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Cytology: lymph node aspirate

ISSN 2398-2950


Synonym(s): Fine needle aspiration

Overview

  • Lymph node aspirate cytology is a useful tool to identify the underlying cause of lymphadenopathy without the need for anesthesia.
  • Fine needle aspirate cytology can distinguish between hyperplasia, lymphoma Lymphoma    Skin: lymphocytic neoplasia, lymphadenitis, infectious agents, reactive nodes and metastatic neoplasia.

Uses

Alone

  • Identify the presence of metastasis.

In combination

  • Cytological examination of lymph nodes in combination with peripheral blood, bone marrow and enlarged extra nodal sites is useful for clinical staging of lymphoma, which is a well established prognostic indicator.
  • Immunocytochemistry can be applied to the atypical lymphoid population seen on light microscopy to determine B or T cell phenotype, for prognostic purposes.

Sampling

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Tests

Methodologies

Availability

  • Aspirates can be examined immediately in practice by a veterinarian experienced in cytology.
  • Widely available at commercial laboratories.

Validity

Sensitivity

  • Excellent if representative sample is obtained.

Specificity

  • Excellent if representative sample is obtained.

Predictive value

  • Tumor metastasis in dogs and cats with solid tumors, can reliably be identified by cytological examination with 100% sensitivity and 96% specificity (Langenbach A et al, 2001).

Technique intrinsic limitations

  • In patients with multicentric lymphadenopathy it is useful to aspirate more then one lymphnode as submandibular lymphnodes are often very reactive and prescapular lymph nodes may contain large amounts of cell free fat which increases the fragility of lymphocytes, although the latter is more of a problem in canine patients.
  • Tissue architecture is not represented in cytological preparations, may require confirmation by histology Lymphoma.

Technician extrinsic limitations

  • Incorrect sampling tools or technique.
  • Poor slide preparation, ie cells poorly distributed or ruptured.
  • Inexperience in interpretation.

Result Data

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Further Reading

Publications

Refereed papers

  • Recent references from VetMedResource and PubMed.
  • Amores-Fuster I, Cripps P, Graham P, Marrington A M & Blackwood L (2015)The diagnostic utility of lymph node cytology samples in dogs and cats. JSAP 56, 125-129 PubMed.
  • Langenbach A et al (2001) Sensitivity and specificity of methods of assessing the regional lymph nodes for evidence of metastasis in dogs and cats with solid tumours. JAVMA 218, 1424 1428 PubMed.

Other sources of information

  • Raskin R A & Meyer D J (2001) Eds. Atlas of Canine and Feline Cytology. 1st edn. W B Saunders Company publication, USA.
  • Baker R & Lumsden J H (2000) Eds. Colour Atlas of Cytology of the Dog and Cat. 1st edn. Mosby publications, USA.
  • Cowell R L et al (1999) Diagnostic Cytology and Haematology of the Dog and Cat. 2nd edn. Mosby publications, USA.

Further Reading