Abstract
Background
Accurate staging of lung cancer is essential for appropriate treatment planning. Supraclavicular lymph nodes are commonly involved in advanced disease and are easily accessible for sampling. Ultrasound-guided fine needle aspiration cytology (US-FNAC) provides a minimally invasive method for their evaluation.
Objectives
This study aims to evaluate the diagnostic performance of ultrasound-guided fine needle aspiration cytology (US-FNAC) of supraclavicular lymph nodes in patients with suspected lung cancer.
Methods
This prospective study included 40 patients with suspected lung cancer and detectable supraclavicular lymph nodes. US-FNAC was performed under ultrasound guidance. Cytological findings were compared with histopathology from lung biopsy in 27 patients. Diagnostic indices were calculated.
Results
Among 40 patients, initial US-FNAC diagnosed 28 malignant, 5 suspicious, 6 benign/reactive, and 1 inadequate. Repeat FNAC of suspicious cases yielded 4 malignant and 1 benign; the inadequate case was excluded. Histopathology (n = 27) confirmed 24 malignant and 3 benign lesions. Final FNAC correctly identified all malignant cases, misclassifying 1 benign case. The diagnostic performance showed a sensitivity of 100%, specificity of 66.7%, positive predictive value of 96%, negative predictive value of 100%, and an overall accuracy of 96.3%.
Conclusions
US-FNAC is a highly sensitive and reliable technique for detecting metastatic lung cancer. Despite occasional false-positive findings, it remains a valuable tool for staging and guiding clinical management.
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