Background: Fine Needle Aspiration Cytology (FNAC) is a reliable and least expensive method suitable for developing countries like India for the investigation of cervical lymphadenopathy. Knowledge about the pattern of lymphadenopathy is useful in pathological reporting as well as in many clinical settings with diagnostic dilemma. This is a baseline study to investigate the pattern of cervical lymphadenopathy by FNAC in a  population of eastern U.P. The objective was to study the  distribution of various diseases in cervical lymphnodes  based on age,sex,predeliction for site and duration of symptoms in all age groups.

Methods: A retrospective study of  one year duration was conducted at the Heritage Institute Of Medical Sciences,Varanasi by analyzing the case reports on cervical lymph node FNAC of patients all age groups and both genders having the neck swelling for more than four weeks. Review of all cytological reports were done according to standard guidelines and the diagnosis was classified and correlated with patients’ age and other relevant  parameters to explore the pattern and association.

Results: This study showed that the incidence of cervical lymphadenopathy was maximum in age range of 15–59 years with male preponderance.Reactive lymphoid hyperplasia was most prevalent diagnosis on cytological evaluation.Non neoplastic conditions were more common in first three decades of life while malignancies(primary or metastatic) were more common in elderly population.

Conclusions: From this study it can be concluded that in cervical lymphadenopathy clinical evaluation followed by FNAC is most  reliable diagnostic tool, which is  easy to perform, cost effective, speedy  and accurate results can be obtained. The technique reduces the need for more invasive and costly procedures, especially in a Third World country. Culture and histopathology, however, should be considered in cases where repeated fine–needle aspiration cytology is non–diagnostic.