Background: Fine–needle aspiration cytology (FNAC) was proved to be a safe, reliable, rapid, and inexpensive diagnostic method in human pathology. It has a cardinal role in diagnosing different diseases involving lymph nodes including lymphoma, metastasis, recurrence and other reactive and inflammatory conditions. It is also very helpful in directing the patterns of further investigations and management in certain groups of patients based on the cytological diagnosis alone without resorting to surgical biopsies

Objectives: This study has been performed to further assess the reliability of FNAC diagnosis in lymph node diseases compared to histopathology and to determine whether FNA could replace tissue biopsies in certain cases; either in establishing diagnosis or in follow up and outlining further investigations and treatment plans.  Expanding the use of FNA as replacement for tissue biopsies –whenever possible– would be very helpful and useful for physicians, patients and the medical institute –as a whole– as it is cheaper, less invasive and carries a lower risk of complications.

This study aimed to verify the sensitivity of FNAC in correlation with histopathology.

Methods: This retrospective analysis was carried out on patients presented with cervical lymphadenopathy and underwent fine needle aspiration from January 2002–January 2014 at King Hussein Medical Center. Patient‘s medical record reviewed, only patients who had a comparative excisional biopsy of same lesion were included. Definitive results of FNAC were compared with the excisional biopsy results in order to establish a comparison of the two techniques. 

Results A total population of 194 patients were included in the final stage of the study. Fine–needle aspiration cytology was highly sensitive in diagnosing lymphomas 98.3%, less sensitive in cases of metastatic carcinoma and granulomas 85.4% and 81.2 % respectively. Fine–needle aspiration cytology was false negative in 29.8% of cases diagnosed as benign lymphadenopathy.

Conclusion: This study highlighted the usefulness of FNAC as a safe, reliable, rapid, and inexpensive investigation for lymphadenopathy. However, it was not a substitute for the conventional excisional biopsy but was complimentary to it.