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What Does My FNAC Test Report Indicate?

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Posted on Wed, 3 Aug 2016
Question: My FNAC of Right Cervical Lymph Node, Received 3 fixed unstained smears. Microscopic study says "Sparsely Cellular Smears show heterogenous population of reactive lymphocytes". "Granulomas are not seen".
FNAC of Cervical Lymph Node for Gram Stain shows "No pus cells seen, No Organisms seen"
FNAC of Cervical Lymph Node Zeihl Neelsen Stain Shows"AFB not seen"
doctor
Answered by Dr. T Chandrakant (54 minutes later)
Brief Answer:
As described below

Detailed Answer:
Hi.
Thanks for your information.
Please ask the query.
I have read and understood your history.
The FNAC of the cervical lymph node shows the following:
The reports shows the following with explanation, if this is the information an explanation you want:
- Sparsely cellular smears: means the spray o the aspirated material from the lymph node is sparse, not much but definitely sufficient for the reporting as indicated by the given reports.
- heterogenous means of different types
- population of reactive lymphocytes. This means there are more of lymphocytes (a type of white cells) seen in more quantity that that seen in normal lymph nodes.
Reactive means as a reaction to some challenge >
This challenge is not from Tuberculosis or any bacteria as seen in the smear as
seen on gram staining and ZN staining.

Hence this is a reactive lymphadenopathy.
Seen your other reports which show reduced hemoglobin of 7.70 in spite of normal RBC and platelet counts, Electrophoresis done.
For this you need further evaluation, diagnosis and treatment under the care of a Hematologist, a very specialized field.

I hope this answer helps you, please feel free to ask for further relevant queries if you feel that there is a gap of communication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (1 hour later)
Thank you very much for your detailed explanation.
Just wanted to confirm on few things:
How do we rule out whether is it due to Viral Infection
Secondly is there a risk of Cancer (Lymphomas and Leukamias)
Doctor they have also mentioned that Granulomas not seen. (Meaning)
doctor
Answered by Dr. T Chandrakant (3 hours later)
Brief Answer:
As explained below.

Detailed Answer:
Thanks for your appreciation.
- There is no confirmed way that can rule out or confirm whether this is due to viral infection. This is usually a diagnosis by exclusion.
- Risk of cancer or lymphoma can be ruled out only on Excision biopsy of the whole lymph node. FNAC takes the smallest possible sample and although it has very good sensitivity and specificity, full excision biopsy is recommended for confirmation of certain diseases as you have mentioned as this has to be a 'confirmed diagnosis'
- Granuloma is the name given for specific diseases for example, tuberculosis- when found is reported as tubercular granuloma.

I hope this answer helps you.
Please feel free to ask for further if you need to.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (14 minutes later)
Thank you doctor, but can we make out the risk of cancer if at all in the CBC. Sir what do you suggest at your end.
What can we find out by removing Excision Biopsy of the whole lymph node.
Sir you have mentioned "certain diseases" (Such As) to name a few.
Is it serious?

Thanks & Regards,
Burjese
doctor
Answered by Dr. T Chandrakant (10 minutes later)
Brief Answer:
Request your Doctors to go for confirmed diagnosis.

Detailed Answer:
CBC can tell only about Leukemia and such things.
Excision biopsy can give confirmed diagnosis.
Please try to go for the certain diagnosis, discussions can create confusions, increases stress and anxiety as nothing is certain till a confirmed diagnosis but one starts thinking about the unknown and most serious things. See you have another question about 'certain diseases'
Granulomas are not cancerous diseases and the list is long. The seriousness depends upon the final diagnosis so I request you not to go into into details if you
agree with me.

Request your Doctors to go for the certain diagnosis at the earliest as we discussed earlier. I think you Need to consult the Hematologist first.

