1- Introduction :
– lymph node FNA, is a simple technique, painless when practiced fine needle, allowing in some cases to avoid lymph node biopsy.
These benefits are undeniable, but the interpretation must be prudent and take into account the size of the ganglion, its consistency, its location, and the clinical context, wherein practiced FNA.
– a device node accessible to the puncture is an enlarged lymph node.
L & rsquo; increased volume of the ganglion may be a reaction to infectious diseases.
In tumor pathology (lymphoma and metastases) ganglion is home d & rsquo; diffuse infiltration or partial, at the expense of normal structures.
2- Technical puncture :
the puncture is :
– Immobilizing the node between two fingers
– the puncture is made with a thin and short needle, by repeated outward and return to the node, accompanied by & rsquo; s rotation & rsquo; needle to loosen the cell sap.
L & rsquo; without aspiration needle is removed so as not to alter the morphology of the cells.
The content of & rsquo; needle is then projected onto one or two blades and spread.
L & rsquo; operation can be reproduced a 2nd and 3rd time in another node area.
L & rsquo; suction can be recommended in case of necrosis, or when the node is fibrous constitution, to d & rsquo; obtain cellular material, which while impaired can guide diagnosis.
3- Smear Analysis :
– situations or cytology is suggestive of the diagnosis
A- follicular hyperplasia :
C & rsquo; is the most common situation, smear is polymorphic, compound B cell,lymphocytes T,dendritic cells, macrophages.
This aspect s & rsquo; bacterial infections observed in court, viral.
– toxoplasmosis : FNA shows a table d & rsquo; hyperplasia (absence of interference).
– Infectious mononucleosis : presence of lymphocytes, lymphoblastes ; immunoblastes, plasmocytes.
– Infection with HIV : the presence of & rsquo; lymphadenopathy is a reaction related pathology (opportunistic infection, or a tumor).
B- Adénite granulomateuses :
Characterized by hyperplasia of epithelioid cells (histiocytic cells, large size has cytoplasm éttendu, claire, very limited, the core is elongated or oval, regular chromatin,with one or two small nucleoli.
Granulomatous lymphadenitis are represented by the node sarcoidosis tuberculosis
Cat's claw disease
C- no lymph node swelling :
It can s & rsquo; act :
– cyst, Pathology of the salivary glands, sweat glands.
D- tumor pathology :
s can & rsquo; act :
– lymphoma (malin hodgkinien, or not hodgkinien)