Publication:

Cytopathological and histopathological evaluation of neck mass in a tertiary care hospital

Background Patients with neck swellings are commonly seen in ENT outpatient and leads to dilemma in diagnosis. To prevent unnecessary investigations and surgery a simple and sensitive diagnostic tool is needed. Fine needle aspiration cytology (FNAC) is a simple and sensitive diagnostic tool that can provide results in minutes.

Methods This prospective study was done at the department of ENT, Mandya institute of medical sciences, Mandya, Karnataka, India from November 2017 to April 2019 including 100 cases of neck masses in patients aged above 18 years. FNAC was done for all neck masses and then these cases were subjected for biopsy. The cytological features was then reviewed with corresponding histopathology features.

Results Out of the 100 neck masses under study 67 (67%) were males and 33 (33%) were females with male:female ratio (1:2.03). Thyroid aspirations (43%) were most common followed by lymph node (24%), salivary gland aspirations (18%), congenital swellings (8%) and others (7%). Out of the 100 cases 26% were neoplastic and 74% were non-neoplastic. Histopathological correlations were available in all the 100 cases with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 84.2%, 98.65%, 95.65% and 94.81% respectively. FNAC was in correlation with histopathology in 86% of cases and found to be statistically significant.

Conclusions FNAC is safe, simple and minimally invasive first line investigation of choice for the patients presenting with palpable neck masses and can provide results rapidly and but histopathology remains the gold standard.