Study of fine needle aspiration cytology of palpable head and neck lesions in tertiary care centre

Abstract

Introduction: Fine Needle Aspiration Cytology (FNAC) of neck masses is a quick, easy, safe and cheap technique and has been a well accepted procedure in diagnosing various swellings. In head and neck regions FNAC is widely used such as in the lymph nodes, thyroid, salivary glands and other neoplasms. Aims and Objectives: 1.To evaluates the role of FNAC and its utility in diagnosis of palpable head and neck masses; 2. To study the spectrum of head and neck lesions in rural population; 3. To study diagnostic accuracy of FNAC by histopathological correlation wherever possible. Materials and Methods:The present study includes 706 cases of palpable head and neck swelling in department of pathology of tertiary care centre from January 2016 to June 2017. Aspiration was done and cytological diagnosis was given. Cytohistopathological correlations were done wherever possible. Result: Total 706 patients of palpable head and neck lesions studied out of that lymph node (33.00%) was common site followed by, thyroid lesion (30.31%), miscellaneous (22.80%) and salivary gland (13.88). Most common nonneoplastic, benign neoplastic and malignant neoplastic lesion is reactive lymphadenitis, colloid goiter of thyroid and metastasis of squamous cell carcinoma in lymphnode respectively. Accuracy rate of FNAC in 70 cases which are correlated with histopathological examination was 95.71% with sensitivity and specificity of 78.57% and 100% respectively. Conclusion: Fine needle aspiration cytology is simple, rapid and safe diagnostic tool with accuracy of 95.71% for differentiating neoplastic from nonneoplastic lesions of palpable head and neck region.

Utility of fine needle aspiration cytology in head and neck lesions and its correlation with histopathology- a study in tertiary care hospital

“…Other studies also observed reactive lymphadenitis as the most common diagnosis similar to this study. 10,13,17,20,21 In the present study female predominance was seen in lymph nodes in contrast to the other studies where there was male predominance. 9,11 In contrast to our study where TB lymphadenitis was the second most common cause (14%), few other studies showed TB lymphadenitis as the most frequent cause of lymph node swelling.…”

“…3,[9][10][11][12] In the present study, the overall head, and neck swellings were more commonly encountered in females with male to female ratio being 1:2.2 which is similar to other studies. 9,[13][14][15] The peak incidence of head and neck lesions in the majority of the studies was in the second decade, unlike the present study where the lesions were seen in the fourth decade (18.4%). 9,13,16,17 Similar to the studies done by Khetrapal et al, 9 nonneoplastic lesions were the dominant cause for head and neck swelling in the present study.…”

“…9,[13][14][15] The peak incidence of head and neck lesions in the majority of the studies was in the second decade, unlike the present study where the lesions were seen in the fourth decade (18.4%). 9,13,16,17 Similar to the studies done by Khetrapal et al, 9 nonneoplastic lesions were the dominant cause for head and neck swelling in the present study. The majority of the benign and non-neoplastic cases were prevalent in the age groups below 40 years (50.4%) whereas the malignant and suspicious cases were seen predominantly in the age groups above 40 years (73.3%).…”

“…Different authors use different criteria for the diagnosis of tuberculous lymphadenitis and the combination of FNAC with ZN staining for AFB is of the utmost significance as a diagnostic modality. 9,13 In the present study, the cyto-diagnosis of TB lymphadenitis was based on the morphological findings of caseous necrosis and epithelioid cell granulomas. ZN stain could demonstrate acid-fast bacilli in 15 cases among the 23 cytological cases of granulomatous lymphadenitis with or without caseous necrosis.…”

The utility of Fine Needle Aspiration Cytology (FNAC) in the diagnosis of head and neck lesions at tertiary health care level

“…The study of Shaan Khetrapal et al [15] noted that the largest number of cases from lymph node lesions 64.1% and the least number of cases were from oral cavity 1.03% which is comparable to the present study. [16] found 67.3% and the study of Dr. Kusum Borsaikia [23] found 62.50% and study of Apoorva KP et al [24] found 64.5%. In the present study, Papillary carcinoma was highest 10% in a malignant lesion which is similar to the study of Rashmi Rekha Goswami et al [16] noted 5.4% and the study of Chauhan Savitri et al [25] noted 3.1%.…”