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Study of Cytodiagnosis of Head and Neck Neoplastic Lesions and Comparision with Histopathology

Maniyar Amit U, Patel Harshid L, and Parmar BH

The development of aspiration cytology is one of the biggest advances in anatomic pathology. Cancer has become one of the ten leading causes of death in India. Head and neck neoplasia is a major form of cancer in India, accounting for 23% of all cancers in males and 6% in females. The advantages of FNAC are : it is safe, gives a rapid report, is sensitive and specific for the diagnosis of malignancy, requires little equipment, causes minimal discomfort to the patient, is an outpatient procedure, avoids the use of frozen section, reduces the rate of exploratory procedures, allows a definitive diagnosis of inoperable cases, is repeatable and cost effective. Fine needle aspiration cytology (FNAC) is of particular relevance in head and neck lesions because of easy assessibility, excellent patient compliance, miminally invasive nature of procedure and helping to avoid surgery in non-neoplastic lesions, inflammatory conditions and also some tumors. To test the utility of FNAC, to establish the diagnostic accuracy of cytology by comparision with histopathology diagnosis and to establish the sensitivity and specificity of this technique in head and neck neoplastic lesion. The present study was undertaken in the Department of pathology, Government medical college and hospital, Nashik between January 2008 – June 2009. In the present study, maximum number of aspirates from head and neck neoplastic lesions were found to be of lymph nodes (56.37%). Of the total 378 cases, 71.69% were malignant. 6th decade was the most common age group affected (26.46%). Mean age group was found to be 45.84 years. Males were more commonly affected (65.34%). The male to female ratio was 1.8: 1. Out of 92 cases available for follow-up, 85.87% of the cases were same as histopathological diagnosis. Excisional biopsy remains the gold standard for diagnosis of head and neck neoplastic lesion, cytological study can establish the diagnosis of the majority of head and neck neoplastic lesions and can be recommended as an adjunct to histopathology