# Sydney System for lymph node fine-needle aspiration cytopathology

Source: https://onco.cc/terms/sydney-system-lymph-node-fna/  
OnCo record `sydney-system-lymph-node-fna` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The Sydney System is how a needle test of a swollen lymph node is reported: first one of five basic categories, then a specific diagnosis where extra tests allow one.

## Summary

A committee of cytopathologists, endorsed by the International Academy of Cytology and the European Federation of Cytology Societies, proposed the Sydney System (Al-Abbadi and colleagues, Acta Cytologica 2020). It has two levels. The first gives five categories: inadequate or insufficient, benign, atypical lymphoid cells of uncertain significance, suspicious, and malignant, each with recommendations. The second, where achievable, names the specific benign or malignant entity using ancillary tests. The system also covers indications, technique and the clinical, imaging and blood findings to integrate.

## Fields

- Kind: Term
- Last checked: 2026-11-04
- Also known as: Sydney System

## Sources

- Al-Abbadi et al., A proposal for the performance, classification and reporting of lymph node fine-needle aspiration cytopathology: the Sydney System (Acta Cytol 2020): https://doi.org/10.1159/000506497

## Connected records

- terms: [Bethesda category (thyroid cytology)](https://onco.cc/terms/bethesda-category/), [Core needle biopsy and fine-needle aspiration (FNA)](https://onco.cc/terms/core-needle-biopsy/), [Lymph node](https://onco.cc/terms/lymph-node/), [WHO Reporting Systems for cytopathology](https://onco.cc/terms/who-cytopathology-reporting-systems/)
- cancers: [Hodgkin lymphoma](https://onco.cc/cancers/hodgkin-lymphoma/), [Non-Hodgkin lymphoma (all types)](https://onco.cc/cancers/non-hodgkin-lymphoma/)

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