Abstract

Background: Head and neck swellings are the commonest clinical findings affecting all the age groups. FNAC is of great value in early diagnosis and differentiation of wide plethora of infective, benign and malignant lesions, in head and neck region. Prior cytodiagnosis by FNAC helps in delineating the heterogenous lesions occurring in head and neck region which serves as an aid in the evaluation and planning of necessary management.

Objectives of the study: To study the cytomorphological features and classify various head & neck lesions. To evaluate the role of FNAC in head and neck lesions. To study diagnostic accuracy of FNAC by histopathological correlation wherever available.

Materials and Methods: A prospective study was conducted from January 2016 to December 2018. FNA was performed on 1568 cases of head and neck lesions and cytomorphological features were studied. These cytomorphological features were correlated with concomitted histopathologic diagnosis, wherever available. Data analysis was done by Statistical Package for the Social Sciences software version 22.0 and presented in terms of proportions or percentage. Chi-square test was used to see the association between the different variables. A p-value of < 0.05 was considered as significant.

Results: There were 1568 FNAC cases enrolled, out of which lymph node lesions (n = 703) were the most commonest lesions followed by thyroid gland, miscellaneous group and salivary gland. Reactive hyperplasia of lymph nodes, nodular goiter, epidermal cyst and pleomorphic adenoma were the predominant diagnoses of lymphnodes, thyroid gland, miscellaneous group and salivary gland respectively. Histopathological correlation was available in 348 cases and showed sensitivity of 80.76%, specificity of 100%, positive predictive value of 100% and negative predictive value of 98.4%. The diagnostic accuracy of FNAC was 98.55%. The association between FNAC diagnoses and histopathological diagnoses were considered to be statistically significant.

Conclusion: FNAC is a valuable preliminary diagnostic tool for assessing head and neck lesions and serves as a guide for diagnosis, therapeutic and better management of various cases.

• 1.   Orell SR, Klijanienko J. (2012). Head and neck; salivary gland. In: Orell SR, Sterrett GF (eds). Fine Needle Aspiration Cytology. 5th ed. New Delhi: Elsevier Ltd, 38–150.
• 2.   Schwarz R, Chan NH, MacFarlane JK. (1990). Fine Needle Aspiration Cytology in the evaluation of head and neck masses. The American Journal of Surgery, 159:482–85.
• 3.   Howlett DC, Harper B, Quante M, et al. (2007). Diagnostic adequacy and accuracy of Fine Needle Aspiration Cytology in neck lump assessment: Results from a regional cancer network over a one year period. The Journal of Laryngology & Otology, 121:571–79.
• 4.   Fernandes H, D’souza CRS, Thejaswini BN. (2009). Role of FNAC in palpable head and neck masses. Journal of Clinical and Diagnostic Research, 3(5):1719–25.
• 5.   Swamy GG, Singh A, Ahuja JM, Satyanarayana N. (2010). Accuracy of fine needle aspiration cytology in the diagnosis of palpable head and neck masses in a tertiary health care center. Journal of College of Medical Sciences-Nepal, 6(4):19–25.
• 6.   Martin HE, Ellis EB. (1930). Biopsy of needle puncture and aspiration. Annals of Surgery, 92:169–81.
• 7.   Nanik J, Rathore H, Pachori G, et al. (2015). Cytomorphology of head and neck lesions: A study in tertiary care hospital. Pacific Journal of Medical Sciences, 5(3):145–49.
• 8.   Kishore SH, Rajshri DP, Nandkumar DV, et al. (2015). Spectrum of FNAC in palpable head and neck lesions in a tertiary care hospital in India: A 3 years study. Indian Journal of Pathology and Oncology, 2(1):7–13.
• 9.   Sreedevi P, Kishore Ch, Pararkusa NC. (2016). Diagnostic Role of FNAC in evaluation of Head and Neck Lesions. IOSR Journal of Dental and Medical Sciences, 15(9):11–15.
• 10.   Meenai FJ, Jain R, Ojha S, et al. (2018). Study of spectrum of head and neck lesions diagnosed on fine needle aspiration cytology (FNAC). Tropical Journal of Pathology and Microbiology, 4(1):93–100.
• 11.   Muddegowda PH, Srinivasan S, Lingegowda JB, et al. (2014). Spectrum of Cytology of Neck Lesions: Comparative Study from Two Centers. Journal of Clinical and Diagnostic Research, 8(3):44–45.
• 12.   Valiya LG, Padhariya BB, Baxi SN. (2016). Spectrum of FNAC in Palpable Head and Neck Lesions In a tertiary care hospital in Western India: A 2 years study. IOSR Journal of Dental and Medical Sciences, 15(6):14–19.
• 13.   Singal P, Bal MS, Kharbanda J, et al. (2014). Efficacy of fine needle aspiration cytology in head and neck lesions. International Journal of Medical and Dental Sciences, 3:421–30.
• 14.   Rathod GB, Parmar P. (2012). Fine needle aspiration cytology of swellings of head and neck region. Indian Journal of Medical Sciences, 66(3):49–54.
• 15.   Gagneten CB, Lowenstein A. (1987). The role of fine needle aspiration biopsy cytology in the evaluation of the clinically solitary thyroid nodule. Acta Cytologica, 31:595–98.
• 16.   Bhagat VM, Tailor HJ, Saini PK, et al. (2013). Fine needle aspiration cytology in non-thyroid head and neck masses-a descriptive study in tertiary care hospital. National Journal of Medical and Allied Sciences, 3(3):273–76.
• 17.   Sahni S, Shankar VS, Krishnappa A. (2017). Diagnostic Efficacy of Fine Needle Aspiration Cytology in Cystic Lesions of Head and Neck Region: A single Experience at Tertiary Health Care Centre. National Journal of Laboratory Medicine, 6(2):1–7.
• 18.   Maniyar AU, Patel H, Parmar. (2013). Study of Cytodiagnosis of Head and Neck Neoplastic Lesions and Comparison with Histopathology. Research and Reviews: Journal of Medical and Health Sciences, 2:54–59.
• 19.   Khetrapal S, Jetley S, Jairajpuri Z, et al. (2015). FNAC of head & neck lesions and its utility in clinical diagnosis: A study of 290 cases. National Journal of Medical Research, 5(1):33–8.
• 20.   Jadhav DS, Barge AK, Valand AG. (2018). Study of fine needle aspiration cytology of palpable head and neck lesions in tertiary care centre. Indian Journal of Pathology and Oncology, 5(3):375–81.
• 21.   Sharma N, Sharma S, Sarkar M, et al. (2016). Study of Pathological Spectrum of Neck Lesions with Cytohistopathological Correlation. National Journal of Laboratory Medicine, 5(3):58–63.
• 22.   Dallari S, Gusella PM, Campanella P, et al. (2017). Current usefulness of aspiration cytology (FNAC) in the head and neck diagnosis. Pathologica, 109:355–62.