Fine Needle Aspiration Cytology in the Diagnosis of Superficial Lymphadenopathy in Children and Adolescents: An analysis of 869 cases

Objective: Fine needle aspiration cytology (FNAC) in children has gained acceptance gradually and is currently used extensively as an initial diagnostic tool. This study was undertaken to determine the value of FNAC in peripheral lymphadenopathy in pediatric and adolescent patients in Kuwait. Design: Retrospective Setting: Mubarak Al-Kabeer Hospital, Kuwait Subjects: Eight hundred and sixty-nine children and adolescents (ranging from five months to 20 years) from January 2000 to September 2009 Intervention: FNAC Main Outcome Measure(s): The spectrum of disease of lymph nodes in pediatric and adolescent age groups, using FNAC Results: Out of the 4116 lymph node aspirates performed, the cytology reports of 869 (21.1%) pediatric aspirates were reviewed. There were 409 (51.3%) male and 388 (48.7%) female patients. Seventy-two (8.3%) were considered unsatisfactory. Out of the 797 (91.7%) satisfactory aspirates, reactive lymphoid tissue was reported in 616 cases (77.3%), lymphadenitis in 115 (14.4%), atypical cytology in 18 (2.3%), lymphoreticular malignancy in 46 (5.7%) and metastatic tumor in 2 (0.3%). The lymphadenitis included 8, 66, 23 and 18 cases of necrosis only, granulomatous lymphadenitis, necrotizing granulomatous lymphadenitis and tuberculous lymphadenitis (where acid fast bacilli were detected) respectively. Conclusions: FNAC of lymph nodes in children and adolescents is feasible and reliable. Majority of the nodes revealed reactive lymphoid tissue and helped allay the fears of parents thereby preventing unnecessary surgery.