Comparison of Cell Blocks and Smear Examination With Fine Needle Aspirates in the Diagnosis of Superficial Palpable Head and Neck Lesions

Abstract

OBJECTIVE: To compare the findings of cell blocks and smear examination with fine needle aspirates (FNA) in the diagnosis of superficial palpable head and neck lesions taking histopathology as the gold standard.
 METHODS: This cross-sectional comparative study was conducted at Pakistan Institute of Medical Sciences, Islamabad and Institute of Basic Medical Sciences, Khyber Medical University, Peshawar. Eighty patients of all age groups, having superficial clinically palpable lesions of head and neck region were recruited in the study from August 2014 to August 2015. FNA cytology, cell block and open biopsy were performed in all cases and compared with the histopathological examination. The data was recorded in a proforma and analyzed through SPSS Version-23.
 RESULTS: Out of 80 patients, 44 (55%) were males and 36 (45%) females. The age of patients ranged from 01-81 years with a mean age of 45.68±20.43 years. Lesions involving lymph nodes (n=31; 38.8%) and salivary gland (n=24; 30%) were common in head and neck region. Tuberculosis (n=15: 48.38%) and pleomorphic adenoma (n=13; 54.16%) were the common lesions involving lymph nodes and salivary glands respectively. Overall, 49 (61.2%) cases were benign/reactive and 31 (38.8%) cases were malignant on histopathology. Sensitivity, specificity, positive predictive value and negative predictive value was 74.2%, 95.9%, 92% & 85.5% for FNA smears and 83.9%, 98%, 96.3% and 90.6% for Cell Block respectively in diagnosing head and neck lesions. 
 CONCLUSION: Cell block with better diagnostic accuracy can be used as adjunct to FNA smears in diagnosis of superficial palpable head and neck lesions.