Publication:

A comparative study of different neck swellings by clinical radiological and pathological findings

Background Neck swellings are common clinical conditions encountered by ENT surgeons across all age groups and often present with variable duration of symptoms. This study aimed to classify the different types of neck swellings and assess the diagnostic accuracy of ultrasonography (USG), fine-needle aspiration cytology (FNAC), and computed tomography (CT) in comparison with histopathology. Age and gender distribution were also analyzed.

Methods This study included patients with neck swellings who underwent appropriate surgical intervention after ethical approval and according to defined inclusion and exclusion criteria. All patients underwent clinical examination, radiological and pathological investigations, and subsequent surgical management. Histopathological examination of excised tissue was considered the gold standard for diagnosis.

Results A total of 38 patients were included, with ages ranging from 9 to 68 years. There were 27 females and 11 males. The duration of swelling varied, with about 18 patients presenting within 12 months of symptom onset. Compared with histopathology, USG showed a sensitivity of 66.7%, specificity of 92.3%, and diagnostic accuracy of 84.2%. CT demonstrated a sensitivity of 75.0%, specificity of 92.3%, and diagnostic accuracy of 84.0%. FNAC showed the best diagnostic performance, with a sensitivity of 75.0%, specificity of 100%, and diagnostic accuracy of 92.1%.

Conclusions FNAC was the most reliable diagnostic modality for neck swellings because of its highest specificity and accuracy. CT was a useful adjunct, particularly where FNAC facilities were limited. USG, although valuable as an initial investigation, had lower sensitivity and limited usefulness for definitive diagnosis.