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Pediatric Lymphadenopathy: Cytological Diagnosis Over a Period of Two Years in a Rural Teaching Hospital

Background: Lymphadenopathy (LAP) is a common clinical presentation seen in pediatric patients attending the outpatient department. The etiology of LAP varies from a benign process to malignancy. Fine needle aspiration cytology (FNAC) is a very rapid and easy to perform diagnostic test. Majority of cases can be diagnosed and managed on FNAC without need of histopathology. The aim of this study was to evaluate the role of FNAC in diagnosis of superficial LAP in pediatric population.

Methods: This retrospective study was carried out over a period of two years from January 2015 to December 2016 in the department of Pathology, Dr. RPGMC, Tanda, Himachal Pradesh, India. All cases of superficial LAP seen in pediatric population where FNAC was performed were included in the study.

Results: A total of 357 lymph nodes were aspirated in pediatric population during the study period. Majority of cases (98%) were benign. The results were categorized into three broad categories as reactive lymphadenitis (296; 82%), granulomatous lymphadenitis (56; 16%) and malignancy (05; 02%). The five cases of malignancies identified in this population comprised of two cases each of Hodgkin’s Lymphoma (HL) and Non-Hodgkin’s Lymphoma (NHL). One case was diagnosed as metastasis from papillary carcinoma thyroid.

Conclusion: FNAC should be considered as a first line investigation for evaluating the peripheral LAP in pediatric population. The main etiology of LAP is reactive lymphadenitis. Majority of these cases can be diagnosed and managed on FNAC alone. FNAC can play a key role in triage of appropriate cases, so that these patients may be further investigated to make a diagnosis or for referral to higher centers.

Author(s): Manupriya Sharma, Aruna Gupta and Rashmi Kaul

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