Cytomorphological study of head and neck lymph node lesions

Abstract

The head and neck area is a complex anatomical structure which includes various nonneoplastic and neoplastic lesions of lymph node, salivary gland, thyroid gland and soft tissue. Fine needle aspiration cytology of head and neck lymph nodes proved useful in separating inflammatory lesions, which do not require surgical excision from cystic and neoplastic lesions with good certainty. Fine needle aspiration cytology (FNAC) is a simple, feasible, cost effective and minimally invasive procedure. But histopathological examination is more valuable for confirmatory diagnosis in suspected lesions. Aim: To assess the utility of FNAC in diagnosis of head and neck lymph node lesions and to establish the diagnostic accuracy of cytology by comparing with the histopathological diagnosis, wherever possible. Materials and Methods: A 6 months retrospective study was done from March 2020 to August 2020 at Khaja Bandanawaz institute of medical sciences on 50 patients presenting with head and neck lymph node enlargement. Result: 50 cases were evaluated by FNAC. In this study out of 34 benign cases, 14 cases were of Reactive lymphadenitis, 17 cases of Granulomatous/Tuberculous lymphadenitis and 3 cases were of Acute suppurative lymphadenitis. Out of 16 malignant cases, 5 cases were of Non Hodgkins lymphoma, 2 cases were of hodgkins lymphoma and 9 cases were of metastatic carcinoma. Conclusion: FNAC has been found to be a satisfactory tool in the diagnosis of tubercular and malignant lymphadenopathy in our study. The lucidity and rapidity of the procedure makes it most appropriate for use on outpatient basis even in peripheral hospitals and dispensaries.