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Petrone G, Rossi ED, Gallus R, Petrelli L, Marrone S, Rizzo D, Piras A, Garofalo G, Rindi G, Galli J, Paludetti G, Bussu F. Utility of ultrasound-guided fine needle aspiration cytology in assessing malignancy in head and neck pathology. Cytopathology 2021; 32:407-415. [PMID: 33501764 DOI: 10.1111/cyt.12955] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/28/2020] [Accepted: 12/21/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Fine needle aspiration cytology (FNAC) is a well-established diagnostic procedure for head and neck masses not clearly originating from mucosal or cutaneous surfaces. We analysed head and neck masses evaluated over a 2-year period, to assess the reliability of FNAC for the evaluation of malignancy. METHODS We enrolled all patients undergoing FNAC, from April 2013 to July 2015, in a single service of a large Italian university hospital. Relevant clinical data and ultrasonographic parameters of the lesions were recorded. We performed both conventional and thin-prep smears. Clinical presentation, ultrasonographic features and final cytology diagnoses were analysed and correlated with histology. RESULTS The series included 301 lesions in 285 patients, with a single (94.4%) or two (5.6%) lesions. Only eight samples were considered non-diagnostic/inadequate (2.6%). Among the cases, 139 FNAC (46.1%) underwent surgery. Cytological-histological correspondence was found in 89% of the cases. Concerning malignancy, we documented less than 4% false positives and less than 2.5% false negatives, with 92.7% sensitivity and 94.6% specificity. CONCLUSION FNAC diagnosis can be highly specific. Most importantly, it is highly reliable in assessing malignancy, thus defining the priority and guiding the management procedures.
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Affiliation(s)
- Gianluigi Petrone
- Pathology, Fondazione Policlinico Universitario, A. Gemelli IRCCS, Rome, Italy
| | - Esther Diana Rossi
- Pathology, Fondazione Policlinico Universitario, A. Gemelli IRCCS, Rome, Italy
| | | | - Livia Petrelli
- Otolaryngology Division, Ospedale San Filippo Neri, Rome, Italy
| | - Sabino Marrone
- Department of Head and Neck Surgery, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Davide Rizzo
- Otolaryngology Division, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Antonio Piras
- Otolaryngology Division, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Gabriella Garofalo
- Otolaryngology Division, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Guido Rindi
- Pathology, Fondazione Policlinico Universitario, A. Gemelli IRCCS, Rome, Italy.,Institute of Pathology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Jacopo Galli
- Department of Head and Neck Surgery, Università Cattolica del Sacro Cuore, Roma, Italia.,ENT Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Gaetano Paludetti
- Department of Head and Neck Surgery, Università Cattolica del Sacro Cuore, Roma, Italia.,ENT Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Francesco Bussu
- Otolaryngology Division, Azienda Ospedaliera Universitaria, Sassari, Italy.,Dipartimento delle Scienze Mediche, Chirurgiche e Sperimentali, Università di Sassari, Sassari, Italy
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Arlı C, Şanlı A, Aydın S, Evren C, Tezer İ. Baş-Boyun Kitlelerinde İnce İğne Aspirasyon Biyopsisinin Değeri: İİAB ile Cerrahi Sonrası Patoloji Sonuçlarının Karşılaştırılması. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2018. [DOI: 10.17944/mkutfd.446030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Sharma SD, Kumar G, Horsburgh A, Huq M, Alkilani R, Chawda S, Kaddour H. Do Immediate Cytology and Specialist Radiologists Improve the Adequacy of Ultrasound-Guided Fine-Needle Aspiration Cytology? Otolaryngol Head Neck Surg 2014; 152:292-6. [DOI: 10.1177/0194599814561204] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective To assess whether a dedicated “1-stop” neck lump clinic has improved the percentage of adequate fine-needle aspiration cytology (FNAC) samples and reduced the need for repeat FNAC. Study Design Retrospective review. Setting District General Hospital in the United Kingdom. Subjects and Methods Patients attending for ultrasound-guided FNAC over a 6-month period from August 2012 to February 2013. Patients were placed in 4 groups: group 1, FNAC performed by any of the subspecialist radiologists with cytology support (n = 100); group 2, FNAC performed by general radiologists without cytology support (n = 112); group 3, FNAC performed by a particular subspecialist radiologist with cytology support (n = 61); and group 4, FNAC performed by the same subspecialist radiologist without cytology support (n = 125). Results There was a significantly higher rate of adequacy of FNAC in the presence of a subspecialist radiologist with immediate cytology (group 1) versus a general radiologist without cytology support (group 2; 87/100 vs 63/112, P = .0001), a significantly higher rate of adequacy of FNAC in the presence of cytology support with the same radiologist (group 3 vs group 4, 55/61 vs 97/125, P = .04), and a significantly higher rate of adequacy of FNAC in the presence of a subspecialist radiologist versus a general radiologist without cytology support (group 4 vs group 2, 97/125 vs 63/112, P = .0005). Conclusion Immediate cytology and the presence of a subspecialist radiologist increase the adequacy of FNAC. The adequacy rate of non–cytology-supported FNAC or nonsubspecialist FNAC is below the adequate rate expected from the literature or as recommended in national guidelines.
