Efficacy of ‘two-man’ FNAB technique in the assessment of patients with non-thyroid neck masses

Abstract

Objective: To show the superiority of ‘two-man’ FNAB technique comparing to the standard FNAB technique, in order to identify the cause of non-thyroid neck masses. Methods: Over an 18 months period, a consecutive paired study was conducted in the tertiary referral Venizelion General Hospital. Forty-four cytologic examinations were performed in patients with non-thyroid head and neck masses. The samples were taken from the same side using both techniques the standard FNAB technique and the ‘two-man’ FNAB technique (for which two persons carried out the procedure). The slides were seen by the pathologist and were defined as diagnostic, suggestive or inconclusive. The diagnosis was confirmed in any case by definite histology after surgical treatment or open biopsy. Results: From 44 samples taken with the ‘two-man’ technique, 34 were diagnostic (all true) verified by histopathology, seven suggestive (five true and two false) and three inconclusive (6.82%). The correct diagnosis was confirmed in 39 cases (88.64%). From 44 samples of standard technique, 22 were diagnostic (all true), 12 suggestive (five true and seven false) and 10 inconclusive (22.72%). The correct diagnosis was confirmed in 27 cases (61.36%). The accuracy of diagnosis with the standard FNAB technique was 0.79 (SE=0.07), while with the ‘two-man’ FNAB technique was 0.95 (SE=0.03), a significant statistical difference (Fischer exact test, P=0.041). Conclusions: ‘Two-man’ FNAB technique proved to be as safe and patient friendly as the standard FNAB, but more accurate and may be easier to perform than this. The ‘two-man’ FNAB technique could become the preferred method for fine-needle cytology, particularly for difficult to reach areas of the head and neck.