Published: 2016-12-29

Evaluation of fine needle aspiration cytology in the diagnosis of head and neck masses and its correlation with histopathological findings

Ajay Singh Thakur, Renuka Gahine, Vishal Kulkarni


Background: A number of masses may develop in the head and neck region and these can also be called swellings, growths, tumors or lumps. Various diseases may affect head and neck region, which present clinically as swellings. Commonly presenting head and neck masses occur within the thyroid, salivary glands and lymph nodes. The evaluation of head and neck mass is a common clinical dilemma and a condition which clinicians routinely encounter. It is evident that their early diagnoses provide the best chance of successful treatment. FNAC is a simple, quick and cost effective method to sample superficial masses found in the head and neck region. An early differentiation of benign from malignant pathology greatly influences the planned treatment. FNAC can be both diagnostic and therapeutic in cystic swellings.

Methods: The present Retro prospective study (Prospective for one year from January 2013 to December 2013 along with five year retrospective from January 2008 to December 2012) was carried out in the Department of Pathology, Pt. J.N.M. Medical College and associated Dr. B.R.A.M. Hospital, Raipur. Cases for prospective study were selected from patients presented with head and neck masses attending the ENT OPD and indoor patients. Two techniques were used to perform FNAC. (Aspiration technique and Non-aspiration technique) After FNAC of head and neck lesions follow up of cases was done for histopathological examination. Final histopathological diagnosis was compared with the FNAC findings to assess the accuracy of cytodiagnosis.

Results: A total of 12,514 FNACs done during six years, 1874 (14.9%) cases were diagnosed as head and neck lesions. Of the total 1874 cases of head and neck lesions, lymph node lesions were the commonest, accounting for 50.8% of cases. Thyroid and salivary gland lesions constituted 32.6% and 10.4% respectively. Analysis of FNAC of thyroid lesions, discordance was found more in malignant (11.8%) as compared to benign lesions, while Discordance was found more in benign lesion (12.4%) as compared to malignant lesion aspirates in lymph node lesions.

Conclusions: FNAC is having a high diagnostic rate to differentiate benign and malignant lesions.


Head and neck mass, FNAC, Histopathology, Discordance

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Chandak R, Degwekar S, Bhowte RR, Motwani M, Banode P, Chandak M, et al. An evaluation of efficacy of ultrasonography in the diagnosis of head and neck swellings, Dentomaxillofac Radiol. 2011;40(4):213-21.

Setal C, Rathod D, Joshi DS. FNAC of Swellings of Head and Neck Region. Indian Journal of Applied Basic Medical Sciences. 2011;13(17):1-6.

Tracy TF Jr, Muratore CS. Management of common head and neck masses. Semin Pediatr Surg. 2007;16(1):3-13.

Amatya BB, Joshi AR, Singh SK, Panth R, Basnet RB. A study of fine needle aspiration cytology of head and neck masses and their corroboration by histopathology post Graduate Medical Journal of National Academy of Medical Sciences. 2009;6(2).

Orell SR. Manual and Atlas of FNAC Second edition, 1995.

Mahar SA, Husain A, Islam N. Fine needle aspiration cytology of thyroid nodule: diagnostic accuracy and pitfalls. J Ayub Med Coll Abottabad. 2006;18(4):26-9.

Nguyen GK, Lee MW, Ginsberg J, Wragg T, Bilodeau D. Fine Needle Aspiration of the Thyroid: an overview. Cyto Journal. 2005;2(12):1742-64.

Mukunyadzi P. Review of fine-needle Aspiration of Salivary Gland Neoplasms, With Emphasis on Differential diagnosis. Am J ClinPathol. 2002;118(Suppl 1): S100-15.

Zajicek J. The aspiration smear, In: Koss LG, eds. Diagnostic Cytology and its Histologic Bases. 3rd ed. Philadelphia: Lippincott. 1979:1082-100.

Koss LG. Stain techniques. In: Koss LG, eds. Diagnostic Cytology and its Histopathologic Basis. 1st ed. London: JB Lippincott. 1961.

Singal P, Bal MS, Kharbanda J, Sethi PS. Efficacy of fine needle aspiration cytology in Head and Neck lesions.Int J Med and Dent Sci. 2014;3(2):421-30.

Jindal U. Spectrum Of Head And Neck Swellings In The Rural Population Of India Based On Fine Needle Aspiration Findings." Internet Journal of Head & Neck Surgery. 2012;5:2.

Solanki PK. Fine needle aspiration cytology as a Diagnostic procedure in head and neck Swellings. National journal of community medicine 2012;3(3):433-6.

Sharma R, Mathur D.R. "Fine Needle Aspiration Cytology (FNAC) Of Palpable Lesions Of Head And Neck Region." International Journal of Current Research and Review. 2012;4(22):74-84.

Huq MM. "Evaluation of neck swelling by cytological and histopathological examination." Bangladesh Journal of Otorhinolaryngology. 2012;18(1):23-9.

Uddin MS, Abdullah M, ABMK. Alam; "Co-Relation between FNAC Findings and Histopathological Diagnoses of Neck Masses-A Study of Sixty Cases." Medicine Today. 2012;23(2):83-7.

Dhaded TVAV, Jain R. Fine needle aspiration cytology of Head and Neck masses. Indian J. Pathol.Microbiol. 2002;45(1):23-30.

Gupta M, Gupta V, Bajaj P, Kanwardeep Jhajj K; “Role of preoperative cytology in the management of salivary gland neoplasms”. Journal of Evolution of Medical and Dental Sciences. 2013;2(39):7475-82.

Rakhshan M, Rakhshan A. “The diagnostic accuracy of fine needle aspiration cytology in neck lymphoid masses”, Iranian Journal of Pathology. 2009;4(4):147-50.

Fernandes H, D’Souza CRS. FNAC Head And Neck Masses. Journal of clinical and diagnostic research 2009;3(5):1719-25.