CORRELATION OF CYTOLOGY WITH THE HISTOPATHOLOGY IN BENIGN AND MALIGNANT LESIONS OF LYMPH NODES

Background & Objectives: Lymph node swellings are one of the commonest clinical presentation of patients and it encompasses a wide spectrum ranging from benign lesions to a malignant lymphoma or a more obnoxious metastatic malignancy. The objective of the study was to study the role of FNAC in the evaluating lymph node swellings of cervical , axillary , supraclavicular in the body and to understand the various cytological patterns of FNAC in correlation with histopathology of lymph node swellings. Methods: Patients referred to the Department of Pathology, CAIMS ,karimnagar from cancer Hospital and its allied branches, for palpable lymph node swelling on whom FNAC procedure was performed were included in the study. FNAC diagnosis of patients was compared with histopathology in cases which underwent surgical excision and its diagnostic accuracy was studied. Results: Out of 280 cases which included in the study, lymph node biopsy was carried out in 150 cases, 4 cases were inconclusive. Most were in 31 to 40 years. Gender wise, there was female preponderance. Cervical group of lymph node were most affected. Benign /non neoplastic lymphadenopathies were diagnosed in 83 cases(55.5%) of cases. Metastatic deposits were diagnosed in 28 cases(18.6%) of cases. Lymphomas contributed to 39 cases(26%). On correlation of FNAC ndings with histopathology. The overall correlation rate was 97.33%. Interpretation & Conclusion: FNAC of lymph nodes is an excellent rst line method to investigate the nature of lesions as it is economical and an easy alternative to open biopsy

Prospective Comparison of [18F]Fluorodeoxyglucose Positron Emission Tomography and Computed Tomography in Patients With Melanoma With Palpable Lymph Node Metastases: Diagnostic Accuracy and Impact on Treatment

Purpose Patients with melanoma with potentially resectable lymph node metastases require accurate staging to prevent unnecessary surgery. [18F]Fluorodeoxyglucose (FDG) positron emission tomography (PET) is attractive for this because melanoma typically is FDG avid. The aim of this prospective multicenter study was to perform a head-to-head comparison of FDG-PET and computed tomography (CT) in staging of patients with melanoma with palpable lymph node metastases in terms of diagnostic accuracy and impact on treatment. Patients and Methods All consecutive patients with palpable, proven lymph node metastases of melanoma between mid 2003 and 2007 were prospectively included. The number/site of distant metastases detected with FDG-PET and CT were recorded. Histology/cytology or 6 months follow-up were the reference standard. Intended and performed treatment was recorded. Results Distant metastases were suspected by FDG-PET in 32% of the 251 patients and by CT in 29% (P = .26). Upstaging was correct in 27% by FDG-PET and in 24% by CT (P = .18). FDG-PET detected more metastatic sites (133 v 112, P = .03), detecting significantly more bone and subcutaneous metastases. Treatment changed in 19% of patients; in 79% as a result of both scans, in 17% exclusively by FDG-PET, and in 4% exclusively by CT. In 34 patients (14%), FDG-PET had an additional value over spiral CT, and in 23 patients (9%), CT had additional value over FDG-PET. Conclusion As a result of FDG-PET and CT, 27% of patients were upstaged, and treatment changed in one of five patients. FDG-PET and CT are equivalent in upstaging; however, FDG-PET detected more metastatic sites, especially bone and subcutaneous. FDG-PET and/or CT are indicated in the staging of patients with melanoma with palpable lymph node metastases.