Retrospective audit of Ultrasound guided fine needle aspiration cytology and core biopsy in the assessment of head and neck lumps excluding thyroid nodules at South Warwickshire NHS Foundation Trust

Objectives: Compare rates of diagnostic versus non diagnostic outcomes for fine needle aspiration (FNA) and core biopsy for non-thyroid head and neck lumps.Methods: Audit on biopsy technique used for ultra sound guided biopsies of non-thyroid neck lumps was performed over a 12-month period in South Warwickshire NHS Foundation trust (SWFT) in the year 2022. Data was collected from records in the Histopathology laboratory and electronic patient records.Results: A total of 72 lumps underwent biopsy during this period at SWFT and amongst them were 38 parotid lumps, 3 submandibular lumps, 29 lymph nodes and 2 other head and neck lumps. There were 34 fine needle aspirations were done for parotid lumps and 8 of them were non diagnostic. 4 of them went on to have core biopsies and all of them were diagnostic. There were 21 ultra sound guide core biopsies performed and only 2 of them were non diagnostic and required excision biopsy. There were 8 patients who underwent FNA and only 4 of them were diagnostic. The sensitivity of FNA for lymph nodes and salivary glands was 50% and 77% respectively. Core biopsy showed a 100% sensitivity for salivary gland and a 90.5% sensitivity to lymph nodes.Conclusion: FNAC yields good results with salivary gland lumps. Core needle biopsy has better sensitivity for investigation of enlarged cervical lymph nodes and has added advantage of immunohistochemistry and molecular testing.