Comparative Evaluation of Cell Block Histopathology and Conventional Smear Cytology in FNAC of Clinically Suspected Cervical Lymph Node Malignancy

Introduction: Cervical lymphadenopathy is a common clinical presentation in various departments of clinical practice. Fine needle aspiration cytology (FNAC) is usually the first choice to diagnose superficial cervical lymphadenopathy. However, FNAC sometimes does not yield information for precise diagnosis, and the risk of false-negative and indeterminate diagnosis is always present. In order to overcome these problems, cell block technique has been resorted to make the best use of the available material. Objective: The aim of this article is to evaluate whether there are any diagnostic advantages of cell block histopathology over conventional smear cytology by corroborating with excisional biopsy. Materials and Methods: A descriptive study with cross-sectional design was performed among 106 cases with clinical suspicion of malignancy. FNAC was performed without anesthesia, and the aspirated material was flushed on slides and then fixed immediately. The remaining materials were processed into cell blocks followed by HE staining. The data obtained were analyzed using SPSS (IBM Statistics, Version 20.0, SPSS, Chicago, IL, USA) statistical software. Ethical approval was obtained from the Institutional Ethics Committee, and informed consent was taken from all the participants before the procedure. Results: Out of the 106 cases, 101 (95.28%) cases were diagnosed as malignant lesions and 5 (4.72%) cases diagnosed as non-malignant lesions. The majority of the patients were in the 40–59 year age group and were males. The sensitivity of cytology to provide specific diagnosis in malignant lesions was 90.57%, whereas those of cell block histopathology and cell block histopathology with cytology were 94.34% and 98.11%, respectively. Conclusion: Cell block as an adjunct to FNAC can be a useful diagnostic technique in cervical lymphadenopathy. Compared with FNAC, it gives more accurate diagnostic architecture and apparent histopathological features.