Accuracy of fine‐needle aspiration cytology of head and neck masses

Abstract

Background Head and neck masses are a common presentation in daily practice and can be challenging to both clinicians and cytopathologists. Fine needle aspiration cytology (FNAC) is a widely used method for the diagnosis of head and neck masses. The aim of the study was to assess our institutional experience of the accuracy of FNAC in the diagnosis of head and neck masses. Methods A total of 1262 FNACs were conducted from January 2013 to December 2016 and subdivided into benign and malignant categories. The thyroid and salivary glands FNACs were classified according to the Bethesda System for Reporting Thyroid cytopathology and to the Milan System for Reporting Salivary Gland Cytopathology respectively. The measures of diagnostic accuracy of FNAC were determined taking histology as a gold standard. Results A total of 7 false negative (FN) and 6 false positive (FP) FNACs were identified. Overall sensitivity and specificity of FNAC for a malignant diagnosis were 92% and 94.4%, respectively. Accuracy of FNACs of head and neck masses was 93.5% for all sites. The salivary gland group had the highest rate of FN (2.8%). All FP were reported in the thyroid group. These cases were cytologically classified suspicious for malignancy (n = 3) and papillary carcinoma (n = 3) and proved to be lymphocytic thyroiditis on final histology. Among the most common locations, cytology of lymph nodes provided the best sensitivity (98.2%). Salivary glands as well as lymph nodes had the best specificity (100%). Conclusion FNAC of head and neck masses has a high accuracy allowing a correct therapeutic management. However, this accuracy depends on the anatomic location of the mass.

Ultrasound‐guided FNA cytology of groin lymph nodes improves the management of squamous cell carcinoma of the vulva: Results from a comparative cytohistological study

“…According to the literature, it represents the first and most useful diagnostic tool in the evaluation of several body lesions. In fact, among the others, it has demonstrated interesting results in terms of diagnostic accuracy in head and neck cancer, breast carcinoma, and cervical carcinoma . To date, only 2 studies, from the same institution, have been published on the diagnostic utility of ultrasound with guided FNAC in the assessment metastatic lymph node disease in vulvar carcinoma.…”

“…In fact, among the others, it has demonstrated interesting results in terms of diagnostic accuracy in head and neck cancer, breast carcinoma, and cervical carcinoma. [10][11][12][13][14] To date, only 2 studies, from the same institution, have been published on the diagnostic utility of ultrasound with guided FNAC in the assessment metastatic lymph node disease in vulvar carcinoma. Moskovic et al, in their pilot study on 21 patients with early vulvar carcinoma using ultrasound and FNAC, confirmed an overall sensitivity of 83% and specificity of 82% for the detection of groin lymph node metastases.…”

“…It makes sense that a reliable tool in the evaluation of lymph nodes is represented by ultrasound combined with fine‐needle aspiration cytology (FNAC). This technique has demonstrated interesting results in terms of diagnostic accuracy in head and neck cancer, thyroid neoplasms, and breast, lung, and cervical carcinoma …”

“…This technique has demonstrated interesting results in terms of diagnostic accuracy in head and neck cancer, thyroid neoplasms, and breast, lung, and cervical carcinoma. [10][11][12][13][14] So far, only a few studies have investigated the diagnostic utility of ultrasound-guided FNAC of lymph nodes in the assessment of vulvar carcinoma, and the majority of them have had a prevalent focus on the radiological more than the cytological aspects of this examination. 15,16 In the current report, we evaluate the diagnostic accuracy of ultrasound-guided FNAC in our cohort of patients affected by vulvar carcinoma by comparing the reliability of cytological versus histological samples.…”

A Nomogram to Predict the Outcome of Fine Needle Aspiration Cytology in Head and Neck Masses

“…As reported in literature, FNAC has a high sensitivity (72.4-100%), a high specificity (85.3-100%) as well as a high accuracy (73.3-98.0%) [1]. However, certain rates of non-diagnostic or inconclusive results have also been reported [2,3]. In case of a non-diagnostic result, the sample contains not enough cells, or it was contaminated by blood cells.…”