Cytohistological Study of Head and Neck lesions and their Diagnostic Pitfalls
Keywords:
Cytology, Lymph Node, Thyroid, Histopathological Examination
Abstract
Background: Head and neck swellings often present with a perplexing diagnostic dilemma and may originate from lymph nodes, thyroid and salivary glands. FNAC is presently employed for both therapeutic and prognostic reasons, thereby helping the surgeon to decide modality of treatment. Thus this study was conducted with an aim to correlate cytological diagnosis of head and neck swellings with histopathology and to compare statistical data employing sensitivity, specificity and diagnostic accuracy.Methods: This was a retrospective study carried out for duration of 3 years and included 1231 cases referred to the Department of Pathology. FNAC was done from palpable head and neck masses and correlated with histopathology findings. Statistical analysis was done to calculate the sensitivity, specificity and diagnostic accuracy of cytological diagnosis.Results: Of 1231 cases for which FNAC was done, 234 cases were available for histopathological correlation. There was an overall male preponderance with male:female ratio being 1.04:1. The age of patients ranged between 16 years to 90 years. The maximum number of aspirates were from lymph nodes (680 cases, 55.23%) followed by thyroid gland (324 cases 26.32%), neck and post-auricular swellings (117, 9.5%) and salivary gland (110, 8.9%). Statistical analysis was done to calculate overall diagnostic accuracy sensitivity, specificity of FNAC and was found to be 93.4%, 72.8%, 97.3% respectively.Conclusion: FNAC is fairly accurate, reliable and cost effective method for rapid and reliable diagnosis of palpable lesions in the head and neck region, thus helping the surgeon modify or monitor his surgical approach.References
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2. Mitra P, Bharti R, Pandey MK. Role of fine needle aspiration cytology in head and neck lesions of paediatric age group. J Clin Diag Res 2013;7:1055-8.
3. El Hay IA, Chiedozi LC, al Reyees FA, Kollur SM. Fine needle aspiration cytology of head and neck masses. Seven years experience in a secondary care hospital. Acta Cytol 2003;47:387-92.
4. Boccalo P, Altavilla G, Blandamura S. Fine needle aspiration biopsy of salivary gland lesions. A reappraisal of pitfalls and problems. Acta Cytol.1998;42:888-98.
5. Singal P, Bal MS, Kharbanda J, Sethi PS. Efficacy of fine needle aspiration cytology in Head and Neck lesions. IJMD 2014; 3(2):131-4.
6. Tandon S, Shahab R, Benton JI, Ghosh SK, Sharad J, Jones TM. Fine needle aspiration cytology in a regional head and neck cancer center: Comparison with a systematic review and meta analysis. Head Neck 2008;30(9):1246-56.
7. Fernandes H, D’souza CR, Thejaswini BN. The role of fine needle aspiration cytology in palpable head and neck masses. J Clin Diagn Res 2009;3:1719-25.
8. Taviad DS, Jadav K, Nikhra P, Panchal A, Patel V. Role of fine needle aspiration cytology in head and neck swelling. Int.J Res Med 2014;3:131-4.
9. Tilak V,Dhadad Av, Jain R. Fine needle aspiration cytology of head and neck masses. Indian J Pathol Microbiol.2002;4591):23-9.
10. Khan RA, Wahab S, Chana RS, Naseem S, Siddique S. Children with significant cervical lymphadenopathy: clinicopathological analysis and role of fine needle aspiration in Indian setup. J Pediatr (Rio J).2008;84(5):449-454.
11. Javaid M, Niamalulla, Anwar K, Said M. Diagnostic value of fine needle aspiration cytology in cervical lymphadenopathy. JPMI 2006;20:117-120.
12. Wakeley PE. Fine needle aspiration cytopathology in diagnosis and classification of malignant lymphoma: accurate and reliable ? Diagn Cytopathol 2000;22:120-25.
.
13. Orell SR, Sterrett GF, Walters Max N et al: Lymph nodes. In Manual and Atlas of Fine Needle aspiration of cytology, 4th Edn. New York: Churchill Livingstone 2005:103-114.
14. Rosai J. ed. Rosai and Ackerman’s surgical Pathology 9th ed. Vol. 2, New York Mosby; 2004: 1908- 09.
15. Ng WK, Ip P, Choy C, Collins RJ. Cytologic findings of angioimmunoblastic T-cell lymphoma. Analysis of 16 fine needle aspiration over a 9 year period. Cancer(Cancer cytopathol) 2002;96:166-73.
16. AI Shangeely D, Mourad Wa. Diagnosis of peripheral T-cell lymphoma by fine needle aspiration biopsy: a cytomorphologic and immunophenotypic approach. Diagn Cytopathol 2000;23:375-79.
17. Frable WJ, Kardos TF. Fine needle aspiration biopsy. Application in the diagnosis of lymphoproliferative disease. AM J surg Pathol 1988;12:62-72.
18. Baloch ZW, Livolsi VA. Cytologic and architectural mimics of papillary thyroid carcinoma. Am J Pathol. 2006;125:135-44.
19. Canberk S, Firat p, Schmitt F. Pitfalls in the Cytological Assesment of Thyroid Nodule. Turkish Journal of Pathology 2015;31( Suppl):18-33.
20. Neki NS, Kazal HL. Solitary Thyroid Nodule-An Insight. JIACM 2006;7(4):328-33.
21. Jayram G. Fine needle aspiration cytology study of the solitary thyroid nodule. Profile of 308 cases with histologic correlation. Acta Cytol 1985;29 (6):967-73.
22. Kollur SM, ElL Sayed S, EL Hag IC. Follicular thyroid lesions coexisting with Hashimoto’s thyroiditis: incidence and possible sources of diagnostic errors. Diagnostic Cytopathology 2003; 28(1):35-38.
23. Khafaji BM, Nestok BR, Katz RL. Fine- needle aspiration of 154 parotid masses with histologic correlation. Cancer Cytopathol 1998;84(3):153:59.
24. Pawani AV, Ali SZ. Diagnostic accuracy and pitfalls in fine needle aspiration interpretation of Warthin tumour. Cancer 2003; 99:166-71.
25. Thapliyal N, Joshi U, Vaibhav G, Sayana A, Srivastva AK, Jha RS. Pilomatricoma Mimicking Small Round. Cell Tumor on Fine Needle Aspiration Cytology. A Case Report. Acta Cytologica 2008;52(5):2008.
26. Poorey VK, Tyagi A. Accuracy of Fine Needle aspiration Cytology in Head and Neck Masses. Indian J Otolaryngol Head Neck Surg. 2014; 66(2):182-86.
27. Hidvegi DF, Sorensen K, Lawrence JB, Nieman HL, Isoe C. Castleman’s disease. Cytomorphological and cytochemical features of a case . Acta Cytol 1982;26(2):243-46.
28. Balakrishnan K, Castling B, Mc Mahon J, et al. Fine needle aspiration cytology in the management of a parotid mass: a two centre retrospective study. Surgeon 2005;3 (2):67-72.
Published
2016-11-06
Section
Original Article
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