Role of Fine Needle Aspiration Cytology in the diagnosis of maxillofacial swellings-A Clinical Study
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 5
Abstract
Background: FNAC is now accepted as a reliable diagnostic method in diagnosis of swellings in general. The technique is simple, minimally invasive, reliable and cost effective. It has become an important pre-operative tool in management of patients with swellings of the maxillofacial region. The credibility of FNAC depends on technique of obtaining smears and accuracy of interpretation of smears. This requires a skilled and experienced cytopathologist. It has a high accuracy for distinguishing between benign and malignant neoplasms. Objectives 1. To correlate the cytological findings in maxillofacial swellings with histopathology and thus assess the validity of FNAC in the diagnosis of such swellings. 2. To analyze and study the salient cytologic features of various maxillofacial swellings. Method: Fifty-six (56) patients with maxillofacial swellings, who attended the Oral medicine & Radiology clinic over a period of one year, were selected for the study. After careful history taking & clinical examination, FNAC was done and cytologic smears prepared by standard procedures. The provisional diagnoses obtained from clinical examination & cytology was compared. Histopathological examination was done for the swellings and this diagnosis was taken as the gold standard for comparison. Results: FNAC showed a sensitivity of 92%, specificity of 98%, positive predictive value of 92%, negative predictive value of 98% and an accuracy of 98% in diagnosing reactive change in a cervical lymph node. FNAC showed a sensitivity of 70%, specificity of 100%, a positive predictive value of 100% and a negative predictive value of 94% in diagnosing metastatic cervical nodes from a primary tumor of squamous cell carcinoma in the head & neck. The overall accuracy of FNAC in diagnosing sialadenits was 93%. FNAC was 70% sensitive, 100% specific and 94.6% accurate for diagnosing malignancy in maxillofacial swellings. Conclusion: FNAC is a widely recognized, useful, inexpensive and practical test for pre-operative tissue diagnosis of maxillofacial swellings. It is quite reliable for distinguishing inflammatory (no surgical excision required), cystic and neoplastic lesions, and further, to delineate malignancies from benign swellings, which enhances surgical planning. Sampling errors and errors of interpretation are the main drawbacks of FNAC. This could be minimized by meticulous technique, repeated aspirations, if possible under ultrasound guidance, adequate sampling when cell yield is poor and adherence to strict quality assurance.
Authors and Affiliations
Deepa Sujatha
Keywords
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