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Affiliation(s)
- Sunil Dutt Sharma
- Department of Otorhinolaryngology, Queens Hospital, Rom Valley Way, Romford, Essex, United Kingdom
| | - Gaurav Kumar
- Department of Otorhinolaryngology, Queens Hospital, Rom Valley Way, Romford, Essex, United Kingdom
| | - Avril Horsburgh
- Department of Otorhinolaryngology, Queens Hospital, Rom Valley Way, Romford, Essex, United Kingdom
| | - Mahmuda Huq
- Department of Otorhinolaryngology, Queens Hospital, Rom Valley Way, Romford, Essex, United Kingdom
| | - Raed Alkilani
- Department of Otorhinolaryngology, Queens Hospital, Rom Valley Way, Romford, Essex, United Kingdom
| | - Sanjiv Chawda
- Department of Otorhinolaryngology, Queens Hospital, Rom Valley Way, Romford, Essex, United Kingdom
| | - Hesham Kaddour
- Department of Otorhinolaryngology, Queens Hospital, Rom Valley Way, Romford, Essex, United Kingdom
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Veivers D, Dent J. Lateral cervical cysts: an Australian perspective. ANZ J Surg 2012; 82:799-802. [DOI: 10.1111/j.1445-2197.2012.06187.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2012] [Indexed: 11/27/2022]
Affiliation(s)
- David Veivers
- Department of Otolaryngology Head and Neck Surgery; Royal North Shore Hospital, The University of Sydney; St. Leonards; New South Wales; Australia
| | - James Dent
- Northern Clinical School; The University of Sydney; St. Leonards; New South Wales; Australia
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Javadi M, Asghari A, Hassannia F. Value of fine-needle aspiration cytology in the evaluation of parotid tumors. Indian J Otolaryngol Head Neck Surg 2011; 64:257-60. [PMID: 23998031 DOI: 10.1007/s12070-011-0297-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Accepted: 08/12/2011] [Indexed: 10/17/2022] Open
Abstract
Fine needle aspiration cytology (FNAC) is commonly used in the study of parotid masses; however controversy exists regarding its diagnostic accuracy. The objective of this study was to evaluate the effectiveness of FNAC as a preoperative diagnostic tool of parotid tumors. Sixty-five patients had satisfactory preoperative FNAC and underwent subsequent surgery to the parotid between March 2002 and July 2009 at our institution. The results of the FNAC were compared to the permanent histopathological diagnosis. The sensitivity, specificity, positive predictive value, negative predictive value, and the overall accuracy of FNAC for parotid masses were 57.9, 97.8, 91.7, 84.9, and 86%, respectively. FNAC is useful in the preoperative assessment of parotid tumors and surgical planning. The non-diagnostic and false-negative results are the limitations of FNAC that should be reduced to improve its usefulness in the evaluation of parotid tumors.
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Affiliation(s)
- Morteza Javadi
- Department and Research Center of Otolaryngology, Head and Neck Surgery, Tehran University of Medical Sciences, Hazrate Rasoul Akram Hospital, Niayesh St., Satarkhan Ave, Tehran, Iran
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Ganguly A, Giles TE, Smith PA, White FE, Nixon PP. The benefits of on-site cytology with ultrasound-guided fine needle aspiration in a one-stop neck lump clinic. Ann R Coll Surg Engl 2010; 92:660-4. [PMID: 20663278 PMCID: PMC3229373 DOI: 10.1308/rcsann.2010.92.8.660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2010] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION In the National Institute for Health and Clinical Excellence (NICE) guidance on cancer services published in 2004, it was recommended that specialist clinics should be set up for the assessment of patients with neck lumps, structured in a similar way to one-stop breast lump clinics with a cytopathologist present and preferably ultrasound guidance. The aim of this study was to audit the performance of ultrasound-guided fine needle aspiration (FNA) with on-site cytology in a one-stop neck lump clinic at The Royal Liverpool University Hospital. PATIENTS AND METHODS Data were collected between November 2008 and May 2009 (7 months). Details of the adequacy rate for the FNA were recorded and whether multiple passes were required. The likely adequacy rate if ultrasound guidance was not available was also calculated. RESULTS A total of 274 patients were included in the audit. Of these, 227 (83%) patients required a single pass for adequate diagnostic material. Of the remaining, 45 (16%) required two passes and 2 (1%) required three passes. The overall sample inadequacy rate was 11 of 274 (4%). From these results, it could be predicted that, if immediate cytological evaluation was unavailable, the inadequacy rate would have been 41 of 274 (15%). CONCLUSIONS This audit has illustrated the benefits of a one-stop clinic with on-site cytology in providing a rapid diagnostic head and neck cancer service.
