Study of Cytodiagnosis of Head and Neck Neoplastic Lesions and Comparison with Histopathology

ABSTRACT Introduction The development of aspiration cytology is one of the biggest advances in anatomic pathology. Cancer has become one of the 10 leading causes of death in India. Head and neck neoplasia is a major form of cancer in India, accounting for 23% of all cancers in males and 6% in females. The advantages of fine needle aspiration cytology (FNAC) are: it is safe, sensitive and specific for the diagnosis of malignancy, gives a rapid report, requires little equipment, causes minimal discomfort to the patient, is an out patient procedure, repeatable and cost effective avoids the use of frozen section, reduces the rate of exploratory procedures and allows a definitive diagnosis of inoperable cases. FNAC is of particular relevance in head and neck lesions because of easy assessibility, excellent patient compliance, minimally invasive nature of procedure and helping to avoid surgery in non-neoplastic lesions, inflammatory conditions and also some tumors. Aims and objectives To test the utility of FNAC, to establish the diagnostic accuracy of cytology by comparison with histopathology diagnosis and to establish the sensitivity and specificity of this technique in head and neck neoplastic lesion. Materials and methods The present study was undertaken in the Department of Pathology, Government Medical College and Hospital, Nashik, between January 2008 and June 2009. Results In the present study, maximum number of aspirates from head and neck neoplastic lesions were found to be of lymph nodes (56.37%). Of the total 378 cases, 71.69% were malignant. 6th decade was the most common age group affected (26.46%). Mean age group was found to be 45.84 years. Males were more commonly affected (65.34%). The male to female ratio was 1.8:1. Out of 92 cases available for follow-up, 85.87% of the cases were same as histopathological diagnosis. Summary and conclusion Excisional biopsy remains the gold standard for diagnosis of head and neck neoplastic lesion, cytological study can establish the diagnosis of the majority of head and neck neoplastic lesions and can be recommended as an adjunct to histopathology. How to cite this article Amit MU, Patel HL, Parmar BH. Study of Cytodiagnosis of Head and Neck Neoplastic Lesions and Comparison with Histopathology. Int J Head Neck Surg 2013; 4(3):119-122.

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UTILITY OF FNAC AS A DIAGNOSTIC TOOL IN HEAD AND NECK SWELLINGS

10.36106/gjra/7303125 ◽

2021 ◽

pp. 30-33

Author(s):

Akhil Nadesan ◽

Aparna M. Kulkarni ◽

Rajendra B. Madane

Keyword(s):

Head And Neck ◽

Diagnostic Tool ◽

Cost Effective ◽

Clinical History ◽

Excisional Biopsy ◽

Needle Aspiration ◽

Minimal Risk ◽

Accuracy Rate ◽

Female Ratio ◽

Neoplastic Lesion

Head and neck lesions encompass a multitude of congenital, inammatory or neoplastic lesions including several anatomic sites and originating in different tissues and organs. Fine needle aspiration cytology (FNAC) is a simple, quick, feasible, cost effective and repeatable outpatient procedure with minimal risk of complication. The study included 407 patients presented with palpable head and neck swelling in Department of Pathology RCSM GMC, Kolhapur from November 2016 to January 2018. Detailed clinical history of patient was noted. Aspirations were done by using 10 ml syringe and 22/23 gauge needles. Smears were stained with PAP, Haematoxylin and eosin and Leishman stain. Cyto-histopathological correlations were done wherever possible. Results: Out of 407 patients of head and neck lesions studied, lymph node 48.16%, was the predominant site aspirated with reactive lymphadenitis being the commonest lesion. Thyroid lesions constituted 32.68%, followed by soft tissue and miscellaneous 14.25% and salivary gland 4.91%. In our study females predominated with male to female ratio 1:1.7 . Overall accuracy rate of FNAC was 96.33% with sensitivity 93.10%, specicity 97.5% and positive predictive value of 93.10%. Conclusion: Though excisional biopsy is the gold standard for diagnosis of head and neck neoplastic lesion. FNAC is a rapid, cheap diagnostic tool now-a-days with overall accuracy rate of more than 90%.

