Evaluation of diagnostic value of fine needle aspiration cytology (FNAC) in head and neck neoplasms with application of immunological markers in selected cases

Background: Fine needle aspiration cytology is a simple, quick, inexpensive and minimally invasive technique used to diagnosed head and neck neoplasms commonly originated from cervical lymph node, thyroid, parotid and other salivary glands. In this study a correlation was done between cytology and histopathology whenever surgical specimens are available along with application of immunological markers in problematic cases. Aim: To assess the frequency of various benign and malignant neoplasms in different age group and to evaluate the diagnostic accuracy of fine needle aspiration cytology (FNAC) in head and neck neoplasms. Materials and methods: The study was conducted between September 2011 to August 2014 and total 336 cases of head and neck neoplasms were analysed. Patients between 1 to 80 years were included in the study. Fine needle aspiration cytology (FNAC) diagnosis was correlated with histopathology whenever possible. Results: Out of 336 head and neck neoplasms 164 (48.81%) were from cervical lymph node, 47 (13.99%) were from thyroid, 82 (24.40%) were from salivary glands, 5 (1.49%) were nasal mass and 38 (11.31%) were from other site (skin, soft tissue, orbit). M: F was 1.07: 1. Most commonly affected age group was 41- 60 years. Metastatic squamous cell carcinoma (SCC) was the most commonly encountered neoplastic lesion. Over all sensitivity, specificity, and diagnostic accuracy were 98.08%, 96.23%, 97.46% respectively. Cytologically and histologically consistent and inconsistent cases showed t = 2.722, p < 0.05. Few problematic cases 15(4.46%) needed immunohistochemical analysis for confirmation. Conclusion: Fine needle aspiration cytology is a highly sensitive, specific and has a definite role in diagnosing most of the head and neck neoplasms.