A Study of Fine Needle Aspiration Cytology as an Evaluation Tool in Head and Neck Masses

Abstract

Background and objectives: Masses in head and neck region are a common clinical problem. The clinical evaluation of head and neck masses can be difficult because of anatomical peculiarities, proximity of tissues of various types and wide range of primary and metastatic neoplasm of these areas. The aim of pre-operative and pretreatment investigation is to arrive at a precise and whenever possible type specific diagnosis. The conventional surgical histopathological examination is considered as confirmatory test. So arise the need for a technique which is less invasive and with less complication, so that treatment can be directed early. Materials and method: A prospective study was done in department of Pathology from Feb 2008 to Aug 2010. The patients presenting to ENT OPD were subjected to FNAC, whenever possible, these patients were subjected to histopathological study by biopsy. Only those cases, which were subjected to, FNAC and Biopsy, were taken for the study. All cases were examined in detail regarding site, size, and consistency of swelling. Acute inflammatory conditions like neck abscesses and nasal masses like polyps were excluded from the study. Results: Fifty cases were studied and data were analysed. 27 patients were females and 23 were males. Of the 50 cases 5 (10%) were seen in nasal cavity, 2 (4%) cases were seen in maxillary sinus, 12 (24%) cases were in oral cavity, 11 (22%) in salivary glands i.e. in parotid 6 (12%), 5 (10%) in Submandibular gland, 10 (20%) were in thyroid, 10 (20%) in neck i.e. including both lymph nodes and soft tissue swellings. Conclusion: Fine needle aspiration cytology (FNAC) is a rapid, cost effective and simple out patient procedure which can be performed safely. It has high accuracy rate for head and neck masses. FNAC is the first step of pathological examination in all head and neck masses. In primary diagnosis, accuracy varies with site of lesions, the tissue of origin and the nature of the process. Clinically FNAC should only be used as a guide for preliminary diagnosis, especially in malignant pathologies. Final treatment decision should not be made according to the results of FNAC and tissue biopsy should be obtained before definitive treatment.