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FNAC and histopathological correlation of salivary gland lesions: an observational study

International Surgery Journal ◽

10.18203/2349-2902.isj20172624 ◽

2017 ◽

Vol 4 (7) ◽

pp. 2148 ◽

Cited By ~ 4

Author(s):

Sneha Kakoty ◽

Tridip Dutta Baruah ◽

C. P. Ganesh Babu

Keyword(s):

Salivary Gland ◽

Observational Study ◽

Needle Aspiration ◽

Age Group ◽

Aspiration Cytology ◽

Fine Needle ◽

Histopathological Correlation ◽

Neoplastic Lesions ◽

Malignant Lesions ◽

Needle Aspiration Cytology

Background: Fine needle aspiration cytology (FNAC) is a sensitive and specific and yet an economically effective technique for diagnosis of salivary gland lesions. FNAC of salivary glands has achieved a pivotal role in the diagnosis and management of salivary gland lesions since its induction by Stewart et al in 1933. However, it has always been under scrutiny when compared to histopathology. Histopathology of salivary gland lesions is still the final method to establish diagnosis and predicting prognosis in these lesions.1Methods: A prospective observational study of 50 patients with salivary gland lesions was done at Gauhati Medical College and hospital from June 2011 to May 2012. 39 patients underwent histopathological confirmation. Cases with histopathological correlation were included in calculating diagnostic accuracy. The cytological findings were correlated with that of the histopathological diagnosis to obtain the accuracy of the cytological diagnosis. The parameters of diagnostic validity of the cytological technique in terms of sensitivity, specificity and predictive value were evaluated.Results: Study population included patients of age group ranging from 13-70 years with median age group being 31-40 years (30%). 54% of the affected patients were male with the parotid being the most commonly involved gland (62%). Neoplastic lesions constituted the major bulk of the lesions (39 cases, 78%) with benign tumours constituting 54%. The most commonly involved benign neoplastic lesion was pleomorphic adenoma (22cases, 44%). Among the non-neoplastic lesions (22%), the acute sialadenitis was frequently noted. Histopathological correlations were available in 39 cases with 11 cases being the malignant lesions. The acute sialadenitis lesions did not undergo histological examination. 28 cases of non-malignant lesions underwent the histological confirmation. In the present study, the specificity and the sensitivity were found to be 96.42% and 90.91% respectively. The predictive value of salivary gland cytology was 90.91% and diagnostic accuracy was 94.87%.Conclusions: Fine Needle Aspiration Cytology is thus a safe, reliable, quick, convenient and accurate method of diagnosis and should be considered as one of the first line of investigations in the evaluation of salivary gland lesions.

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Accuracy Of Fine Needle Aspiration Cytology (FNAC) In The Diagnosis Of Thyroid Swellings

Journal of Dhaka National Medical College & Hospital ◽

10.3329/jdnmch.v18i2.16023 ◽

2013 ◽

Vol 18 (2) ◽

pp. 47-51 ◽

Cited By ~ 1

Author(s):

Md Alamgir Hossain Sikder ◽

AZM Mahfuzur Rahman ◽

Md Abul Khair

Keyword(s):

Thyroid Gland ◽

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Histopathological Examination ◽

Needle Aspiration ◽

Histopathological Diagnosis ◽

Aspiration Cytology ◽

Female Ratio ◽

Fine Needle ◽

Needle Aspiration Cytology

Objective: To evaluate the accuracy of fine needle aspiration cytology (FNAC) in comparison to paraffin section in thyroid swelling. Study design: Cross sectional study. Place and duration of study: Department of Surgery, Bangabandhu Sheikh Mujib Medical University from July 2009 to June 2011. Patient and method: One hundred patients with enlarged thyroid gland of both sexes were selected from admitted patient of Surgery department. All patients had preoperative FNAC, performed by pathologist at the Histopathology department and postoperative specimen were also examined and histopathological diagnosis were made. All FNAC diagnosis were correlated with the histopathological diagnosis. Results: Out of 100 patients 23 were male and 77 were female, male-female ratio 1: 3.3. In FNAC 76 patients were diagnosed as benign lesion of which 8 were later diagnosed as malignant on histopathological examination (68 were true negative 8 were false negative). 22 cases were diagnosed as malignant, both on FNAC and histopathological examination. Only 2 cases were diagnosed as follicular neoplasm on FNAC but on histopathological examination diagnosed as follicular carcinoma (22 cases were true positive) in this study. Overall sensitivity of FNAC were 68.75%, specificity 100.00% and accuracy 90%; PPV=100% & NPV=87.18% Conclusion: FNAC is a reliable, safe and accurate method as a preoperative evaluation in thyroid gland swelling before surgery. FNAC has more accuracy and specificity in detecting thyroid gland malignancy and therefore it is a reliable diagnostic test for evaluating thyroid swellings. DOI: http://dx.doi.org/10.3329/jdnmch.v18i2.16023 J. Dhaka National Med. Coll. Hos. 2012; 18 (02): 47-51

