Fine Needle Aspiration: An Atraumatic Method to Diagnose Head and Neck Masses

Abstract

BackgroundPatients presenting with a mass require tissue biopsy for histological diagnosis and treatment. Fine needle aspiration (FNA) is offered as an atraumatic, well tolerated, and inexpensive method for obtaining a biopsy from these lesions.ObjectivesIn this study we evaluated the accuracy of FNA as an atraumatic method among patients with nonthyroidal masses for diagnosis of neoplastic masses compared to open surgery.Patients and MethodsIn a cross-sectional study, 65 patients with a head and neck masses (nonthyroidal) referred to us from 2004 to 2009. Those who had both FNA and open biopsy (the gold standard) were assessed for specificity, sensitivity, positive and negative predictive values of FNA in diagnoses.ResultsSixty-five cases with both definite diagnoses of open biopsy and FNA were assessed. The mean (± standard deviation) age of patients was 39.96 ± 19.69 years (range 10 to 82 years). Twenty-five (40.8%) subjects were categorized as malignant neoplasms, 16 (19.4%) as benign neoplasms, and 24 (39.8%) as non-neoplastic lesions. The sensitivity, specificity, positive and also negative predictive values of FNA in the diagnosis of neoplastic masses were 95%, 85%, 92.68%, and 91.66% respectively, and the diagnostic accuracy was 92.3%.ConclusionsIt seems that FNA is a useful atraumatic diagnostic technique with a high diagnostic accuracy which can provide a highly sensitive diagnosis with low false positive diagnoses in patients with nonthyroidal masses.

Effectiveness of fine-needle aspiration cytology in the diagnosis of lateral cervical nonthyroid tumors

“…In regard to the diagnostic accuracy of fine-needle aspiration cytology in differentiating malignant and benign lesions, we found a Se of 78.1% and a Sp of 76.5%. Similar studies reported Se between 82.14% and 95%, and a Sp of 62.7% to 100%; [ 3 , 6 , 8 , 17 , 21 , 22 , 32 – 34 ] thus our results are in line with those found in the literature.…”

“…We found a female:male ratio of 1:1.4 for patients with lateral cervical masses, similar to the results reported by Manjula et al [ 17 ] and Akhavan-Moghadam et al [ 6 ] in their series of 386 and 65 patients, respectively. Still, many clinical studies reported uneven data regarding gender distribution of lateral cervical masses; in their extensive study of 850 cases, Modi et al [ 18 ] found a female:male ratio of 1.06:1, whereas Soni et al [ 3 ] described the involvement of 66.15% female patients and 33.89% males in their study of 59 cases.…”

“…Regarding the nature of lateral cervical tumors, we found 62% malignancies, 25.9% benign tumors, and 12.1% inflammatory lesions. Similar studies conducted in geographic areas with a high prevalence of inflammatory lesions reported less tumor masses: the study published by Manjula et al [ 17 ] found 27.36% malignant tumors, only 6.57% benign tumors, and 49.2% inflammatory lesions of the lymph nodes, whereas Akhavan-Moghadam et al [ 6 ] found 40.8% malignant tumors, 19.4% benign tumors, and 39.8% nonneoplastic lesions in their series.…”

“…Other authors have already confirmed that metastatic lymphadenopathies are the most common lateral cervical malignant lesions, and their diagnosis can be efficiently established based on cytology, using fine-needle aspiration. [ 2 , 6 , 17 , 21 – 24 ]…”

“…The technique has very few contraindications and risks, and it is suitable for use in an ambulatory setting. [ 1 , 3 , 6 , 7 ] It can offer valuable information for the diagnosis of lateral cervical masses by differentiating inflammatory or benign lesions from malignant ones and guiding therapeutic management. [ 3 , 5 ] Although it cannot replace histologic examination, as the biological material obtained does not provide precise cellular architectural details, fine-needle aspiration has the advantage of providing samples from multiple lesion sites, [ 1 ] thus rendering incisional biopsy unnecessary in some cases.…”