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<p>Lymph nodes are essential components of the human immune system, and lymph node lesions present considerable challenges for pathological diagnosis due to their complexity and heterogeneity. Conventional diagnosis mainly relies on histopathological examination of surgical specimens, whereas fine-needle aspiration cytology (FNAC) of superficial enlarged lymph nodes is a rapid, minimally invasive, and clinically valuable tool for preliminary etiological identification and targeted treatment planning. This study aimed to summarize the cytomorphological features of FNAC in four major categories of superficial enlarged lymph node lesions (lymph node reactive hyperplasia (LNRH), non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), and lymph node metastatic carcinoma (LNMC), evaluate the diagnostic efficacy of FNAC using histopathological results as the gold standard, and provide evidence-based references for clinical preliminary diagnosis and treatment decision-making. We retrospectively analyzed 133 consecutive cases of lymph node FNAC followed by surgical resection and histopathological confirmation at a single center from January 2023 to December 2024. FNAC smears were stained with Liu’s solution, histopathological sections with hematoxylin and eosin, and immunohistochemistry was applied for disease-specific marker detection. The overall diagnostic accuracy of FNAC was 89.47%. The sensitivity was highest for LNMC (95.52%, 95% CI: 87.23–98.97%), and the specificity was 100.00% for HL (95% CI: 97.19–100.00%). NHL showed a sensitivity of 80.95% and a positive predictive value of 84.00%, while LNRH had a negative predictive value of 90.91%. Chi-square test revealed significant intergroup differences in cellular atypia, cell distribution patterns, and characteristic cells among the four lesion types (<i>P</i> &lt; 0.001). In conclusion, FNAC is a moderately reliable minimally invasive screening tool for superficial enlarged lymph node lesions. Clarifying its diagnostic efficacy and distinct cytomorphological features provides valuable morphological and quantitative evidence for clinicians to conduct preliminary classification and formulate appropriate treatment strategies.</p>

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Retrospective single-center cytohistologic correlation study of fine-needle aspiration cytology for excised superficial enlarged lymph node lesions in different disease entities

  • 期刊论文

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  • 发表日期：

    2026年6月25日

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  • Xiang Shi,
  • Yingyuan Wangsun,
  • Yan Lei,
  • Sanyan Li

摘要

Lymph nodes are essential components of the human immune system, and lymph node lesions present considerable challenges for pathological diagnosis due to their complexity and heterogeneity. Conventional diagnosis mainly relies on histopathological examination of surgical specimens, whereas fine-needle aspiration cytology (FNAC) of superficial enlarged lymph nodes is a rapid, minimally invasive, and clinically valuable tool for preliminary etiological identification and targeted treatment planning. This study aimed to summarize the cytomorphological features of FNAC in four major categories of superficial enlarged lymph node lesions (lymph node reactive hyperplasia (LNRH), non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), and lymph node metastatic carcinoma (LNMC), evaluate the diagnostic efficacy of FNAC using histopathological results as the gold standard, and provide evidence-based references for clinical preliminary diagnosis and treatment decision-making. We retrospectively analyzed 133 consecutive cases of lymph node FNAC followed by surgical resection and histopathological confirmation at a single center from January 2023 to December 2024. FNAC smears were stained with Liu’s solution, histopathological sections with hematoxylin and eosin, and immunohistochemistry was applied for disease-specific marker detection. The overall diagnostic accuracy of FNAC was 89.47%. The sensitivity was highest for LNMC (95.52%, 95% CI: 87.23–98.97%), and the specificity was 100.00% for HL (95% CI: 97.19–100.00%). NHL showed a sensitivity of 80.95% and a positive predictive value of 84.00%, while LNRH had a negative predictive value of 90.91%. Chi-square test revealed significant intergroup differences in cellular atypia, cell distribution patterns, and characteristic cells among the four lesion types (P < 0.001). In conclusion, FNAC is a moderately reliable minimally invasive screening tool for superficial enlarged lymph node lesions. Clarifying its diagnostic efficacy and distinct cytomorphological features provides valuable morphological and quantitative evidence for clinicians to conduct preliminary classification and formulate appropriate treatment strategies.