Abstract
We studied the usefulness of a new reporting system for neck lymph node cytology which replaces the Papanicolaou system, similar to the one now used for the salivary, thyroid, or mammary gland. The new reporting system has simplified categories and encourages the addition of a suggested diagnosis where possible. We retrospectively reviewed the charts of 88 cases that underwent neck lymph node biopsy. Fine-needle aspiration cytology (FNAC) was performed in 33 of the 88 cases. Only adequate cytology samples with sufficient quality were given one of the four categories: negative, indeterminate, suspected malignancy, or positive. The histopathological diagnosis of the 33 FNAC cases was malignant lymphoma (20 cases), reactive hyperplasia (8), tuberculosis (3), and epithelial tumor (2, malignant in 1). The sensitivity and specificity were 55% and 100%, respectively. All the samples categorized as “indeterminate” in the new reporting system were classified as “class III” in the Papanicolaou system, and all the “suspected malignancy” samples as “class IV”. Therefore, the sensitivity and specificity of the new reporting system were considered to be equivalent to those of the Papanicolaou system despite the simplified reporting categories of the new system. Moreover, the new system with textual classification names has the advantage of being able to inform physicians more appropriately, than the Papanicolaou system which is characterized by numerical reporting, of the impossibility of further judgment based on a cytology specimen of the lesion.
