Fine needle aspiration cytology of parapharyngeal tumors

Abstract

Background:Parapharyngeal tumors are rare and often pose diagnostic difficulties due to their location and plethora of presentations.Objectives:The study was undertaken to study the occurrence in the population and to evaluate the exact nature by fine needle aspiration cytology (FNAC).Materials and Methods:A total of five hundred and six cases of lateral neck lesions were studied over three and half years. Of these 56 suspected parapharyngeal masses were selected by clinical and radiological methods. Cytopathology evaluation was done by fine needle aspiration cytology with computed tomography and ultrasonography guidance wherever necessary. Histopathology confirmation was available in all the cases.Results:On FNAC diagnosis could be established in 54 cases while in two cases the material was insufficient to establish a diagnosis. The tumors encountered were, pleomorphic adenoma (33), schwannoma (3), neurofibroma (11), paraganglioma (5), angiofibroma (1) and adenoid cystic carcinoma (1). Four false positives and two false negative cases were encountered. Overall sensitivity was 96%, with specificity of 99% and accuracy being 98.8%.Conclusions:With proper clinical and radiological assessment, FNAC can be extremely useful in diagnosing most of these lesions except a few which need histopathological and even immunohistochemical confirmation.