Fine Needle Aspiration Cytology of Palpable Head and Neck Masses: A Descriptive Cross-sectional Study

Background: Fine needle aspiration cytology (FNAC) is a rapid, economical and less invasive method used for diagnosis in case of head and neck lesions which are commonly seen in general practice. Aim: The present study was designed to find out the spectrum of head and neck masses, and to assess advantage of using FNAC in the diagnosis of palpable head and neck masses. Material And Methods: This was a retrospective study conducted over a period of 3 years from May 2019 to May 2022 in the department of pathology at district hospital JLNM. FNAC was performed on head and neck swellings and were evaluated for cytomorphology. Results: A total of 583 cases were studied. Majority of the patients belonged to the age group of 30 to 50 years. Out of 583 cases, 299 were males and 284 were females. Maximum cases were from lymph nodes (241) accounting for 41.3% of total cases. 35.5% (207 cases) were from skin and soft tissue swellings. 17.4% (102 cases) were of thyroid, and 5.6% from salivary gland (33 cases). Conclusions: FNAC is a reliable procedure for screening and diagnosing palpable head and neck lesions. It is extremely sensitive, specific and helps as an adjunct to histopathology. FNAC helps to decide as to whether to resect a benign tumour or to plan extensive surgeries and helps in guiding the therapeutic management by avoiding unnecessary surgeries and expenses. Keywords: Head & Neck, Lymphadenopathy, FNAC.

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. Cyto-histopathological 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. Keywords: FNAC, Head and neck, Lymphnode, Thyroid.

Background: Head and neck lesions encompass a multitude of congenital, inflammatory or neoplastic lesions including several anatomic sites and originating in different tissues and organs. Fine needle aspiration cytology (FNAC) is a simple, quick, feasible, cost effective and repeatable outpatient procedure with minimum risk of complications. Aim: 1. To evaluate the role of FNAC and its utility in the diagnosis of palpable head neck masses. 2. To study the spectrum of head neck lesions in rural population. Material and methods The study included 304 patients presented with palpable head and neck swellings from January 2015 to December 2015. Detailed clinical history of the patient was noted. Aspirations were done by using 10 ml syringe and 22/23 gauge needles. Smears were stained with Haematoxylin and eosin and Leishman stain. Cytomorphological diagnosis was given. Results: Out of 304 patients of head and neck lesions studied, lymph node (50.32%) was the predominant site aspirated with reactive lymphadenitis being the commonest lesion. Thyroid lesions constituted 44.07% followed by salivary gland (3.28%), and soft tissue 2.30% lesions. Conclusion: The head and neck lesions are very common conditions encountered, with most of them being on OPD basis. Our study found that FNAC is simple, quick, inexpensive and minimally invasive technique to diagnose different types of head and neck swellings. It could differentiate the infective process from neoplastic one and avoids unnecessary surgeries. Thus, FNAC can be recommended as a first line of investigation in the

Fine needle aspiration cytology (FNAC) with it's minimally invasiveness has been a well accepted procedure in the initial diagnosis of various swellings. With time and experience high sensitivity and specificity of FNAC over conventional open biopsy has lead to the wide acceptance of this procedure. To evaluate the utility of aspiration cytology as a first-line diagnostic tool in palpable head and neck masses and correlate with histologic results for evaluating diagnostic accuracy. A hospital based prospective, comparative study was conducted among patients with various swellings at Head and Neck regions in the Department of Pathology, Dhulikhel Hospital between July 2011 to June 2012. FNAC were done from the palpable masses of head and neck regions and were compared with biopsy findings of the same lesions. Data entry and analysis performed using SPSS version 16. The sensitivity, specificity and accuracy rates were calculated. A total 64 patients were subjected to both FNAC and histopathological examination (HPE). Total 39 (61 %) were females and 25 (39 %) were males with M: F ratio of 1:1.6. The age group ranged from 9 to 80 years. Twenty five percent of patients were in the age group below 20 years. The highest number of cases included lymph nodes 29 (45%) followed by thyroid 24(37.5 %), salivary glands 10(16%) and 1 case (1.6%) was a soft tissue swelling over the occipital region. Highest sensitivity, specificity and accuracy rate for diagnosis by FNAC were observed in thyroid. The overall sensitivity and specificity of FNAC were 86% and 97% respectively in determining the various pathologies. The overall accuracy of FNAC in present study was 87.4%. FNAC is a minimally invasive first line investigation with a high sensitivity and specificity for the diagnosis of various head and neck lesions.

