Abstract

FNAC is a safe, reliable, cost-effective, and efficient method for initial screening of patients with cervical lymphadenopathy. Aims: The purpose of this study was to identify cytomorphological features and to evaluate the diagnostic efficacy of FNAC as a screening tool for cervical lymphadenopathy. Materials and Methods: A study included 952 cases of FNAC, with 215 cases being compared to histological diagnosis. Subsequently, discordant cases, including both false negatives and false positives, were retrospectively re-evaluated. Additionally, a thorough review of previous research on the factors that contribute to misdiagnosis was conducted. Results: Discordance was found more in benign lesions (12.4%) as compared to malignant lesion aspirates (4.9%). When suspected malignant and malignant group are all classified as cytologically positive, the sensitivity and specificity are 97.3% and 95.8% respectively. Overlapping cytological features, heterogeneity, unsampled areas and error in interpretation were the primary factors contributing to false positive and false negative diagnosis. Conclusion: FNAC of cervical lymphadenopathy is a precise, sensitive, and specific initial diagnostic procedure. However False-negative diagnoses are mainly due to issues with the specimens obtained, while false-positive diagnoses are primarily caused by errors in interpretation. Experienced cytopathologists are expected to analyze the outcomes of FNAC while considering the accompanying clinical, radiographic, and laboratory information. In cases where there is ambiguity in the interpretation of these results, additional investigations and ancillary technique are essential to address potential misdiagnoses.

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