1Mohammed Alsaleh

1King Fahad Specialist Hospital

Background(s):

To assess the diagnostic adequacy, failure, and repetition rates of the cervical lymph nodes fine needle aspiration sampling, as well as the different factors affecting its diagnostic yield at King Fahad Specialist Hospital in Dammam, Saudi Arabia.

Material(s) and Method(s):

This is a single center retrospective study that was evaluating all included patients who underwent fine needle aspiration (FNA) for the diagnosis of cervical lymphadenopathy at King Fahad Specialist Hospital at Dammam in the period between June 2018 to June 2020. The data is collected from Picture Archiving Communication System (PACS), and electronic patient file and record (Medicaplus software). Approval for the study has been obtained from The Ethical Committee of King Fahad Specialist Hospital, Dammam, Saudi Arabia. SPSS was used to analyze the data.

Result(s):

The study included 98 patients; 64.3% of our patients were females, and 38.8% were younger than 40 years old. The most common size of the needle used was 22G (79.6%). The diagnostic accuracy rate was 77.6%. 22.4% were inconclusive necessitating a repeat sampling. The use of 22G needle appears to increase the likelihood of inconclusive sample when compared to 25G needle, however this difference did not appear to be statistically significant. History of prior thyroid cancer appears to significantly correlate with the rate of malignant FNA (P-value 0.014).

Conclusion(s):

Ultrasound guided FNA appears to be accurate in the diagnosis of cervical lymphadenopathy with an accuracy rate of 77.6% with approximately 22.4% of the study cohort requiring a repeat sample which were all benign on repeat sampling. History of prior thyroid cancer appears to significantly correlate with the rate of malignant FNA. The rate of of inconclusive sample appears to show a trend of being affected by the needle size although this was not statistically significant and a further prospective randomized trial with larger sample size is warranted to assess this effect.