{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:18:33Z","timestamp":1790050713298,"version":"4.0.1"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fine\u2010needle aspiration cytology (FNAC) is a vital first\u2010line diagnostic tool in evaluating lymphadenopathy, particularly in the head and neck region, where malignancies often present with nodal enlargement. Historically, the lack of a standardised reporting system for lymph node cytology has resulted in interobserver variability and inconsistent diagnoses. The Sydney System, introduced in 2019, provided a structured five\u2010tier framework, which was further refined by the newly proposed World Health Organisation (WHO) Reporting System for Lymph Node, Spleen, and Thymus Cytopathology (2024). This study aims to assess the diagnostic performance of the proposed Sydney system in the context of head and neck lymphadenopathy and determine the associated risk of malignancy (ROM) for each diagnostic category.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>A retrospective\u2010prospective study was conducted on 295 cases of cervical and supraclavicular lymphadenopathy evaluated through FNAC, with or without ultrasound guidance, after institutional ethical clearance. ROM values were calculated and compared with those previously published in the literature for the years 2024 and 2025. Ancillary techniques, such as ROSE and cell block preparations, as well as immunohistochemistry, were employed as necessary.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study demonstrated high sensitivity (89.9%), specificity (92.9%) and diagnostic accuracy (90.47%). The ROM varied across diagnostic categories, with the highest in malignant cases and the lowest in benign cases. No cases were reported as atypia of undetermined significance (AUS), reflecting effective clinicoradiological correlation. When plotted as an ROC curve, the present study demonstrates a strong diagnostic ability (AUC\u22480.91).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>FNAC, when interpreted using a standardised system like the WHO or Sydney framework, remains an effective, minimally invasive and cost\u2010efficient diagnostic tool. It enhances communication, reduces diagnostic ambiguity and facilitates streamlined treatment planning, particularly in resource\u2010limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dc.70053","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T10:57:23Z","timestamp":1763981843000},"page":"125-134","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Assessment of Risk of Malignancy Using the Sydney System for Reporting Head and Neck Lymph Node Cytopathology: An Institutional Experience"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1045-1510","authenticated-orcid":false,"given":"Bharti","family":"Sushma","sequence":"first","affiliation":[{"name":"Department of Pathology Manipal TATA Medical College and Tata Main Hospital  Jamshedpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8249-5673","authenticated-orcid":false,"given":"Singh","family":"Renu","sequence":"additional","affiliation":[{"name":"Department of Pathology All India Institute of Medical Sciences, AIIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6427-6634","authenticated-orcid":false,"given":"Sharma","family":"Manupriya","sequence":"additional","affiliation":[{"name":"Department of Pathology All India Institute of Medical Sciences  Bilaspur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5087-1889","authenticated-orcid":false,"given":"Pralhad","family":"Potdar","sequence":"additional","affiliation":[{"name":"Department of Community Medicine GAIMS  Bhuj India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"issue":"3","key":"e_1_2_13_2_1","first-page":"489","article-title":"Role of Fine Needle Aspiration Cytology to Analyze Various Causes of Lymphadenopathy","volume":"4","author":"Patel M. M.","year":"2013","journal-title":"National Journal of Community Medicine"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.14218\/jctp.2023.00044"},{"key":"e_1_2_13_4_1","unstructured":"WHO Reporting System for Lymph Node Spleen and Thymus Cytopathology. 2025. In Press."},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.2265.1252\u2010a"},{"key":"e_1_2_13_6_1","volume-title":"StatPearls","author":"Koroulakis A.","year":"2022"},{"issue":"3","key":"e_1_2_13_7_1","first-page":"225","article-title":"Clinical Approach to Pediatric Neck Masses: Retrospective Analysis of 98 Cases","volume":"4","author":"Unsal O.","year":"2017","journal-title":"Northern Clinics of Istanbul"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22890"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/joc.joc_20_24"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010025\u201093330\u20109"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.21276\/apalm.3370"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/joc.joc_168_23"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.53555\/AJBR.v27i1S.1519"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.path.2024.04.010"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14161801"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22936"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.22159\/ajpcr.2025v18i5.54339"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000535797"},{"key":"e_1_2_13_19_1","first-page":"39","article-title":"Structured Reporting of Lymph Node Cytopathology Using the 2020 Sydney System Guidelines: A Retrospective Study","volume":"12","author":"Sreelekshmi J. R.","year":"2023","journal-title":"National Journal of Laboratory Medicine"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000530038"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-014-4119-2"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1159\/000530984"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.13079"}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.70053","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T09:03:16Z","timestamp":1767258196000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.70053"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,24]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/dc.70053"],"URL":"https:\/\/doi.org\/10.1002\/dc.70053","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"value":"8755-1039","type":"print"},{"value":"1097-0339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,24]]},"assertion":[{"value":"2025-09-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}