Diagnostic Accuracy of Fine Needle Aspiration and Imprint Cytology of Head and Neck Lesions (Comparative Study)

Abstract

Background 
 Fine needle aspiration cytology has been considered as the first-step procedure for microscopic evaluation of any mass or swelling in the head and neck area and the entire body following taking a full history and physical examination. It is considered as an alternative procedure to open surgical biopsy. On the other hand, imprint cytology is a well-recognized simple technique. Imprint cytology can be used as an adjunct to or as a substitute for frozen section method; since it has been proven to be more efficient than frozen section, and has higher concordance with histological results
 Objectives 
 To improve clinical and diagnostic cytological experiences among oral pathologists, compare the results of cytological techniques with that of routine histopathological findings, and specify the merits and pitfalls of the above techniques.
 Materials and Methods
 A prospective study is conducted on 66 patients indicated for FNA. In 27 cases, histological examinations were available for comparison with cytological diagnosis, among which 20 cases had imprint cytology. All samples were stained with H&E and Pap stain, while salivary gland lesions were additionally stained with Diff-quick. Cytological specimens were compared with the histopathological examination to find diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV).
 Results
 Fine needle aspiration cytology was performed on 62 patients, 25 males, and 37 females. The total benign lesions were the commonest (46.7%), followed by inflammatory lesions (38.7%), then malignant lesions (14.5%). The overall diagnostic accuracy of FNAC was 88.8%. The sensitivity, specificity, PPV, and NPV were 75%, 94.7%, 85.7%, and 90% respectively. Whereas in imprint cytology 4 cases were diagnosed as malignant, 11 cases as benign and 5 cases as inflammatory. The diagnostic accuracy of imprint cytology was 90%. The sensitivity, specificity, PPV and NPV were 66.6%, 100%, 100%, 87.5%, and 90% respectively. 
 Conclusion
 Fine needle aspiration cytology FNAC showed 88.8% diagnostic accuracy, while imprint cytology has a slightly higher diagnostic accuracy of 90% for head and neck lesion.