Spectrum of cytomorphological diagnosis of palpable head and neck lesions - in Central India.

Abstract

Back ground: Lump in head and neck lesions are one of the most common lesions attending OPD of various departments making patients become very anxious. FNAC is a quick and non-invasive OPD procedure help patients to relieve anxiety and surgeon for early differentiation of inflammatory, infective, benign and malignant lesions.

Objective: To assess the spectrum of various pathological lesion of head and neck mass by FNAC.

Method: This prospective study included 115 patients with palpable head and  neck mass in pathology from Sep 2015 to August 2016. The detailed history and examination of swelling were done after informed consent. FNAC was performed and smear stained with Giemsa, H&E stain.  Zeihl Neelsen stain done whenever required. 

Result and Conclusion: Male were affected more commonly (68.51%) with lymph node lesions, which is significant statistically (?² -13.31, p value 0.000026).  Thyroid lesions in females were significantly (?²- 26.30, p value 0.00001) and more commonly affected (85.71%). Distribution of head and neck mass lesion shows lymph node (46%) as predominant site of FNAC followed by thyroid lesion (30.43%), soft tissue (18.26%) and salivary glands lesion (4.34%). Among lymph nodes metastatic lesion were most common (46.49%) followed by chronic granulomatous lymphadenitis (27.22%) and chronic non-specific lymphadenitis (16.16%). In respect of thyroid lesion colloid goitre (74.28%) most common followed by  sub-acute thyroiditis (8.57%) and granulomatous thyroiditis (5.71%).Chronic non-specific sialadenitis and pleomorphic adenoma each contribute 40% among salivary gland lesion while malignant only in 20%. Among soft tissue and miscellaneous lesion epidermal cystic constitute 33% followed by acute inflammatory cystic lesion 14.28%.

Conclusion: It was concluded that lymph node lesions were most common followed by thyroid in head and Neck region. Among lymph node lesion metastatic deposits were most common followed by tubercular lymphadenitis. Colloid goitre mostly encounter in thyroid in our study. Owing to its simplicity, rapidity, accuracy and cost effectiveness, we recommend FNAC as the first line investigation in diagnosing head and neck swellings.

Keywords: Key word: FNAC, lymph node, thyroid, metastatic deposit, granulomatous lymphadenitis, colloid goitre