Cytopathological Spectrum of Lesions in the Axilla - A Population Based Study from a Tertiary Care Centre in North-East India

Abstract

BACKGROUND The axilla is a triangular space between the lateral wall of thorax and the upper part of arm. The component of axilla can give rise to different diseases ranging from developmental and reactive to neoplastic. Various mesenchymal tissues present in the axilla can give rise to different lesions. Fine needle aspiration cytology (FNAC) is a safe, quick, easy, and a cheap diagnostic tool to decipher the benign or the malignant nature of the swelling. Imaging techniques and FNAC, both used individually or coupled, improve the accuracy of diagnosis and help in avoiding unnecessary invasive procedures. The most common lymph node lesion in axilla is benign reactive lymph node hyperplasia. It is caused by inflammation of the lymph nodes or the adjacent organs, such as the breast or lung. METHODS The present study is a retrospective review of swellings aspirated from axillary region. FNAC was performed following strict aseptic precautions. Inadequate aspirates were excluded from the study. The aspirated sample was blown on clean glass slides and smears were made using squash preparation. Smears were fixed using air dried and alcohol fixation method. Smears were stained with Giemsa stain, and the alcohol - fixed smears were stained with haematoxylin and eosin and Papanicolaou stains. Cytological smears were evaluated for adequacy, cellularity, type of cells, arrangement of cells and nuclear as well as cytoplasmic features. RESULTS A total of 191 axillary swelling were aspirated during the study period. Out of which 148 (77.5 %) cases were females and 43 (22.5 %) cases were males. Most common lesion was lipoma followed by axillary tail of breast. CONCLUSIONS Various pathological processes may affect the axilla. There is overlap in the imaging findings of these diseases. FNAC is a diagnostic tool which is required for conformation of diagnosis of axillary lesions. KEYWORDS Axillary Swelling, Fine Needle Aspiration, Lipoma