A prospective observational study was conducted in a zonal care hospital probing the role of FNAC in palpable head and neck lesions & its diagnostic utility which can differentiate the various neoplastic and non neoplastic lesions of head and neck very cost effectively. To study diagnostic utility of fine needle aspiration cytology(FNAC) in head and neck lesions. A one year prospective observational study carried out at a zonal care hospital, which included a total of 120 patients reported with head and neck masses in the Otorinolaryngology OPD. Out of 120 FNACs, 38 (31.66%) cases were of thyroid origin, 35 (29.16%) cases included cervical lymph nodes, 34 cases (28.33%) arised from soft tissue and 04 (3.33%) from salivary glands. Thyroid lesion involvement (31.66%) was more common than any other lesion, out of which 84.21% were colloid goitre, 7.89% were Hashimoto’s thyroditis, 5.26% follicular neoplasm and 2.56% papillary carcinoma of thyroid. Amongst the lymph node swellings, 13 cases (36.11%) were reactive/ nonspecific lesion, 12 cases (33.33%) were tuberculous granulomatous lymphadenitis, 16.66% were cases of suppurative lymphadenitis. In malignant lesions of lymph nodes, metastatic deposit of carcinoma and poorly differentiated carcinoma were the predominant pathology and lymphoma case was nil. FNAC of head and neck swelling is a worldwide accepted diagnostic modality. It is simple, inexpensive and rapid method for the diagnosis of head and neck lesion and avoids unnecessary surgery in the form of excision biopsy for diagnosis.

Background: Head and neck swellings are a very common presentation encountered by clinicians and patients across all age groups. Various lesions give rise to head and neck lumps. Swellings can arise from soft tissues, lymph nodes, thyroid gland, salivary glands etc. FNAC being minimally invasive, quick and inexpensive helps in differential diagnosis of head and neck masses.Materials and Methods: A retrospective study was conducted at Karwar institute of medical sciences Karwar from January 2018 to December 2021 in coastal population, to evaluate the role of FNAC in palpable head and neck masses and also to study their distribution and To evaluate the diagnostic accuracy, sensitivity and specificity of FNAC in diagnosing Head and neck lesions and cyto-histopathological correlation (wherever possible). 500 patients with head and neck swelling underwent FNAC. FNAC diagnosis was correlated with detailed clinical history and investigations.

Palpable masses in head and neck are a common clinical finding, affecting all age groups. These lumps may be extremely worrying for both physician and patient, as a wide variety of pathological conditions. Accurate cytological analysis has played a major role in evaluation and planning for surgery. We attempted to evaluate the role of Fine Needle Aspiration Cytology (FNAC) in diagnosing lesions of the head and neck region and to review the diversity of lesions in the patients attending the hospital. The study was conducted retrospectively in the department of pathology at College of Medical Sciences- Teaching Hospital, Bharatpur, Nepal a tertiary health care centre. The target population comprised patients presenting with palpable masses at head and neck region during the period of February 2007 to December 2009. The accuracy of FNAC was verified by histological examination in this final study group of (n=125) patients. In these (n=125) patients, twenty five were males and hundred were females. Thyroid gland (60%) was the commonest site aspirated, followed by lymph node (20%), salivary gland (16%) and soft tissue lesions (4%). In our study the sensitivity was 87.5%, the specificity was 100%, the positive predictive value was 100%, the negative predictive value was 98.26% and false negatives were 12.5%. We concluded that FNAC is a safe, cost-effective, sensitive and specific technique in the initial evaluation of head and neck masses. A correct cytological diagnosis can be achieved in a majority of cases, avoiding the need for surgical interventions. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 19-25 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6721

