Retrospective audit of Ultrasound guided fine needle aspiration cytology and core biopsy in the assessment of head and neck lumps excluding thyroid nodules at South Warwickshire NHS Foundation Trust

Abstract

Objectives: Compare rates of diagnostic versus non diagnostic outcomes for fine needle aspiration (FNA) and core biopsy for non-thyroid head and neck lumps.Methods: Audit on biopsy technique used for ultra sound guided biopsies of non-thyroid neck lumps was performed over a 12-month period in South Warwickshire NHS Foundation trust (SWFT) in the year 2022. Data was collected from records in the Histopathology laboratory and electronic patient records.Results: A total of 72 lumps underwent biopsy during this period at SWFT and amongst them were 38 parotid lumps, 3 submandibular lumps, 29 lymph nodes and 2 other head and neck lumps. There were 34 fine needle aspirations were done for parotid lumps and 8 of them were non diagnostic. 4 of them went on to have core biopsies and all of them were diagnostic. There were 21 ultra sound guide core biopsies performed and only 2 of them were non diagnostic and required excision biopsy. There were 8 patients who underwent FNA and only 4 of them were diagnostic. The sensitivity of FNA for lymph nodes and salivary glands was 50% and 77% respectively. Core biopsy showed a 100% sensitivity for salivary gland and a 90.5% sensitivity to lymph nodes.Conclusion: FNAC yields good results with salivary gland lumps. Core needle biopsy has better sensitivity for investigation of enlarged cervical lymph nodes and has added advantage of immunohistochemistry and molecular testing.