Role of FNAC with Histopathology in Head and Neck Lesions.

Luck, C P (2007) Role of FNAC with Histopathology in Head and Neck Lesions. Masters thesis, Kilpauk Medical College, Chennai.


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Fine Needle Aspiration Cytology as practiced to-day, is still a relatively new discipline and no single pathologist can lay claim to the vast experience of its every facet. The numerous case reports of all kinds of rare and exotic tumours and other pathological processes diagnosed by fine needle aspiration cytology (FNAC) published in the cytology journals create the impression that nothing is impossible for this technique. As fine needle aspiration procedure being cost - effective, simple office procedure, quick diagnosis at the first contact of patient and it can delineate between benign and malignancy and can be repeated for definite confirmation on doubtful diagnosis. We have taken up lesions of Head and Neck fine needle aspiration cytology in comparison with histological correlation for available lesions like thyroid, lymphnode, salivary glands and soft tissue tumours. Head and neck masses are common and the lesions are varied, ranging from inflammation to neoplasms. Fine needle aspiration cytology helps us to catagorise the lesions which require surgical intervention and those which do not. FNB is of great assistance in the management of patients, since therapeutic decisions can be made earlier and without the need for further diagnostic surgery. The diagnostic accuracy of FNAC in suspected and recurrent and metastatic tumours is generally high. Small nodal metastasis can be missed. By far the most common indication for FNB in the head and neck is the investigation of suspected local recurrence or nodal metastasis of previously diagnosed and treated cancer18. FNAC being a minimally invasive technique is particularly suitable in this sensitive area where an incisional biopsy may present problems. A preoperative cytological diagnosis of a primary neoplasm may allow more rational planning of surgery. The anaplastic and poorly differentiated lesions can be planned for palliative radiotherapy or chemotherapy. Fine needle aspiration cytology of the thyroid gland is firmly established as a first line of diagnostic test for the evaluation of pre operative diagnosis of thyroid lesions with the combination of necessary laboratory tests20. The present study was undertaken to evaluate the accuracy of FNAC in diagnosing both benign and malignant lesions and also to correlate the cytologic diagnosis with histopathological findings. Lymphadenopathy is a sign of inflammation, infection, primary or metastatic malignant tumours. This is commonly seen involving the head and neck region. Their persistence for a prolonged period of time, requires further investigation. In recent years aspiration has become popular for the diagnosis and typing of "Lymphoma"23. The salivary glands are eminently accessible to FNB and material is easily obtained. The variety of lesions having diagnostic dilemma in salivary neoplasms are not uncommon. Problems of pitfalls in FNAC diagnosis of salivary gland lesions have attracted considerable interest in recent years.. The purpose of FNAC is not a substitute for histology and if it is used in conjunction with clinical and radiological parameters it will provide the best initial assessment on which management decisions can be based. It is true that the increasing use of ancillary techniques such as, immunohistochemistry, electron microscopy, cytogenetics and molecular biology techniques has significantly enhanced the potential to make precise type specific diagnosis but they are expensive and not done as a routine, can be applied in problem cases. Representativeness, adequacy and quality of preparation will always remain "sine qua non" no matter how sophisticated the supplementary techniques18.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Role of FNAC; Histopathology ; Head and Neck Lesions.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 27 Jun 2017 12:16
Last Modified: 27 Jun 2017 12:25

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