Lymph Nodes Cytology

Abstract

Lymphadenopathy, with or without history of malignancy, is often clinically concerning. However, complete surgical excision of an enlarged lymph node is not always practical for histological assessment. Fine needle aspiration is often performed first to determine whether the increase in the size of a lymph node is secondary to a benign or malignant process. While surgical excision may be subsequently performed, the advantage of an initial fine needle aspiration is that it’s a rapid assessment and can be done as a much less invasive procedure. Certain shortcomings are nonetheless associated with lymph node cytology. Sampling error is always a possibility whenever a negative cytology is obtained. Inaccurate “false-positive” diagnosis unfortunately is also a real possibility. Reactive or inflamed lymph nodes can yield cellular material with features that can strikingly resemble a neoplastic process. In this chapter, these features will be discussed along with recommendations on how to avoid these pitfalls.