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CLINICOHISTOPATHOLOGICAL PROFILE OF NASAL AND SINONASAL LESIONS: A STUDY FROM CENTRAL INDIA

International Journal of Medical Science and Diagnosis Research ◽

10.32553/ijmsdr.v4i8.657 ◽

2020 ◽

Vol 4 (8) ◽

Author(s):

Manjiri G Khade ◽

Rekha N Patil ◽

Dinkar T Kumbhalkar ◽

Suwarna B Patil ◽

Pradip S Umap

Keyword(s):

Predictive Value ◽

Treatment Plan ◽

Central India ◽

Clinical History ◽

P Value ◽

Histopathological Diagnosis ◽

Age Group ◽

Female Ratio ◽

Neoplastic Lesions ◽

Sensitivity Specificity

Background: Nasal and sinonasal lesions comprise common as well as rarest rare lesions. This region being a site of histopathologically diverse lesions, interests pathologists. Objectives: The study aimed to find out incidence of nasal and sinonasal lesion with frequency of non-neoplastic, neoplastic lesions, to study spectrum of lesions histopathologically along with correlation of clinical and radiology findings. Material and methods: It was a 2 year retrospective observational study involving 102 cases from January 2012 to December 2013 carried out at Government medical college, Nagpur. Study included all specimens received as nasal and sinonasal lesions. Complete clinical history and radiological findings were correlated with histopathology findings. Results: Nasal and sinonasal lesions are rare having 1.07 % incidence rate. Majority of patients of nonneoplastic and benign neoplastic category belonged to 11-20 age group while malignancies were common in 41-50 age group. We encountered more neoplastic lesions (53.92%) compared to nonneoplastic lesion (46.08%). Male to female ratio was 1.5:1. Sensitivity, specificity and diagnostic accuracy of clinical diagnosis was 94.73%, 97.67 % and 96 % respectively while positive predictive value and negative predictive value was 98.18 % and 93.33 %. p value was 0.317. Discordance in clinic-histopathological diagnosis was in 5.88 % Conclusion: Though there was good correlation between clinicoradiology findings and histopathology, however in 5.88% discordant cases histopathology diagnosis led to significant alteration of treatment plan proving key role of histopathology diagnosis. Keywords: Benign, Central India, Clinicohistopathology, Profile, Malignant, Nasal, Sinonasal.

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Evaluation of peripheral lymphadenopathy by fine needle aspiration cytology: Our experience at a tertiary care center

IP International Journal of Medical Paediatrics and Oncology ◽

10.18231/j.ijmpo.2021.014 ◽

2021 ◽

Vol 7 (2) ◽

pp. 67-72

Author(s):

