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Fine-needle aspiration of lymphadenopathy of suspected infectious etiology
Abstract:
We present a protocol for culture of lymph node find-needle aspirations in a series of 44 patients. Clinical indications for inclusion in the protocol included fever, localized erythema, pain or heat, an independent clinical diagnosis of infection by the referring physician, or a grossly purulent appearance of the initial aspirate material. Organisms (fungi, bacteria, or mycobacteria) were isolated in 13 (30%) of the aspirates. The probable contamination rate was 9%. These figures approached the culture yields obtained from open biopsy specimens as reported in the literature. A notable discrepancy existed between the cytologic appearance of the aspirates and culture results in three cases of mycobacteria. Six unsuspected malignancies were diagnosed. There were no complications from the procedure in this series. Based on this study, we present recommendations for culture of fine-needle aspirates from lymph nodes.
Insights
Culturing lymph node fine-needle aspirates (FNA) is effective for diagnosing infections, yielding organisms in 30% of cases with a low contamination rate. This protocol offers valuable insights for clinical practice.
Area of Science:
- Medical Microbiology
- Diagnostic Cytopathology
- Infectious Diseases
Background:
- Lymph node fine-needle aspiration (FNA) is a minimally invasive diagnostic tool.
- Infection is a common indication for lymph node aspiration.
- Optimizing culture techniques for FNA specimens is crucial for accurate diagnosis.
Purpose of the Study:
- To present a standardized protocol for culturing lymph node fine-needle aspirates.
- To evaluate the diagnostic yield and safety of this protocol.
- To establish recommendations for lymph node FNA cultures.
Main Methods:
- A protocol for culturing lymph node FNAs was applied to 44 patients.
- Inclusion criteria included clinical signs of infection or purulent aspirates.
- Organisms were identified using standard microbiological techniques.
Main Results:
- Organisms were isolated in 13% (30%) of aspirates, including fungi, bacteria, and mycobacteria.
- The probable contamination rate was 9%.
- Six unsuspected malignancies were diagnosed, and no complications occurred.
Conclusions:
- Lymph node FNA cultures can achieve yields comparable to open biopsy specimens.
- The protocol is safe and effective for diagnosing lymph node infections.
- Recommendations for optimizing lymph node FNA culture are provided.