The diagnostic value of fine needle aspiration cytology in hematology: a study of 40 cases

Fine-needle aspiration cytology (FNAC) is a simple and safe procedure that has proven to be accurate in the diagnosis of a variety of neoplasms. It is performed in an outpatient setting, and results are routinely available within 24 hours. To evaluate the diagnostic value of FNAC in the assessment of lymph nodes, we conducted a prospective study of patients with no history of previews malignancy, who underwent FNAC of an enlarged lymph node, during the period of January 2010 through June 2011. Cytologic findings were correlated with either histologic findings, clinical information, or both. Sensibility, specificity, and predictive values in differentiating between benign and malignant lymphadenopathy were high (81-92%). False negative results could be explained by the fact that pathology may be focal rather than widespread and therefore not seen on a cytologic smear. FNAC has become an integral part of the initial diagnosis and management of patients with persistent lymphadenopathy. However, the most important limitations are the high percentage of inadequate material (37%). Sensitivity and specificity are to be improved in our practice by improving the adequacy of the sampling, as well as the skill, experience, and familiarity of the cytopathologist.