Comparison of fine needle aspiration and fine Needle non aspiration cytology in head and neck swellings.

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.