Comparative and Evaluative Study of Fine Needle Aspiration Versus Capillary Sampling Techniques in Superficial Lymph Nodes

Abstract

Background: Fine needle aspiration cytology (FNAC) is a well established widely used primary diagnostic modality in both neoplastic and non-neoplastic conditions of superficial and deep seated mass lesions. Fine needle capillary sampling (FNCS) has been attempted in various organs and studies have shown this procedure to yield qualitatively superior material compared with FNAC. Studies evaluating the efficacy of this technique in lymph nodes are rare. The present study has been attempted to compare the efficacy of FNCS with that of FNAC of superficial lymph node lesions. Materials and Methods: Both the tecniques were conducted in 50 randomly selected superficial enlarged lymph nodes. All needle sampling procedures were done by single operator. All the smears were evaluated according to objective scoring system devised by Mair et al. The score of individual parameters in each case as well as total scores for FNCC and FNAC procedures were calculated separately. Diagnosis was confirmed by histopathological examination. Result: Greater number of diagnostically superior samples were obtained by FNCS, however FNAC yielded more number of diagnostically adequate smears. FNCS scored marginally over FNAC in all the parameter except for amount of cellular material. Total score and average score per case by FNCS were slightly higher than by FNAC and difference was statistically significant. The diagnostic accuracy was higher for FNAC(86.3%) than by FNCS (81.8%). Conclusion: FNCS offers a distinct advantage of diagnostically better quality smears but FNAC assures diagnostically adequate material quantitatively. Our study proved the technical superiority of the FNCS technique in cellular lymph node lesions, emphasizing the need for the less publicised procedure to be more widely applied.

Keywords

• aspiration cytology
• capillary sampling
• fine needle
• lymphadenopathy
• non aspiration