BACKGROUND Fine needle aspiration cytology (FNAC) is a rapid, economical and less invasive method used for diagnosis in case of head and neck lesions which are commonly seen in general practice. Aim was to assess advantage of using FNAC in case of diagnosis of palpable head and neck masses. We wanted to assess the prevalence and distribution of head and neck swellings diagnosed by FNAC, assess the frequency and distribution of various lesion as per the site, age, and gender as well as according to the lesion being benign or malignant. METHODS This was a retrospective study conducted among five hundred and forty-four patients who went through FNAC for different types of head and neck swellings evaluated for cytomorphology. RESULTS Majority of the patients belonged to the age group of 31 to 40 years. Out of 544 cases, maximum lesions were from lymph nodes 264, followed by thyroid gland 193, salivary gland 59, cheek lesions 18, post–auricular 8 and forehead / scalp lesions 2 cases respectively. CONCLUSIONS FNAC being extremely sensitive, specific and a reliable procedure for screening and primary diagnosis of palpable head and neck lesions, helps as an adjunct to histopathology. For surgical and radiological decisive purposes, to decide as to whether to resect a benign tumour or to plan extensive surgeries, FNAC helps in guiding the therapeutic management by avoiding unnecessary surgeries and expenses. KEY WORDS Head & Neck, Lymph Node, Goiter

Background: In adults, lymph nodes are not normally palpable. A number of patients with asymptomatic lymphadenopathy never visit physicians for the condition, and thus, this important sign is often missed by the medical practitioner if it is not the presenting complaint. The incidence of lymphadenopathy is suggested to be increasing. While lymphadenopathy is benign and self-limiting in most patients, the underlying disease may range from treatable infectious etiology to malignant neoplasms. In most cases clinical examination and history guide towards the cause of lymphadenopathy. In recent years, fine needle aspiration cytology (FNAC) has become an easy clinical tool (with or without the assistance of CT, MRI, and ultrasound) for the diagnosis of the underlying cause of lymphadenopathy.Aims and objectives: To find out the cytomorphological pattern in superficial lymphadenopathy with the help of FNAC.Materials and methods: This descriptive cross-sectional study was conducted at HBS General Hospital, Islamabad from January 2017 to June 2019. Patients presenting with superficial lymphadenopathy were included in the study. FNAC was performed by the pathologist, histopathological reports were examined and analyzed using Statistical Package for the Social Sciences (SPSS) version 22 (IBM Corp., Armonk, NY). Results: Six hundred and thirty-two patients underwent FNAC. Tuberculous lymphadenitis was the most common diagnosis (56.1%) followed by reactive hyperplasia (28.29%). The sample showed metastatic malignancy 3.36% and lymphoma 2.05%. Cervical lymphadenopathy was the most common site for TB (49.36%). Metastatic cancer observed in cervical lymph nodes was 3.16% and lymphoma was 1.74%.Conclusion: FNAC is recognized as a simple and safe diagnostic technique that can diagnose cases of superficial and deep lymphadenopathy easily. The most common cause of superficial lymphadenopathy in our study was tuberculosis with cervical lymph nodes.

Background: Fine needle aspiration cytology is a minimally invasive technique used in the initial diagnosis of different types of lesions located in head and neck region commonly originating from cervical lymph node, thyroid gland, salivary glands and soft tissues. The objective of this study was to evaluate the diagnostic accuracy, sensitivity and speci city of FNAC in various head and neck lesions in correlation with their histopathological examination. Materials and methods: A hospital based prospective study was conducted among 209 patients with palpable head and neck region swellings in the Department of Pathology, Bhaktapur Cancer Hospital and the Department of Pathology, Nepal Medical College from August 2014 to July 2015. FNAC were done from palpable masses of head and neck regions. Data entry and analysis were done using SPSS 17. Result: There were 209 FNAC cases enrolled, out of which lymph node lesions (n=128) were the most common lesions followed by thyroid (n=40), other soft tissues (n=27) and salivary gland (n=14). Reactive lymph nodes, colloid goiter, epidermoid cyst and sialadenosis were the predominant diagnosis of lymph nodes, thyroid gland, soft tissues and salivary gland respectively. Highest accuracy, sensitivity and speci city were observed in thyroid gland, salivary gland and soft tissues. However, four false negative results for malignancy were reported in lymph node lesions. Conclusion: Head and neck region swellings are the commonly encountered conditions. FNAC being highly accurate, sensitive and speci c makes it useful and reliable procedure for screening and diagnosis of palpable masses in head and neck region.

