BACKGROUND: Ultrasonography guided fine needle aspiration cytology has an important role in diagnosing lymphadenopathies. It has an accuracy of 70–90%,depending on the site under evaluation.Lymphadenopathy is one of the commonest clinical presentations of patients. It has a varied presentation, which varies from an inflammatory process to a malignant condition. USG guided Fine Needle Aspiration Cytology (FNAC) is an accurate, simple and an easy diagnostic technique in evaluation of the causes of lymphadenopathy, and the reports can be made available within an hour that will form the basis of treatment, decrease the number of surgical procedures and unnecessary surgical intervention.

OBJECTIVES: Analyzing and studying the cytological features in lymphadenopathy and categorize them with respect to aetiology, age, sex and site of occurrence, and to have a histopathological correlation of USG guided FNAC findings, wherever possible.

 METHODS: All patients referred to the Department of Pathology and Radiology of a secondary hospital for FNAC of the north east region ,of superficial and deep lymph nodes less than 1 cm were included in the study period ,were comprehended for the study. The patients were clinically evaluated and details were analyzed . FNAC was performed and their diagnosis made. The data was analysed.

RESULTS: Out of the total  24 guided cases only 03 aspirates were inadequate for reporting. Most of the cases were in the age group of 19 – 39 years, with a male preponderance. The most commonly involved were cervical group of nodes, with the deep–seated nodes least involved.81.33% of cases were diagnosed as benign lymphadenopathies, most of which were reactive lymphadenitis (49.44%). ZN stain for AFB was positive in 25.49% of cases with suspected tuberculosis. Maximum number of positive cases (58.75%) was found, when purulent material was aspirated.Microfilaria was found positive in  ( 4.3%)of the lymphadenopathies.Dual presentation of microfilaria with granulomatous lymphadenitis was seen in 4.3% cases. Histopathological data was available for only 2 cases as lymph node biopsy was not done and reffered to higher centres . 19 cases correlated well with FNAC.  Specificity of FNAC was 90%.

CONCLUSION: USG guided Fine Needle Aspiration Cytology (FNAC) is an accurate diagnostic technique in diagnosing aetiology of lymphadenopathies which is one of the commonest clinical presentations of patients attending a health care centre and which can have an inflammatory to a neoplastic aetiology. FNAC provides a speedy diagnosis which will help the clinician to confirm or exclude the clinical differential diagnosis made at first visit of the patient and helps him to further plan the treatment. With the advent of ultrasound and computerized tomographic machines, the evaluation of deep–seated lymph nodes has also become possible through Guided FNAC’s.