Cytological correlation of spectrum of head and neck lesions with epidemiological and diagnostic parameters

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Original Article

Author Details : Rahul Mannan, Sanjay Piplani, Sonam Sharma, Mridu Manjari, Shruti Gupta

Volume : 4, Issue : 1, Year : 2017

Article Page : 92-97

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Abstract

Background: Fine Needle Aspiration Cytology (FNAC) has many advantages and utilities in cervical region. Most of the studies documented in the literature regarding head and neck masses, either describe spectrum of lesions or etiological causes. The studies in the past have also tried to associate the FNAC procedure with statistic parameters such as sensitivity, specificity and predictive values / diagnostic accuracy. However, in the present study an attempt was made to correlate the etiological (diagnostic) and site-specific need of doing a FNAC procedure with epidemiological parameters such as age specific sub groups and sex parameters.
Materials and Methods: 1708 cases of head and neck swellings reporting for FNAC to the Department of Pathology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India over a period of three years (January 2012 - December 2014) were included in the study. The final diagnosis with other epidemiological, anatomical and clinical history was obtained from the requisition forms and the final reports filed in the archives of the department. Statistics employed included central distribution parameters such as mean, median and averages. Chi-Square (?2) test and Fischer’s exact test were employed to analyze and investigate for significance of the cytological diagnosis with epidemiological and anatomical parameters.
Results: The most common age group varied from 20-50 years with M:F ratio being 0.7:1. Overall reactive lymphadenitis and lymph nodes were the commonest cause and site for patients to undergo FNAC for swellings of head and neck region. Thyroid, skin and soft tissue lesions were the next commonest sites (36.29% and 19.33% respectively). Across the board, inflammatory pathologies were the commonest lesion reported (66.56%). Statistically it was found that there was significant difference between type of lesion according to the anatomical site (p value= 0.001) and the difference was not attributable to the more number of cases of lymph nodes itself.
Statistically, for age specific rates there was a strong association between the type of lymph node lesion with the age specific sub groups (p value= 0.0005) and sex (p value= 0.012). Also noted was a strong association between the type of lymph node malignancy and the age group (p value= 0.002) Interesting point was an equal distribution of NHL over the spectrum with almost equal cases seen in children, young adults and early elderly. This again was found to be statistically significant. There was a strong association between the type of thyroid lesions and the age group but no association was seen between the type of thyroid lesion and either the sex or age specific groups of the subjects.
Conclusion: The study concludes that there was significant difference between type of lesion according to the anatomical site. In case of lymph nodes there was a definitive association between the age group and sex of the patient with the ultimate diagnosis rendered. Hence age groups and the sex does play a definitive role in predicting the type of lesion; more so in lymphoid tissue of the head and neck region. There was significant statistical association of the type of lymphoid malignancy with the age and sex. The similar findings were not derived in the rest of the organ systems such as thyroid, salivary glands and skin/ soft tissue lesions.

Keywords: Age Specific, Cytology, Head and Neck, Spectrum, Sex, Site

How to cite : Mannan R, Piplani S, Sharma S, Manjari M, Gupta S, Cytological correlation of spectrum of head and neck lesions with epidemiological and diagnostic parameters. Indian J Pathol Oncol 2017;4(1):92-97

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