Introduction: The head and neck masses are relatively common pathology. These head and neck masses are evaluated by clinical history and examination with the aid of investigations like FNAC, USG and CT of the region and excision biopsy. Fine Needle Aspiration Cytology (FNAC) is a very simple, quick, inexpensive and minimally invasive technique used to diagnose different types of swellings like lymph node, thyroid, soft tissue and salivary glands in head and neck region. Objectives: It is to assess the frequency and incidence of different sites, age, sex and distribution of inflammatory, benign and malignant lesions. Methods: A retrospective study was conducted at GMERS Medical College & Hospital, Junagadh, Gujarat from January 2018 to December 2018. Patients between the ages of 35days to 85 years were enrolled into the study. A total of 139 patients with a head and neck swelling underwent FNAC. Fine needle aspiration diagnosis was correlated with detailed clinical findings and investigations. Result: Out of 139 fine needle aspiration procedures 64.02% (89 cases) were of lymph node, 18.7% (26 cases) were of thyroid, 2.87% from salivary gland(04 cases), 12.94% (18 cases) from skin and soft tissue swellings. Out of total 139 lesions, 80 (57.55%) were inflammatory, 48 (34.53%) benign and09 (6.47%) were malignant and 02 (1.43%) were inconclusive. Conclusion: From our study we concluded that FNAC is simple, quick, inexpensive and minimally invasive first line investigation for differential diagnosis of head and neck masses.

Background: Palpable superficial mass (es) is a major complain making patients attending any surgical and otolarygeal clinic. Most of these lesions are related to thyroid, cervical lymph nodes or salivary glands Triple assessment technique using clinical examination, ultrasound and cytology are usually sufficient in reaching the final diagnosis especially in specialized surgical centers. Aims: The objective of this study was to assess how accurate ultrasound in guessing the diagnosis of the lesion and how accurate as a guide for fine needle aspiration cytology (FNAC). Methods: A prospective study included 50 patients who were presented with self-detected head or neck lump and attending the specialized surgical clinic in the Medical City Complex, Baghdad during the period from November 2019 to October 2020. Their age ranged from 10-63 years. Patients were underwent ultrasound examination after clinical examination and then subjected to ultrasound guided FNAC. Results: Twenty patients presented with palpable lump were included in this study. Their ages ranged between 10 to 63 years (mean age 37.8 years). Regarding the distribution of the anatomical locations the majority of the lesions were lymph nodes (7/20) six of them are cervical and one of them was inguinal, the 2nd common location was the parotid gland seen in four out of twenty, The provisional diagnosis provided by ultrasound for lococregional pathology was benign in majority of Lymph node group (5/7) and malignant in two, three out of four parotid lesions are benign and all thyroid cases are also benign, The FNAC results in correlation with ultrasound findings are in concordance regarding the lymph nodes and parotid aspirates in 100% while thyroid aspirate was in concordance in 100% after two passes due to bloody aspirate, the aspirate from the breast is 50% in line and no concordance seen in 50 %, the aspirate is compatible regarding the hip mediastinum and sternomastoid while is not conclusive in lung aspirate. The accuracy of ultrasound in guiding the needle for targeting the lesion is 100%, and overall accuracy of ultrasound in reaching the final diagnosis is 85% with 100 % sensitivity. Conclusion: Ultrasound guided FNAC represents a reliable interventional radiology modality for targeting the needle to any superficial or ultrasound reachable deep seated head and neck lesion and considered a recommended method for assessment of underlying cause responsible for palpable head and neck mass this is due to reliable focusing the mass lesion, avoiding nearby vital organ or vessel and direct real time visualization of the needle within the lesion and by that sampling cells by flickering the needle within the lesion.

