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- Title
A Novel Approach to Classification and Reporting of Lymph Node Fine-Needle Cytology: Application of the Proposed Sydney System.
- Authors
Vigliar, Elena; Acanfora, Gennaro; Iaccarino, Antonino; Mascolo, Massimo; Russo, Daniela; Scalia, Giulia; Della Pepa, Roberta; Bellevicine, Claudio; Picardi, Marco; Troncone, Giancarlo
- Abstract
Fine-needle cytology (FNC) is a useful diagnostic tool in the first line evaluation of lymphadenopathy of unknown aetiology. Nevertheless, considering the large number of conditions presenting as lymphadenopathy, lymph node cytology represents a challenging scenario. Recently, an expert panel published the proposal of the Sydney system for performing classification and reporting of lymph node cytopathology; the aim of the present study was to evaluate the applicability of this system. Thus, 300 lymph node FNCs performed over 1 year were reviewed and categorized according to the Sydney system classification. Overall, n = 20 cases (6.7%) were categorized as L1-inadequate/non-diagnostic; n = 104 (34.7%) as benign (L2); n = 25 (8.3%) as atypical (L3); n = 13 (4.3%) as suspicious (L4), and n = 138 (46%) as malignant (L5). FNC diagnoses were correlated with histopathologic and clinical follow-up to assess the diagnostic accuracy and the risk of malignancy (ROM) for each diagnostic category. Statistical analysis showed the following results: sensitivity 98.47%, specificity 95.33%, positive predictive value 96.27%, negative predictive value 98.08%, and accuracy 97.06%. The ROM was 50% for the category L1, 1.92% for L2, 58.3% for L3, and 100% for L4 and L5. In conclusion, FNC coupled with ancillary techniques ensures satisfactory diagnostic accuracy and the implementation of the Sydney system may improve the practice of cytopathologists.
- Subjects
LYMPH nodes; LYMPHADENITIS; CYTOLOGY; DIAGNOSIS; CLASSIFICATION; STATISTICS
- Publication
Diagnostics (2075-4418), 2021, Vol 11, Issue 8, p1314
- ISSN
2075-4418
- Publication type
Article
- DOI
10.3390/diagnostics11081314