To study the lesions of anterior triangle of neck in correlation with histopathology and determine the diagnostic accuracy of FNAC

Introduction: Fine Needle Aspiration Cytology (FNAC) is a quick, simple, efficient, and inexpensive way to sample superficial masses in the head and neck due to the wide range of primary as well as metastatic neoplasms and the close proximity of several types of tissues. Due to its minimally invasive nature and easy access to target sites, FNAC has gained popularity and acceptance. Although FNAC cannot provide the same level of morphological detail as histology, it can reveal cells from the whole lesion since aspirating allows for many passes through the lesion. In addition to confirming the existence of metastatic disease, FNAC also offers information on the type and origin of the primary tumor. It provides the added advantage of being an outpatient procedure and lowers the frequency of exploratory procedures. The present study was carried out to study the lesions of the anterior triangle of the neck in correlation with histopathology and determine the diagnostic accuracy of FNAC.
Materials and Methods: This prospective observational study was carried out in the Department of Pathology, MGM Medical College and MYH Hospital, Indore, over a period of 2 years (2013-2015), among 1110 patients of both sexes and all age groups with palpable anterior triangle neck swellings reporting in the Department of Surgery, ENT, Pediatrics, TB, and Cancer hospital, who were referred to Pathology. A detailed clinical history was recorded, and a complete physical examination was carried out. FNAC was performed under all aseptic precautions. Cytological findings from the smears were recorded, and a diagnosis was made. Excisional biopsy specimens received were processed and mounted by DPX. Cytohistopathological correlation was done. Data were collected, compiled, and analyzed using SPSS 22.0 (trial version).
Results: Most participants belonged to the age group of 21-30 years. The male to female ratio was reported to be 1:1.35. A large proportion of lesions (71.08%) were found in lymph nodes, while 22.25% were in the thyroid, and the rest (6.67%) were distributed in various other regions. The majority of the lesions (77.12%) in the anterior triangle of the neck were non-neoplastic (inflammatory) lesions. Among the neoplastic lesions located in the thyroid gland, 13.76% were benign and 1.62% malignant. No benign neoplastic lesions were noted in the lymph node. Rather, 14.57% were malignant. Most lesions (38.66%) in the lymph nodes were classified as tuberculous lymphadenitis, followed by reactive hyperplasia of lymph nodes (15.59%). Thyroiditis was most common (84.62%) among the lesions found in the thyroid gland, followed by colloid goiter (8.10%). The sensitivity and specificity were calculated as 85.50% and 99.23%, respectively.
Conclusion: In addition to being safe and comparatively free of complications, FNAC offers a quick, efficient, and accurate approach to diagnosing lesions, especially of the neck. Consistent results were found between cytological and histological examinations, and hence it works as a useful adjunct to histopathology. It can help to significantly reduce morbidity and mortality by early as well as accurate diagnosis of benign and malignant lesions.