Comparative Clinico-pathological study of fine needle aspiration cytology and histopathology of various neck swellings in Bundelkhand region of Madhya Pradesh, India

Abstract

Introduction: Cervical swellings and lumps are common clinical problems. Neck swellings in children are commonly congenital and benign tumours while neck swellings in adults should be aimed to exclude malignancy. FNAC is the single most important test in the evaluation of neck swellings especially metastatic lymph nodes. FNAC helps in planning out surgical management of neck masses which can be confirmed with histopathology which is the gold standard for diagnosis. Objective: The aim of the study was to evaluate the various swellings in the neck and to compare the findings of FNAC and HPE . Material and Methods: The study is a prospective study conducted over a period of two years from January 2016 to January 2018 in the Department of ENT and Department of Pathology in Bundelkhand Medical College Sagar M.P. The study involved 100 cases of patients with neck swellings who attended ENT OPD and gave consent for both FNAC and biopsy or excision biopsy and HPE. Results : The overall accuracy of FNAC in diagnosing neck swellings is similar to that of HPE. Conclusion: FNAC is an important preoperative tool in the diagnosis of various neck swellings of the neck and is recommended as the first line of investigation in various neck swellings. The sensitivity, and specificity of FNAC in differentiating benign from malignant lesions in the present study was 100% [86.7% to 100%] and 100% [94.7% to 100%] respectively Positive predictive value and Negative predictive value of FNAC in detecting malignancy were both 100% [86.7% to 100%] and 100% [94.7% to 100]respectively. Interrater reliability using Kappa was measured between FNAC and Histopathology and a statistically significant measure of agreement was found (k=0.636,p<0.05).