Our results of fine-needle aspiration cytology of the head and neck masses excluding thyroid: Experience of Uludag

Abstract

Objectives: To evaluate the results of fine needle aspiration cytology (FNAC) used for extra-thyroidal masses of the head and neck in our institution.Methods: The results of 542 FNAC done on 487 patients, referred to our university hospital in five years period from 1998 to 2002, with extra-thyroidal masses of the head and neck were evaluated retrospectively by examining the files in the department of pathology. FNAC results of 127 patients, who also had permanent biopsy results, were evaluated according to age and localization of the pathology. The rates of accuracy, specificity, sensitivity, positive and negative predictive values were calculated.Results: During this period, 62.5% of the all FNACs were done on head and neck masses, and 12.9% of those to extra-thyroidal pathologies. Accuracy rates of FNAC were 94.3% for congenitaldevelopmental pathologies, 89.4% for infectious-inflammatory pathologies (93.5% for specific infections), and 83.7% for neoplastic pathologies (85.9% for malignancies). There were no statistically significant differences between the accuracy rates of FNAC according to patient's age and localization of the pathology. False negative rate was higher than false positive rate in malignant lesions. Correct diagnostic rate based on the cellular differentiation in the malignant pathologies was 50%.Conclusion: 1. FNAC has a high accuracy rate for head and neck masses. 2. FNAC should be first step of pathological examination in all head and neck masses with an intact overlying mucosa or skin. 3. There are no differences between the accuracy rates of the FNAC of the childhood or the adulthood period. 4. There are no differences between the accuracy rates of the FNAC of the pathologies of the neck or the salivary glands. 5. Clinically, FNAC should only be used as a guide for preliminary diagnosis, especially in malignant pathologies. Final treatment decision should not be made according to the results of FNAC and tissue biopsy should be obtained before definitive treatment.