Fine needle aspiration of head and neck masses in the operating room: Accuracy and potential benefits

Abstract

Fine needle aspiration (FNA) in the operating room is a convenient optional diagnostic approach. Our objective of this study was to evaluate the accuracy and study the potential benefits of fine needle aspiration in the operating room. Retrospective review of all intraoperative FNA that were requested and performed by pathologists over 20-month period was carried out. Immediate smears were interpreted by the cytopathology team after staining with Diff Quik stain. All cases were reviewed and correlation with subsequent tissue diagnosis was done. Accuracy was calculated and potential benefits were discussed. The number of aspirates was 32. Adequate material for immediate and final interpretation was achieved in 31 cases (sensitivity 97%). In 20 cases (63%), malignancy was diagnosed while a benign diagnosis was rendered in 12 (37%). All cases had a follow up tissue diagnosis. No false-positive cases were identified (specificity 100%). The information gained from this approach was considered helpful to the surgeons. We concluded that FNA of head and neck masses in the operating room is an accurate and sensitive diagnostic approach. The service provides helpful information to surgeons and is an additional optional diagnostic approach.

Impact of routine cell block preparation on results of head and neck fine needle aspirates

“…While FNA itself has been widely demonstrated to be a clinically beneficial and cost-effective tool in evaluating head and neck lesions, 12,14,15 we are not aware of any previous studies evaluating the impact of routine cell block preparation on FNA diagnostic distribution and accuracy, either for head and neck lesions or elsewhere in the body. The most similar study was performed by Anderson et al and showed that, in a prospective series of 115 consecutive head and neck FNAs, addition of a cell block contributed to diagnosis in nearly a third of cases and was essential to making the correct diagnosis in 12% of cases.…”