Role of ultrasonography and fine-needle aspiration cytology in the evaluation of neck masses

Abstract

Objective: The objective of the study is to study the efficacy of ultrasonography (USG) and fine- needle aspiration cytology (FNAC) in the evaluation of neck masses and differentiating between cystic, inflammatory, benign, and malignant neck masses with a histopathological correlation. Study Design: Prospective study and observational study. Setting: J. L. N. Hospital and Research Centre, Bhilai (C. G). Study Period: June 1, 2016–May 30, 2017. Materials and Methods: Sonographically, neck masses were evaluated final diagnosis was made on the basis of FNAC and histopathology of excised specimens. Finally, the USG findings were correlated with FNAC report and histopathology reports (wherever possible) to evaluate their sensitivity, specificity, and accuracy by statistical methods. Results: Most of the cases clustered between 31 and 60 years of age group. Among all patients, males outnumbered the females with the M:F ratio 1.5:1. Hyperechoic and anechoic lesions suggested benign pathology, whereas chances of malignancy were highest with hypoechoic lesions. As diagnosed by USG, the majority was benign lesion (36.4%), followed by inflammatory neck masses (27.08%), then cystic neck masses (20.83%) and least was malignant masses (15.63%). FNAC impression diagnosed benign mass (32.29%), inflammatory mass (26.04%), cystic mass (19.79%), and malignant mass (15.63%). The diagnostic accuracy of USG, FNAC, and Histopathological Examination (HPE) was comparable as P ≤ 0.05 for inflammatory, cystic, benign, and malignant neck masses. Conclusion: High-resolution grayscale ultrasound can differentiate inflammatory, cystic, benign and malignant neck masses. FNAC can be considered highly efficacious in distinguishing benign and malignant neck masses. A team work between a cytopathologist, radiologist, and clinician maximizes the diagnostic utility of USG and FNAC.