Lymph node enlargement can have different causes, so a special examination is often required for an accurate diagnosis. Lali Gogniashvili, a doctor-cytologist from the Institute of Clinical Oncology, talks about the importance and features of cytological examination.

Enlarged lymph nodes are a common symptom of various diseases. The cause may be a viral, infectious, or cancerous process. In such cases, a detailed examination of the enlarged or damaged lymph nodes is necessary to determine the exact cause of the enlargement and provide timely treatment.

Various methods are used for diagnosis. Although histomorphological and immunohistochemical studies of tissue obtained from lymph nodes are preferred for complete diagnosis of lymph nodes, fine-needle aspiration biopsy (FNA) of easily accessible, structurally altered, and enlarged (hypertrophic) lymph nodes in the subcutaneous and soft tissues is more often performed. Though the material obtained by aspiration is less than the tissue collected by a node biopsy, it often provides enough information to determine the nature of the disease.

Cellular material collected by aspiration is stained by various methods after fixation, and the interpretation of such preparations, in many cases, allows for the assessment of the pathological process at the cellular level: reactive (lymphadenitis of various etiologies, hyperplasia, etc.) or tumoral. It is also possible to differentiate tumoral diseases, e.g., to distinguish malignant lymphoma from metastatic lesions.

Fine-needle aspiration biopsy of lymph nodes is usually performed under ultrasound guidance (control under an ultrasound monitor), which allows the removal of material for examination from the target lymph node or a certain area of it, or, in the case of multiple nodes, the selection of a structurally altered, noteworthy lymph node. This method is particularly effective in detecting metastatic lymph nodes in breast cancer (or other tumors).

Recently, lymph node enlargement caused by viral infections often symptomatically repeats the clinical picture of lymphoproliferative diseases. In such cases, cytomorphological examination obtained through fine-needle aspiration biopsy is a rapid and effective tool for differential diagnosis, which helps both the clinician and the patient to save time and resources and make a timely decision on treatment tactics.