Significance of fine-needle aspiration biopsy of peripheral lymph nodes upon the initial presentation of patients with lymphadenopathy of unknown etiology

Fine-needle aspiration biopsy is safe, simple, cost-effective and efficient technique providing rapid information and, therefore, directing further approach to a patient. Its findings are especially beneficial for verification of lymphoid origin of the enlarged growth, diagnostics and differentiation of metastatic, infectious, reactive and lymphomatous conditions; determination of the extent of tumor; detection of recurrence; monitoring of the course of disease; obtaining of material for special studies such as microbiological cultures, immunological or genetic studies as well as electron microscopy; in addition, for encouragement of patient in case of benign nature of the disease. At the Institute of Hematology, in three-year period, a total of 193 fine-needle aspiration biopsies were performed in 172 patients with the enlarged peripheral lymph nodes. Technically, aspiration biopsy was successful in 175/193 attempted interventions (91%). Punctates were analyzed by cytomorphology and subsequently compared with histopathological findings. In indistinguishable cases, additional immunocytochemical streptavidin-biotin peroxidase staining was carried out. In our studies, immunocytochemical analysis was performed in 63 out of 81 patients (78%), and diagnostic accuracy was 93.6% what was compatible with the results of other authors. It significantly corrected the earlier cytomorphological-histological congruence that used to be 83%. Immunocytochemistry has contributed to diagnostic value of cytological analysis of punctate, before all, in view of its higher diagnostic accuracy, which, according to majority of authors, is about 90%