Comparative Evaluation of Cell Block Histopathology and Conventional Smear Cytology in FNAC of Clinically Suspected Cervical Lymph Node Malignancy

Abstract

Introduction: Cervical lymphadenopathy is a common clinical presentation in various departments of clinical practice. Fine needleaspiration cytology (FNAC) is usually the first choice to diagnose superficial cervical lymphadenopathy. However, FNAC sometimesdoes not yield information for precise diagnosis, and the risk of false-negative and indeterminate diagnosis is always present. In orderto overcome these problems, cell block technique has been resorted to make the best use of the available material. Objective: The aimof this article is to evaluate whether there are any diagnostic advantages of cell block histopathology over conventional smear cytologyby corroborating with excisional biopsy. Materials and Methods: A descriptive study with cross-sectional design was performed among106 cases with clinical suspicion of malignancy. FNAC was performed without anesthesia, and the aspirated material was flushedon slides and then fixed immediately. The remaining materials were processed into cell blocks followed by HE staining. The dataobtained were analyzed using SPSS (IBM Statistics, Version 20.0, SPSS, Chicago, IL, USA) statistical software. Ethical approval wasobtained from the Institutional Ethics Committee, and informed consent was taken from all the participants before the procedure.Results: Out of the 106 cases, 101 (95.28%) cases were diagnosed as malignant lesions and 5 (4.72%) cases diagnosed as non-malignantlesions. The majority of the patients were in the 40–59 year age group and were males. The sensitivity of cytology to provide specificdiagnosis in malignant lesions was 90.57%, whereas those of cell block histopathology and cell block histopathology with cytologywere 94.34% and 98.11%, respectively. Conclusion: Cell block as an adjunct to FNAC can be a useful diagnostic technique in cervicallymphadenopathy. Compared with FNAC, it gives more accurate diagnostic architecture and apparent histopathological features.