Diagnostic approach to FNA biopsy of cystic lesions of the head and neck

Cystic lesions of the head and neck encompass a wide spectrum of benign and malignant entities, which often presents diagnostic challenges as a result of the region’s complex anatomy. Despite extensive literature, variability persists in diagnostic strategies and approaches. Fine-needle aspiration biopsy is a commonly used and highly effective method for the initial assessment of these lesions by offering a minimally invasive technique to collect cellular material for diagnostic evaluation. A multidisciplinary approach integrating clinical, radiologic, and cytologic findings is essential in diagnosing cystic lesions of the head and neck. This review provides readers with an organ-based algorithmic approach for integrating anatomic location (central vs. lateral neck), radiologic features, and cytomorphology to refine diagnoses and guide patient management.