Role of Aspiration Cytology and Biopsy in the Rapid Diagnosis of Nasopharyngeal Carcinoma – A Comparative Study From a Tertiary Care Centre .

Abstract

BACKGROUND: Nasopharyngeal carcinoma accounts for a fair number of malignancies in the head and neck region. Cancerous growth in this location maybe very small and inconspicuous. Frequent clinical examination and repeated biopsy needs to be taken to come to an early diagnosis. FNAC can be utilized as a reliable and quick tool to aid in the early diagnosis of nasopharyngeal carcinoma before the patient is subjected to biopsy. FNAC if followed by biopsy rules out any false negative cases by FNAC and further reduces the chances of missing out on a diagnosis of nasopharyngeal carcinoma. OBJECTIVES :To compare the role of FNAC and biopsy in the rapid diagnosis of nasopharyngeal carcinoma. MATERIALS AND METHODS: All suspected case of nasopharyngeal carcinoma underwent FNAC followed by biopsy . FNAC smears were stained with Giemsa stain and biopsy sections were stained in hematoxyline and eosin (H&E) .Special stains were used whenever indicated. RESULTS: Nasopharyngeal carcinoma affected males more than the females and most of the cases were in their 4th - 5th decade . There was a clear preponderance of nasopharyngeal carcinoma amongst the tribal community accounting for 69% of the cases. Metastatic lymph nodes in varied locations were found to be present in 60% of the cases studied. Success rate of FNAC in the rst half of the cases was 26.6% which increased to 60% in the second half of the cases. Biopsy revealed a success rate of 80 % and 66.6 % in the rst and second half of the cases respectively. Out of the 22 histopathologically conrmed cases of nasopharyngeal carcinoma, FNAC could correctly diagnose 63.3 % of the cases and there were no false positive cases. The overall diagnostic accuracy of FNAC was 68 % with a sensitivity of 46.7%, specicity of 100 % while predictive positive value was 100 % and predictive negative value was 55.5 % . CONCLUSION: FNAC is a safe, reliable , cost effective technique for the early diagnosis of nasopharyngeal carcinoma . Other diagnostic modalitieslike endoscopic FNAC or CT guided FNAC may also be incorporated to improve the detection rate in early and deep-seated cases of nasopharyngeal carcinoma.