Clinicopathological Evaluation of Neck Masses

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Clinicopathological Evaluation of Neck Masses

Journal Title: Scholars Journal of Applied Medical Sciences - Year 2015, Vol 3, Issue 9

Abstract

FNAC is the most cost-effective invasive pre-operative investigation, whose simplicity and safety justify its use for “selective” surgery in diagnosing different types of masses. Masses located in the head and neck most commonly originates from cervical lymph nodes, thyroid, salivary glands and other neck masses. The primary objective of the study was to assess the spectrum of head and neck masses and to determine the accuracy of FNAC in detection of various lesions in National Institute of Medical Science and Research Hospital. A prospective study was conducted between the period from December, 2013 to May, 2015 and patients willing to be a part of the study were included. The study was time period specific i.e. the patients which came to NIMS OPD during the specific time period of our study, initiated on December 2013 to May 2015. A total 55 patients were included in the study for statistical ease. All patients were clinically examined. Out of 55 cases, FNAC was done in 52 cases and rest 03 cases were thyroglossal cyst (02) & plunging ranula (01) which was diagnosed clinically & sonographically and later confirmed directly with histopath. Histopathological examination was done in all 55 cases.The results of the FNAC were compared with the tissue diagnosis obtained after surgical removal of the mass. Out of 55 patients diagnosed clinically, in 43 cases the histopathological report confirmed the FNAC diagnosis. In 12 cases, the histopathology report was different. Out of the 55 patients, 13 (23.63%) were of lymph node, 26 (47%) were of thyroid, 7 (12.72%) were of salivary gland and 09 (16.36%) were of other neck masses. Our study evaluated 55 patients and found the overall sensitivity of FNAC in the diagnosis of neck masses to be 78.03%, specificity to be 100% and accuracy 89.57%. Sensitivity was highest (85.71%) for thyroid and lowest for other neck swellings (66.66%). Fine needle aspiration cytology offers a simple method of diagnosis of neoplastic and non neoplastic lesions in the neck to confirm clinical diagnosis. It can be performed as an outpatient procedure.It is the most accurate where there is a close cooperation between clinician, cyto-pathologist and radiologist. Ultrasound guided FNAC allows samples to be taken from a more representative site and increase in accuracy. FNAC is an important tool for preoperative clinical diagnosis of non cystic neck masses with history of more than 3 months. Thus, it helps in planning the surgical management of neck masses and can be confirmed with HPE which is a “gold standard” for diagnosis. Hence we conclude that Fine needle aspiration cytology is a safe, simple and rapid method that can be done in diagnosing wide range of neck masses. Keywords: Neck Masses, FNAC, HPE, Surgery

Authors and Affiliations

Dr. Hitender Basista, Dr. Amit Modwal, Dr. Beni Prasad

Keywords

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EP ID EP373033
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