Fine needle aspiration cytology (FNAC) and neck swellings in the surgical outpatient

Abstract

Background: Fine Needle Aspiration Cytology (FNAC) is a simple, quick and inexpensive method that is used to sample superficial masses like those found in the neck and is usually performed in the outpatient clinic. It causes minimal trauma to the patient and carries virtually no risk of complications. Masses located within the region of the head and neck, including salivary gland and thyroid gland lesions can be readily diagnosed using this technique. The objective of this descriptive study was to see the frequency of various pathological conditions detected on FNAC in patients presenting with neck swellings coming to Surgical Outpatient Department of Postgraduate Medical Institute, Lady Reading Hospital Peshawar.

Methods: This study included patients with neck swellings presenting to the Surgical Outpatient Department of Postgraduate Medical Institute, Lady Reading Hospital Peshawar from January 2007 to December 2007. Patients below 18 years of age were excluded. Patients' data were recorded. Samples of FNAC were sent to the cytologist and results recorded. Frequency of various pathologies was determined.

Results: The study included 50 patients with neck swellings. There were 16 male and 34 female patients with an age range of 15-55 years. Tuberculous lymphadenitis was the commonest diagnosis (36%) followed by reactive/non-specific lymphadenitis (18%). Other pathologies were malignant neoplasms (14%), cysts (10%), benign neoplasms (8%) and sialadenitis (6%). FNAC was inconclusive in 8% of cases. Carcinomas metastatic to lymph nodes were the most common type of malignancy followed by lymphoma and thyroid gland carcinoma (Papillary Carcinoma).

Conclusion: It is concluded that tuberculous lymphadenitis is still the commonest condition in patients presenting with neck swellings followed by non-specific lymphadenitis and malignant neoplasms especially metastatic carcinoma. FNAC is an easy and suitable tool for the assessment of patients with neck swellings in the outpatient clinics. Although its diagnostic accuracy is limited as compared to tissue biopsy but it is a good test for both screening and follow-up.