type of tumors.Practiced puncture skills and intimate knowledge about the histopathological features, diagnostic criteria, and differential diagnosis of the lymphatic system disorders are essential for improving the diagnostic accuracy of FNAC .