Abstract:
INTRODUCTION:
Fine needle aspiration cytology (FNAC) is well-established first line of
investigation used in diagnosis of head and neck swellings. It was thought that FNAC
can cause trauma leading to alteration in cell morphology and also negative pressure
applied during aspiration leads to bloody aspirates in highly vascular organs. Hence
technique of FNAC has undergone various modifications. In 1981 a new modified
technique of FNAC called as fine needle non aspiration cytology (FNNAC) was
introduced.
OBJECTIVES:
To access efficacy of FNNAC technique in cytodiagnosis of head and neck
swelling by comparing cytomorphological features of FNNAC with FNAC.
RESULTS:
Ninty cases of head and neck swellings were studied by FNAC and FNNAC
for five objective parameters, amount of background blood, amount of cellular
material, retention of architecture, cellular degeneration and trauma, using Mair’s
point scoring system. Based on this scoring system head and neck lesions were
categorized under 3 groups such as unsuitable for diagnosis (score 0- 2), adequate for
cytodiagnosis (score 3-6), diagnostically superior (score 7-10). On the basis of these
scores in thyroid lesions in FNAC technique out of 47 cases 10 cases (21.3%) were
diagnostically superior, 21 cases (44.7%) were diagnostically adequate and 16 (34%)
cases were insufficient for diagnosis. In FNNAC out of 47 cases 31 cases (66.6%)
were diagnostically superior, 15 cases (31.9%) were diagnostically adequate and 1
case (2.1%) was insufficient for diagnosis. In lymph-node lesions in FNAC technique
x
out of 31 cases 30 cases (96.8%) were diagnostically superior, 1 case (3.2%) was
diagnostically adequate whereas in FNNAC of lymph node out of 31 cases 25 cases
(80.6%) were diagnostically superior and 6 cases (19.4%) were diagnostically
adequate. In salivary gland FNAC out of 6 cases 5 cases (83.3%) were diagnostically
superior, 1 case (16.7%) was diagnostically adequate. In FNNAC all 6 cases 100%
were diagnostically superior.
CONCLUSION: Greater number of diagnostically superior cases were obtained by
FNNAC in thyroid lesions. However lesser no of diagnostically superior were
obtained in lymph- node lesions by FNNAC. Thus FNNAC technique was better than
FNAC in thyroid lesions whereas in lymph node lesions FNAC technique was better
as compared to FNNAC.
