Change in Pattern of Head and Neck Lesions Diagnosed by FNAC in the Post-COVID-19 Period: Are Lymphoproliferative Disorders on the Rise?

Abstract

ABSTRACT Introduction: Coronavirus disease 2019 (COVID-19) infection is associated with a variety of immune dysregulations. Aberrant immune function can lead to a plethora of lymphoproliferative and autoimmune dysfunctions. This study aimed to compare the reported results of fine-needle aspiration cytology (FNAC) for head and neck lesions in the pre- and post-COVID-19 period and to detect any change in the incidence of lymphoproliferative or granulomatous disorders. Material and Methods: A retrospective analytical study was conducted in a tertiary care hospital. FNAC records of duration from January 2017 to May 2023 were retrieved, collected, and analyzed. All patients who underwent FNAC for head and neck lesions were included, and incomplete, duplicate records and primary thyroid lesions were excluded from the study. Results: A total of 268 and 191 patients were included in the pre-COVID-19 and post-COVID-19 groups, respectively. Both groups were demographically comparable, without any statistically significant difference. The results showed that there is a statistically significant increase in cases diagnosed as lymphoproliferative disorders in the post-COVID-19 group as compared to the pre-COVID-19 group (12.04% vs 4.85%, P = 0.005), while the diagnosis of benign salivary gland tumors was significantly reduced (2.09% vs 5.97%, P = 0.045). There was no statistically significant difference between the study groups for other benign and neoplastic diagnoses. Conclusion: This study reveals a rise in lymphoproliferative disorders in the post-COVID-19 period. Although a causal association could not be established, the study indicates a temporal association. Hence, further research is warranted to explore the possible role of COVID-19 as an etiological agent for lymphoproliferative disorders.