The spectrum of various palpable pathological lesions in head and neck region in a tertiary care hospital – FNAC study

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Original Article

Author Details : Vedashree MK, Girish M, Maruthi CV

Volume : 4, Issue : 1, Year : 2017

Article Page : 122-126

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Abstract

Fine needle aspiration cytology (FNAC) is an important tool for the diagnosis of various palpable lesions of head and neck. It is an inexpensive, reliable and patient acceptable technique for the diagnosis of lesions.
Aim: 1.To study the age and sex incidence and the pathological spectrum of palpable lesions of head and neck in tertiary care hospital.
Objectives: 1. To collect the details regarding age and sex of the patients & site of palpable swellings in the head and neck region. 2. To perform fine needle aspirations in such cases and do cytological study. 3. To analyse the frequency of these lesions based on the site and cytological diagnosis.
Materials & Methods: This prospective study included 72 cases who presented with palpable head and neck swelling to the department of Pathology, district hospital Chamarajanagar from July 2015 to June 2016. The detailed history and examination of swelling were done. FNAC was performed on all cases and the smears were stained with rapid Hematoxylin and Eosin stain and examined. The smears from the lymph node of cases clinically suspicious of tuberculosis were stained with Ziehl Neelsen technique and Auramine O staining.
Results: In our study, females were predominant (63.88%) and males constituted 36.11%. Most of the cases were in thyroid (48.6%), followed by lymph node (40.2%) and equal incidence of lesions in the salivary gland and skin (5.5%). Maximum age was 60 years and the minimum age was 5 years. In thyroid, lymphocytic thyroiditis was the predominant lesion (57.14%) followed by colloid goitre (42.85%). In lymph node FNACs, reactive lymphadenitis was most common (34.48%). Out of 10 smears from lymph node clinically suspicious of tuberculosis, two were positive for Ziehl Neelsen stain and Auramine O stain. Three cases showed metastatic deposits. Out of four salivary gland lesions, three had chronic sialadenitis (75%) and one had Pleomorphic adenoma (25%). All the cutaneous lesions were epidermal cyst cytologically. The age incidence of head and neck swelling was similar to the study conducted in north India but in contrast females were more common in our study than males due to the higher number of thyroid swellings. Cytologically, lymphocytic thyroiditis was higher in our study compared to the studies conducted in the north and western parts of India probably due to the higher prevalence of autoimmunity in this region. The incidence of tuberculous lymphadenitis was less compared to these studies which may be due to less number of lymph node swellings in our study.
Conclusion: FNAC is a reliable and inexpensive outpatient procedure for the rapid diagnosis of various palpable lesions in the head and neck region. Thus it is the first investigation of choice in the diagnosis of these swellings.

Keywords: FNAC, Head and neck lesions, Lymphocytic thyroiditis, Metastatic deposits, Tuberculous lymphadenitis

How to cite : Vedashree Mk, Girish M, Maruthi Cv, The spectrum of various palpable pathological lesions in head and neck region in a tertiary care hospital – FNAC study. Indian J Pathol Oncol 2017;4(1):122-126

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