Investigation of lymphoid lesions of the head and neck using combined fine needle aspiration cytology and flow cytometry: Accuracy and pitfalls

Cytopathology ◽  
2019 ◽  
Vol 30 (4) ◽  
pp. 370-377 ◽  
Author(s):  
Heinrich Crous ◽  
Amanda Gillam ◽  
Mary‐Anne Kalokerinos ◽  
Sasenka Knezevic ◽  
Peter Hobson ◽  
...  
1993 ◽  
Vol 107 (11) ◽  
pp. 1025-1028 ◽  
Author(s):  
N. J. Roland ◽  
A. W. Caslin ◽  
P. A. Smith ◽  
L. S. Turnbull ◽  
A. Panarese ◽  
...  

AbstractThis paper describes the application of fine needle aspiration cytology (FNAC) performed on92 patients with salivary gland lesions in a Head and Neck Surgery Clinic. The aspirates were immediately reported by a cytopathologist and the reports conveyed to the surgeon during the same clinic visit. FNAC results were then compared with histology in those patients who underwent surgery and with the clinical course of the disease at subsequent clinic visits in patients where surgery was not performed. The cytological diagnosis was incorrect in five cases, one of which was a false negative result. There were no false positive results. The sensitivity was 90.9 per cent and the specificity 100 per cent. This rapid report system of fine needle aspiration cytology has been found to be safe, free of complications, and helpful in the planning of treatment.


2015 ◽  
Vol 04 (02) ◽  
pp. 80-85
Author(s):  
Junu Devi ◽  
Kunja Lal Talukdar

Abstract Background : Fine needle aspiration cytology is a simple, quick,inexpensive and minimally invasive technique used to diagnose 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 were available. Aim : To assess the frequency of various benign and malignant neoplasms in different age groups and to evaluate the sensitivity, specificity of fine needle aspiration cytology(FNAC) in head and neck neoplasms. Materials and method : The study was conducted between September 2011 to August 2013 and total 249 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 249 head and neck neoplasms 55.42% were from lymph node, 19.28% were from salivary gland, 14.86% were from thyroid gland, 1.20% were nasal mass, 9.24% from other sites (skin and soft tissue). M:F was 1.4:1. Most commonly affected age group was 51-60 years. Metastatic squamous cell carcinoma was most commonly encountered neoplastic lesion. Overall sensitivity, specificity oflme needle aspiration cytology(FNAC) were 97.92% and 91.67% respectively. Conclusion : Fine needle aspiration cytology is a highly sensitive, specific and has a definite role in diagnosing most of the head and neck neoplasms.


2006 ◽  
Vol 121 (6) ◽  
pp. 571-579 ◽  
Author(s):  
D C Howlett ◽  
B Harper ◽  
M Quante ◽  
A Berresford ◽  
M Morley ◽  
...  

Aim: To establish the diagnostic accuracy and adequacy of fine needle aspiration cytology (FNAC) within a regional cancer network, and to determine what service improvements may be required to allow successful implementation of an FNAC-based, ‘one-stop’ head and neck clinic, as proposed by the current National Institute for Clinical Excellence guidelines.Materials and methods: The Sussex cancer network serves a population of 1 200 000 and contains five hospitals within three acute trusts. In 2004, an audit was undertaken retrospectively to examine the diagnostic adequacy and accuracy of head and neck FNAC across the network. Comparisons were then made with the results of subsequent relevant surgery. For the purposes of the audit, FNAC was subdivided into three main groups: salivary gland, thyroid gland and neck node. As part of the data analysis, we also noted the clinical source of the FNAC and whether it was performed blind or under image guidance.Results: In 2004, 712 FNAC procedures were undertaken in 647 patients, 276 of whom underwent subsequent surgery. Fine needle aspiration cytology was non-diagnostic in 52 per cent of patients in the neck node group, in 50 per cent in the salivary gland group and in 30 per cent in the thyroid group. With these non-diagnostic results removed, statistical analysis was performed on data from those patients who had undergone both FNAC and subsequent surgery. This gave a sensitivity of 89 per cent and a specificity of 57 per cent in the neck node group, a sensitivity of 64 per cent and specificity of 100 per cent in the salivary gland group, and a sensitivity of 62 per cent and specificity of 86 per cent in the thyroid group. Diagnostic problems with FNAC were noted, particularly in the differentiation of reactive nodal hyperplasia from lymphoma and in diagnosing follicular thyroid lesions. Ultrasound guidance was used in 50 per cent of the thyroid FNAC procedures but in only a minority of patients in the neck node and salivary gland groups.Conclusion: This audit demonstrated widespread diagnostic difficulties associated with head and neck FNAC in a large patient sample. It is likely that these problems will be mirrored in other cancer networks. In order for one-stop head and neck clinics to succeed, the non-diagnostic rate of FNAC in particular must be minimised. There are strategies to enable this, depending on local resources, including increased access to cytologists or cytology technicians, diagnostic ultrasound, image guidance for FNAC and the use of ultrasound-guided core biopsy.


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