The cytological Aspect of Clinically Concerned Supraclavicular lymphadenopathy- a Prospective Study

Aims: The purpose of the study was to find out the distribution of various diseases in supraclavicular lymphadenopathy by fine-needle aspiration cytology (FNAC) and to study cytomorphological findings in detail.

Study Design: The present study was a prospective study.

Place and Duration of Study: Department of Pathology, Dr. DY Patil medical college and research centre, DY Patil Vidyapeeth, Pune, Maharashtra, India. The study was conducted over a period of 2 years (i.e., September 2019 to August 2021).

Methodology: Fine needle aspirations (FNA) were performed in 50 cases of supraclavicular lymphadenopathy after obtaining written consent. The cytomorphological features of stained smears were studied in detail.

Results: A total of 50 aspirates were studied. The male to female ratio found was 2:3. The age of the patients ranged from 9 yrs to 81 yrs. The maximum number of cases were found in the elderly (>60 yrs). A predominance of right-sided lymphadenopathy was seen. Diagnosis based on FNAC findings were categorized as metastatic deposits (34% cases), tubercular lymphadenitis (16% cases), reactive lymphadenitis (14% cases), granulomatous lymphadenitis (14% cases), acute suppurative lymphadenitis (12% cases), necrotizing lymphadenitis (8% cases) and one NHL (2% case).

Squamous cell carcinoma (14% cases) was the most commonest metastatic lesion followed by adenocarcinoma (10% cases). Common primary sites were the breast, lung, and gall bladder for adenocarcinoma, whereas the oesophagus and tongue for squamous cell carcinoma.

Conclusion: Supraclavicular node was well known for metastasis but non-malignant cause like tuberculosis is frequently found in developing countries. Enlarged supraclavicular nodes suggest some underlying pathology and chances of malignancy increase with the age of the patient. FNAC can be used as a first-line investigation for diagnosis because of its simplicity, cost-effectiveness, and efficacy to rule out metastasis.