Eurocytology, Module n.4: Lymph node Cytology

Lymph nodes were probably the first organs to be investigated by fine needle cytology (FNC) and the last in which this technique has been accepted by clinicians as a useful diagnostic procedure. Risk of seeding, false negatives, failure to discriminate between reactive hyperplasia and lymphoma, have been put forward as a limitation or useless of FNC. Nonetheless, as this technique is fast, inexpensive and effective, it is often required by general practitioners, specialists and surgeons as first diagnostic approach to lymph nodes; moreover, ancillary techniques such as immuocytochemistry, flow cytometry, fluorescence in situ hybridization and molecular techniques are successfully employed on cytological samples, conferring to FNC of lymph nodes credibility and a definite role in the diagnosis of lymphadenopaties. There are exhaustive books and excellent articles providing lymph nodal cytopathologists with the necessary knowledge of the different pathologies encountered, and the limitations of the technique; however, a small dose of audacity is also a useful complement when practicing this field of cytology.