Fine Needle Aspiration Cytology in the Evaluation of Head and Neck Lesions: A Cross Sectional Study

Abstract

Background
Fine needle aspiration cytology (FNAC) is a minimally invasive technique that provides early differentiation of benign from malignant pathology. This study aimed to explore the cytological spectrum of head and neck swellings and also analyze the diagnostic accuracy, sensitivity and specificity of FNAC, taking biopsy as the gold standard.
Methods
This was an analytical cross-sectional study conducted in the Department of Pathology, College of Medical Sciences-Teaching Hospital from1st January 2024 to 31st December 2024. FNAC samples from 340 patients presenting with head and neck swellings were included in the study. Data was collected using a well structured proforma and entered and analyzed by using Microsoft Excel. 
Results
Among 340 study samples, 295 cases were categorized as benign and non-neoplastic lesions and the remaining 45 cases were diagnosed as malignant lesions by FNAC. The most common site of FNAC was from thyroid gland (59.42%) followed by lymph node (27.35%). Biopsy samples from the same lesions were available in 88 cases and the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of FNAC were calculated to be 53.33%, 86.20%, 66.66%, 78.12% and 75% respectively.
Conclusions
FNAC helps us in differentiating benign, malignant and non neoplastic lesions. Benign lesions can be more reliably detected by FNAC than malignant lesions. Intermediate categories need to be interpreted in the background of clinical and radiological parameters and confirmed by biopsy wherever necessary.