Syed Fiza Mustaqueem ◽

Syed Belal Hassan ◽

Shikha Agarwal

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Hodgkin’S Lymphoma ◽

Needle Aspiration ◽

Hodgkin's Lymphoma ◽

Age Group ◽

Aspiration Cytology ◽

Fine Needle ◽

Neoplastic Lesions ◽

Needle Aspiration Cytology

Peripheral lymphadenopathy is frequently due to a local or systemic benign infectious disease. However, it could be a manifestation of underlying malignancy. Fine needle aspiration cytology (FNAC) acting as a reliable diagnostic tool to find out the cause underlying the lymphadenopathy enables the clinician to plan appropriate management for each patient.The present study was undertaken to assess the utility of FNAC in evaluation of peripheral lymphadenopathy cases in different age groups and sex and to study the cytomorphological patterns in these cases.A retrospective and prospective observational study was conducted in the Department of Pathology, Hind Institute of Medical Sciences over the duration of 2 years. A total of 331 lymph node FNA aspirates were studied. Aspirated material was routinely stained with Haematoxylin & Eosin and Papanicolauo stains. Ziehl Neelsen stain was used wherever required.Most of the patients were in the age group of ≤15 years (117/331). Cervical lymphnodes were the most commonly involved sites (222/331). The largest group of lesions belonged to the non-neoplastic category (227/331). Only 54/331 cases were in the neoplastic category. Amongst the non-neoplastic lesions, granulomatous lymphadenitis comprised the majority (128/277). Amongst the neoplastic lesions, 8 cases showed features of non-Hodgkin’s lymphoma (NHL); where as 3 cases were of Hodgkin’s lymphoma (HL). Non-neoplastic lesions were more common in the younger age group (117/257); where as neoplastic lesions were more common in the older age group (27/54).FNAC is a reliable method of diagnosing the pathology underlying enlarged superficial lymph nodes; thus acting as a triage to distinguish the cases with a suspicion of significant disease. At the same time, it also provides material for ancillary studies especially in lymphoproliferative lesions.

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Profile of oral cavity neoplastic lesions: two year pilot study at tertiary care centre

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202208 ◽

2020 ◽

Vol 6 (6) ◽

pp. 1107

Author(s):

Manish Munjal ◽

Ramandeep Kaur ◽

Porshia Rishi ◽

Nitika Tuli ◽

Harjinder Singh ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Survival Rate ◽

Oral Cavity ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Histopathological Diagnosis ◽

Female Ratio ◽

Neoplastic Lesions

Background: In India 53,251 new head and neck cancer cases are diagnosed every year. Benign tumours are more frequently in the oral cavity than oropharynx.Methods: The prospective study was carried out in the Department of Otolaryngology and Head and Neck Surgery, Dayanand Medical College and Hospital, Ludhiana, over a period of two and half years, comprised of 66 cases of head and neck neoplasia. The demographic, gender profile, clinical presentation, histopathological diagnosis, therapeutic modality undertaken and post op complications of neoplastic lesions of the oral cavity were studied. follow up was done for 6 months. The therapeutic modalities included surgery, radiotherapy and chemotherapy as per the stage of the lesion.Results: Incidence of oral cancer is 13.6% among head and neck neoplasms over a period of 2 years (2011-2012). The overall male to female ratio was 1:1.25, among benign was 1:1 and among malignant was 1:1.3. Benign oral cavity tumors were managed surgically with wide excision. Out of 7, 4 (44%) malignant oral cavity tumor patient experienced difficulty in swallowing. Three (43%) out of 4 squamous cell carcinoma patients complained of difficulty in speaking, which is commonly seen in post-glossectomy patients. The survival rate for 6 months follows up, was 100%.Conclusions: Squamous cell carcinoma is the commonest oral cavity neoplasia. At post treatment follow up period of 6 months survival rate of benign neoplasia is better than malignant neoplasia.

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The Correlation Between Fine Needle Aspiration Cytology and Histopathology of Head and Neck Lesions in Kathmandu University Hospital

Kathmandu University Medical Journal ◽

10.3126/kumj.v11i4.12525 ◽

2015 ◽

Vol 11 (4) ◽

pp. 296-299 ◽

Cited By ~ 5

Author(s):

M Rajbhandari ◽

P Dhakal ◽

S Shrestha ◽

S Sharma ◽

S Shrestha ◽

...

Keyword(s):

