Diagnostic Efficacy of Fine Needle Aspiration Cytology in Cystic Lesions of Head and Neck Region - A single Experience at Tertiary Health Care Centre

Abstract

Introduction: The cystic lesions of head and neck region are common presentation in the Outpatient Department and encompass a wide spectrum of differential diagnosis, ranging from inflammation to malignancy. Though, Fine Needle Aspiration Cytology (FNAC) is a well established modality for the precise diagnosis of solid lesions of head and neck region, its role in cystic lesions has not been assessed much. Aim: To evaluate the role of fine needle aspiration cytology in the diagnosis of cystic lesions in the head and neck region and to correlate the cytology findings with histopathological diagnosis wherever possible. Materials and Methods: This prospective study included FNAC of 162 cases of cystic lesions of head and neck region referred to the department between November 2014 and May 2016. Aspiration was done using 22-25 gauge needles. The aspirates were stained appropriately. Cytomorphology was studied and subsequently correlated with histopathological features wherever possible. Results: Among the 162 cases studied, 123 were negative/ benign, two were suspicious of papillary carcinoma and 34 were malignant cases. The remaining three cases were inadequate for reporting and hence were excluded from statistical analysis. Among the malignant cases, metastatic squamous cell carcinoma was the commonest. Histopathological correlation was available in 88 cases with 85 cases consistent with FNAC diagnosis. Sensitivity and specificity was 85% and 100% respectively. Overall accuracy was found to be 96.59%. Conclusion: The cytological study of cystic lesion of head and neck is important for accurate identification of the lesions preoperatively and expedite the planning of therapy. Hence, the study assumes importance. The limitation of FNAC in cystic lesions can be overcome by re-aspiration from residual solid area after draining the cyst under ultrasound guidance.

Keywords

• cystic aspirate
• cytodiagnosis
• histopathology