Fine Needle Aspiration Cytology in the Diagnosis of Neck Swelling

Open Access

Abstract

Background: In otolaryngology practice, neck swellings are a common clinical presentation that can have a variety of causes, from benign inflammatory conditions to malignant neoplasms. For the preoperative assessment of neck masses, fine needle aspiration cytology (FNAC) has become a popular and reasonably priced diagnostic technique. This study sought to assess the diagnostic precision, sensitivity, and specificity of FNAC in identifying neck swellings. Methods & Materials: This descriptive cross-sectional study was conducted at the Department of Otolaryngology and Head and Neck Surgery, Dhaka Medical College Hospital from January 2024 to December 2024. Under aseptic conditions, FNAC was performed on 100 consecutive patients with neck swelling who satisfied the inclusion criteria using a 23-gauge needle. Histopathological analysis of surgically removed specimens was then used as the reference standard to correlate cytological diagnoses. Sensitivity, specificity, positive and negative predictive values, and overall accuracy were among the diagnostic performance metrics that were computed. Results: The mean age of the 53 male and 47 female participants in the study ranged primarily from 15 to 45 years. Thyroid lesions accounted for the largest proportion of neck masses (42%), followed by lymph node pathologies (35%), was made up of thyroid lesions. Malignant lesions made up 27% of cases, whereas benign and inflammatory lesions made up 73%. With an overall diagnostic accuracy of 87%, FNAC showed a sensitivity of 85.2%, specificity of 87.7%, positive predictive value of 71.9%, and negative predictive value of 94.1%. False-positive and false-negative results were found in 9% and 4% of cases, respectively. Conclusion: For assessing neck swellings, FNAC is a dependable, secure, and reasonably priced first-line diagnostic method with good specificity and tolerable sensitivity. Discordant cases require histopathological confirmation for a conclusive diagnosis and suitable therapeutic management, even though it greatly facilitates preoperative decision-making and minimizes needless surgical procedures.