I hope this answer helps you, please feel free to ask further relevant queries.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (19 days later)
Hello Doctor,
As per the last reply answered by you, we did a Core Biopsy & Gene Expert Test which revealed "Mycobacterium Tuberculosis complex detected" & Rifampicin is Susceptible.
Later we showed to Dr. Udwadia who advised the following TB Treatment:
Rcinex (450g) before breakfast
Benadon (40g) after breakfast
Moxicip (400g) after lunch
Combutol (800g) after dinner.
For Heamoglobin - Orofer XT (twice a day)
Vit C - Celin 500g (Twice a day).
Tab Rinifol once a day for 15 days
After taking the above medications the following symptoms are observed

Heaviness / Light headedness / Imbalance in the head
Ear pressure in both ears & closing of ears
Slight pain near both lower ribs
Puffiness in the face.
Drowsiness / fainting

Latest CBC reflects Chronic Anaemia - 7.9
Please advice at the earliest.
Thanks,
xxxxxxxxxxxxxxx
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
Get a clinical evaluation by a MD Med- Physician.

Detailed Answer:
Thanks for your feedback.
Nice to know that a definitive diagnosis is done and you have been started on anti-tubercular treatment.

Also noted the symptoms of Heaviness / Light headedness / Imbalance in the head, Ear pressure in both ears & closing of ears, Slight pain near both lower ribs, Puffiness in the face, Drowsiness / fainting and low hemoglobin of 7.9.

This needs a thorough clinical evaluation, examination and further tests to know the reasons under the care of a Physician and a second opinion of an ENT to be taken. As said earlier get an opinion of a Hematologist also. Such symptoms need a proper clinical evaluation.

Since your are a diagnosed case of tuberculosis, you have to continue the anti-tubercular treatment, this too can be best decided by your Physician. He can stop the offending medicines if thinks so and add on another proper medication. You have to complete the course.

I hope this answer helps you, please feel free to ask for further relevant queries
if you feel that there is a gap of communication.


Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. T Chandrakant (16 days later)
Hi Dr,
With regards to my last question regarding symptoms of Heaviness / Light headedness / Imbalance in the head, Ear pressure in both ears & closing of ears, Slight pain near both lower ribs, Puffiness in the face, Drowsiness / fainting and low hemoglobin of 7.9, I was told by my doctor to stop Moxicip. Today after removing CBC my RDW-SD and RDW-CV show ZERO in the report though my HGB is 11.70. With regards to RDW-SD and RDW-CV showing ZERO i would like to have your advice as to what does it mean.
Also attached is the CBC report for your reference.
I have been taking TB medicines since past 15 days i.e. R Cinex 450g, Combutol 800g,Benadon 40g, Vitamin C & Orofer XT twice a day.
doctor
Answered by Dr. T Chandrakant (6 hours later)
Brief Answer:
Talk to the Pathologist or Hematologist of the lab that reported

Detailed Answer:
Hi.
Noted your follow up.
There is marked improvement in Hemoglobin and is a good sign.
Let see if stopping of Moxicip helps to alleviate the symptoms that you have mentioned.
I really do not know why they have reported some parameters as Zero - either not calculated by the automated machine used now-a-days for certain reasons that only your Hematologist or the Pathologist of the lab can tell.
Continue the medicines well, without missing a single day.
I hope this answer helps you.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19777 Questions

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What Does My FNAC Test Report Indicate?

Brief Answer: As described below Detailed Answer: Hi. Thanks for your information. Please ask the query. I have read and understood your history. The FNAC of the cervical lymph node shows the following: The reports shows the following with explanation, if this is the information an explanation you want: - Sparsely cellular smears: means the spray o the aspirated material from the lymph node is sparse, not much but definitely sufficient for the reporting as indicated by the given reports. - heterogenous means of different types - population of reactive lymphocytes. This means there are more of lymphocytes (a type of white cells) seen in more quantity that that seen in normal lymph nodes. Reactive means as a reaction to some challenge > This challenge is not from Tuberculosis or any bacteria as seen in the smear as seen on gram staining and ZN staining. Hence this is a reactive lymphadenopathy. Seen your other reports which show reduced hemoglobin of 7.70 in spite of normal RBC and platelet counts, Electrophoresis done. For this you need further evaluation, diagnosis and treatment under the care of a Hematologist, a very specialized field. I hope this answer helps you, please feel free to ask for further relevant queries if you feel that there is a gap of communication.