Fine needle aspiration cytology is a simple, rapid, cost-effective method in diagnosis of head and neck swelling with minimal risk of complications. Head and neck swellings include a broad spectrum of diseases with different management for each. Fine needle aspiration cytology is a suitable and useful method for assessment of these swelling. This study was done with the objective to study the frequency and distribution of various head and neck lesions detected by fine needle aspiration cytology. A descriptive cross-sectional study was conducted at the Department of Pathology in a tertiary care center from February 1 to July 31, 2023 after obtaining ethical approval from Institutional Review Committee (Reference number: IRC-PA-191/2078-79). All the patients presenting with head and neck swelling during the study period were included in this study. Total sampling was done. Fine needle aspiration was done and cytological diagnosis was made. Descriptive analysis was done where frequency and percentage were calculated. Out of 112 cases included in the study, 43 (38.40%) were of lymph nodes, 36 (32.14%) of thyroid, 22 (19.64%) of skin and soft tissue and 11 (9.82%) of salivary glands. Among the lymph nodes cases, there were 11 (25.57%) metastases. In thyroid lesions, beingn lesions were seen in 24 (66.68%). This study found that lymph nodes were the most common site for head and neck swellings, frequently involving metastatic lesions.

Introduction: Head and neck lesions most commonly arise in cervical lymphnodes followed by thyroid gland, soft tissues and salivary gland. Fine Needle Aspiration Cytology (FNAC) is a pre surgical procedure done on OPD (Out Patient Department) basis having advantages like; it is simple, minimally invasive, cost effective and repeatable diagnostic tool. Even though these lesions are common, clinicians routinely face problems in their diagnosis. Hence FNAC plays an important role in providing quick and accurate diagnosis guiding the clinician for appropriate treatment. Aims and objectives: 1.To study the occurrence of various head and neck lesions in this region; 2.To study the cytological features of various head and neck lesions; 3.To correlate the cytological features with clinical data; 4.To emphasize the utility of FNAC in the diagnosis of head and neck lesions. Materials and Methods: A retrospective study was conducted among 500 patients with palpable head and neck lesions including oral cavity attending GIMS Hospital Kalaburagi and the Department of Pathology Gulbarga Institute of Medical Sciences, Kalaburagi from January 2018 to December 2018. Relevant clinical details were recorded and written consent was obtained. Results: A total of 500 FNAC cases of head and neck lesions were included in the present study in which 172(34.4%) were males and 328(65.6%) were females. Patients age ranged from 8 months to 80 years. Peak incidence was seen in between 21-40 years of age. Lymph node lesions 201(40.2%), were the most common lesions followed by thyroid lesions 138(27.6%).Soft tissues 123(24.6%) and lesions from major and minor salivary glands 25(5%) were the other head and neck lesions seen in this study. Reactive lymph node hyperplasia (n=105), colloid goiter (n=78), epidermoid cyst (n= 62) and pleomorphic adenoma (n=12) were the predominant diagnosis of lymphnodes, thyroid gland, soft tissues and salivary gland lesions respectively. Secondaries to the lymph node

Head and neck masses are a common presentation in daily practice and can be challenging to both clinicians and cytopathologists. Fine needle aspiration cytology (FNAC) is a widely used method for the diagnosis of head and neck masses. The aim of the study was to assess our institutional experience of the accuracy of FNAC in the diagnosis of head and neck masses. A total of 1262 FNACs were conducted from January 2013 to December 2016 and subdivided into benign and malignant categories. The thyroid and salivary glands FNACs were classified according to the Bethesda System for Reporting Thyroid cytopathology and to the Milan System for Reporting Salivary Gland Cytopathology respectively. The measures of diagnostic accuracy of FNAC were determined taking histology as a gold standard. A total of 7 false negative (FN) and 6 false positive (FP) FNACs were identified. Overall sensitivity and specificity of FNAC for a malignant diagnosis were 92% and 94.4%, respectively. Accuracy of FNACs of head and neck masses was 93.5% for all sites. The salivary gland group had the highest rate of FN (2.8%). All FP were reported in the thyroid group. These cases were cytologically classified suspicious for malignancy (n = 3) and papillary carcinoma (n = 3) and proved to be lymphocytic thyroiditis on final histology. Among the most common locations, cytology of lymph nodes provided the best sensitivity (98.2%). Salivary glands as well as lymph nodes had the best specificity (100%). FNAC of head and neck masses has a high accuracy allowing a correct therapeutic management. However, this accuracy depends on the anatomic location of the mass.