Value of rapid assessment cytology in the surgical management of head and neck tumors in a Nigerian mission hospital

Abstract

More than 100 patients underwent surgery for head and/or neck masses during the 2-week periods between November 2002 and November 2003. Of these patients, 98 had either preoperative FNA and/or intraoperative touch preparation performed. Twenty-seven patients were male and 71 were female; the ages ranged from 2 months to 70 years. Sites sampled included the following: thyroid (n = 40); facial/jaw area (n = 19); parotid/submandibular gland (n = 13); scalp/skull region (n = 7); cervical lymph nodes (n = 5); neck (n = 5); other (n = 4); supraclavicular lymph nodes (n = 3); and oral cavity (n = 2). On cytologic analysis, there were 79 benign diagnoses, 17 malignant diagnoses, and 2 nondiagnostic samples. A benign versus malignant cytologic diagnosis was accurate in 97 of 98 cases. In conclusion, rapid assessment cytology was invaluable in the surgical treatment of many of the patients.

Cytologic grading of primary malignant salivary gland tumors: A blinded review by an international panel

“…This study contributes to the limited but growing literature on salivary gland FNA by demonstrating its utility for accurately grading nonbasaloid, non–matrix‐producing SGCs 7‐14,17,20,22,29‐48 . This work specifically examines the subject of grading SGCs using a broad range of types of SGC as well as employing a diverse panel of cytopathologists.…”

“…A majority of salivary gland tumors occurs in the parotid or submandibular glands facilitating pretreatment cytologic evaluation by palpation‐ or ultrasound‐guided fine needle aspiration (FNA) 2‐15 . The results of FNA interpretation can have significant implications for the clinical and surgical management of salivary gland lesions 6,16‐25 . Reactive and inflammatory conditions (eg, chronic sialadenitis, lymphoepithelial sialadenitis) are typically managed by clinical observation or treated medically.…”

Raising the Quality of Care During Medical Missions: A Survey to Assess the Need for Clinical and Anatomic Pathology Services in International Medical Missions

“…And lastly, the use of fine-needle aspiration and smears during medical missions is proven to be a rapid, inexpensive, and accurate way of managing patients in resource-limited settings. 10,11 When serving such countries as Tanzania, where fewer than 10 pathologists serve a population of 42.5 million, 5 or Zambia, where there are no newly trained pathologists, 12 having a pathologist from a developed country as part of the STMM should be encouraged. The participation of the pathologists using telepathology is proving to be a very useful, though still fairly expensive, option 12,13 ; therefore, more active participation of currently practicing and already retired pathologists as well as pathology residents is needed during STMMs to assure that the quality of care provided is not compromised.…”

Assisting cytopathology training in medically under‐resourced countries: Defining the problems and establishing solutions

“…Thirdly, western based cytopathologists can spend longer periods of time in one or more institutions in particular countries, maximizing the ratio of time spent teaching to the considerable cost of travelling to various African cities. This will be more productive if teaching is emphasized over provision of routine service, although many pathologists from the developed world have contributed to pathology in developing countries by working in these laboratories 18–20…”

“…The FNB will triage the patient and in most cases make a specific diagnosis so that appropriate treatment can be commenced,30 for example, in an adult presenting with a mid cervical neck mass a FNB can diagnose a mycobacterial infection, a reactive lymph node, HIV related lymphadenopathy, high‐grade lymphoma, metastatic squamous cell cancer or a branchial cyst, replacing the often inappropriate and costly expectant treatment for tuberculosis, that in many cases is the only current management option in much of sub Saharan Africa. FNB can be used for immediate preoperative and intraoperative diagnosis of lesions at surgery replacing, the need for expensive frozen section equipment that cannot be transported into rural hospitals 18…”