Head And Neck ◽

Sensitivity And Specificity ◽

High Sensitivity ◽

Needle Aspiration ◽

Age Group ◽

First Line ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology ◽

Sensitivity Specificity

Background Fine needle aspiration cytology (FNAC) with it’s minimally invasiveness has been a well accepted procedure in the initial diagnosis of various swellings. With time and experience high sensitivity and specificity of FNAC over conventional open biopsy has lead to the wide acceptance of this procedure.Objective To evaluate the utility of aspiration cytology as a first-line diagnostic tool in palpable head and neck masses and correlate with histologic results for evaluating diagnostic accuracy.Methods A hospital based prospective, comparative study was conducted among patients with various swellings at Head and Neck regions in the Department of Pathology, Dhulikhel Hospital between July 2011 to June 2012. FNAC were done from the palpable masses of head and neck regions and were compared with biopsy findings of the same lesions. Data entry and analysis performed using SPSS version 16. The sensitivity, specificity and accuracy rates were calculated.Results A total 64 patients were subjected to both FNAC and histopathological examination (HPE). Total 39 (61 %) were females and 25 (39 %) were males with M: F ratio of 1:1.6. The age group ranged from 9 to 80 years. Twenty five percent of patients were in the age group below 20 years. The highest number of cases included lymph nodes 29 (45%) followed by thyroid 24(37.5 %), salivary glands 10(16%) and 1 case (1.6%) was a soft tissue swelling over the occipital region. Highest sensitivity, specificity and accuracy rate for diagnosis by FNAC were observed in thyroid. The overall sensitivity and specificity of FNAC were 86% and 97% respectively in determining the various pathologies. The overall accuracy of FNAC in present study was 87.4%.Conclusion FNAC is a minimally invasive first line investigation with a high sensitivity and specificity for the diagnosis of various head and neck lesionsKathmandu Univ Med J 2013; 11(4): 296-299

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FNAC as a Diagnostic Tool in the Evaluation of Cytomorphological Spectrum of Peripheral Lymphadenopathy along with Histopathological Agreement - An Experience in a Tertiary Teaching Hospital of Northern India

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2020/601 ◽

2020 ◽

Vol 7 (49) ◽

pp. 2937-2942

Author(s):

Sima Chauhan ◽

Simanta Kumar Behera

Keyword(s):

Diagnostic Tool ◽

Histopathological Examination ◽

Age Groups ◽

Histopathological Diagnosis ◽

Anatomical Site ◽

Safe Procedure ◽

Age Group ◽

Female Ratio ◽

Tertiary Teaching ◽

Neoplastic Lesions

BACKGROUND Lymphadenopathy is one of the commonest presentations in clinical practice. Fine Needle Aspiration Cytology (FNAC) is an established, easy, cost effective, diagnostic tool for lymphadenopathies. Judicious application of FNAC can avoid the need of biopsy. We wanted to compare the accuracy of FNAC and histological analysis of peripheral lymphadenopathy among patients visiting the Departments of Oncology, Pathology, Surgery of K.D. Medical College and determine the most prevalent cause of peripheral lymphadenopathy among different age groups of patients. METHODS This study was done among cases of peripheral lymphadenopathy whose FNAC & biopsy were available. 112 cases of lymph node FNACs were carried out in the Dept. of Pathology for a period of one and half years from July 2018 till December 2019. Special stains were used whenever necessary. RESULTS Out of 112 cases studied 68 cases were male and 44 cases were female. Ratio of M : F = 1.5. The commonest anatomical site for lymphadenopathy was cervical (70 %) followed by supraclavicular (13 %) and axillary (10 %). Coming to the spectrum of the disease 103 cases (91.9 %) were non neoplastic lesions and 9 cases 8.03 % were neoplastic lesions. Reactive hyperplastic was the most common condition 51 cases (45.5 %) followed by tuberculosis 34 cases (30.35 %). Out of cases 9 cases (8.03 %) of malignancy, 5 cases (4.4 %) were metastatic deposits & 4 cases (3.57 %) were lymphomas. The peak age group ranged between 21 - 30 years. Cervical location of distribution of lymphadenopathy is noticed to be highest (70 %), which is then followed by, supra clavicular (13 %), axillary (10 %) and inguinal (5 %). (Maximum number of cases were found in the age group of 21 yr. - 30 yr., least number of cases seen in the age group of 61 yr. – 70 yr. Correlative study between cytopathological &and histopathological examination of lymphadenopathy showed diagnostic discordance in three cases and concordance in 109 cases. CONCLUSIONS Apart from reactive hyperplasia, tuberculosis is the commonest cause of lymphadenopathy & males are commonly affected. FNAC is a safe procedure with high degree of sensitivity and specificity and concordance of 96.64 % with histopathological diagnosis. For confirming the diagnosis of lymph nodes, histopathology is the gold standard. KEYWORDS Lymphadenopathy, FNAC, Histopathology, Biopsy, Tuberculosis

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