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Affiliation(s)
- A Ganguly
- Royal Liverpool and Broadgreen University Hospitals Trust, Liverpool, UK
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7
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Ganguly A, Giles TE, Smith PA, White FE, Nixon PP. The benefits of on-site cytology with ultrasound-guided fine needle aspiration in a one-stop neck lump clinic. Ann R Coll Surg Engl 2010. [PMID: 20663278 DOI: 10.1308/003588410x12699663905032a] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION In the National Institute for Health and Clinical Excellence (NICE) guidance on cancer services published in 2004, it was recommended that specialist clinics should be set up for the assessment of patients with neck lumps, structured in a similar way to one-stop breast lump clinics with a cytopathologist present and preferably ultrasound guidance. The aim of this study was to audit the performance of ultrasound-guided fine needle aspiration (FNA) with on-site cytology in a one-stop neck lump clinic at The Royal Liverpool University Hospital. PATIENTS AND METHODS Data were collected between November 2008 and May 2009 (7 months). Details of the adequacy rate for the FNA were recorded and whether multiple passes were required. The likely adequacy rate if ultrasound guidance was not available was also calculated. RESULTS A total of 274 patients were included in the audit. Of these, 227 (83%) patients required a single pass for adequate diagnostic material. Of the remaining, 45 (16%) required two passes and 2 (1%) required three passes. The overall sample inadequacy rate was 11 of 274 (4%). From these results, it could be predicted that, if immediate cytological evaluation was unavailable, the inadequacy rate would have been 41 of 274 (15%). CONCLUSIONS This audit has illustrated the benefits of a one-stop clinic with on-site cytology in providing a rapid diagnostic head and neck cancer service.
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Affiliation(s)
- A Ganguly
- Royal Liverpool and Broadgreen University Hospitals Trust, Liverpool, UK
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8
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Lee EW, Chen C, Sauk S, Ragavendra N. How diagnostic is ultrasound-guided neck mass biopsy (fine-needle capillary sampling biopsy technique)?: evaluation of 132 nonthyroid neck mass biopsies with pathologic analysis over 7 years at a single institution. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2009; 28:1679-1684. [PMID: 19933482 DOI: 10.7863/jum.2009.28.12.1679] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The purpose of this study was to evaluate the diagnostic value of ultrasound-guided neck mass biopsy (fine-needle capillary sampling biopsy [FNC] technique). METHODS With Institutional Review Board approval, all patients who had an ultrasound-guided neck mass FNC biopsy between January 2000 and December 2006 were retrieved from the ultrasound database. A total of 132 neck mass biopsies were performed in 124 patients. Patient demographics, procedure characteristics, and pathologic diagnoses were recorded. RESULTS Of the 124 patients, 73 were female (mean age, 51.4 years). Biopsies were performed twice in 8 patients. A significant 200% increase from 2000 through 2002 to 2003 through 2004 and from 2003 through 2004 to 2005 through 2006 was found (P < .05). The most biopsied location was in the lymph nodes (34.8%), followed by perithyroid soft tissue masses (28.0%). A 25-gauge needle was used most frequently (97.7%). A total of 41 biopsies were diagnostic for thyroid diseases (31.1%), with the most common being thyroid papillary carcinoma. We found metastases in 31 biopsies (23.5%). Following these 2 were 29 lymph node biopsies. No major complications were noted. Of the 132 neck masses biopsied, 8 were pathologically nondiagnostic (93.9% diagnostic yield), yielding sensitivity, specificity, and accuracy of greater than 95% (97.1%, 95.2%, and 95.8%, respectively). CONCLUSIONS Ultrasound-guided FNC of neck masses is highly diagnostic. The diagnostic yield is especially high for detection of malignancy, including metastases. Together with a high clinical suspicion, ultrasound-guided needle biopsy should be performed to form a correct diagnosis and make appropriate management plans.
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Affiliation(s)
- Edward W Lee
- Division of Ultrasound Imaging, Department of Radiology, Ronald Reagan Medical Center, University of California, Los Angeles, CA 90095, USA
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9
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Tandon S, Shahab R, Benton JI, Ghosh SK, Sheard J, Jones TM. Fine-needle aspiration cytology in a regional head and neck cancer center: Comparison with a systematic review and meta-analysis. Head Neck 2008; 30:1246-52. [DOI: 10.1002/hed.20849] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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10
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Viguer JM, Jiménez-Heffernan JA, López-Ferrer P, Banaclocha M, Vicandi B. Fine-needle aspiration cytology of metastatic nasopharyngeal carcinoma. Diagn Cytopathol 2005; 32:233-7. [PMID: 15754369 DOI: 10.1002/dc.20216] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cytological features of nasopharyngeal carcinoma (NPC) were reviewed in an attempt to select cytological criteria that permit a specific recognition of metastases. For this purpose, 54 fine-needle aspiration (FNA) procedures from 43 patients with NPC were analyzed. Thirty-two (59.3%) procedures were performed before the histological diagnosis. In 25 (46.3%) procedures, smears showed many neoplastic single cells, clusters, and abundant lymphoid cells (mixed pattern). A dissociated (single cell) pattern consisting of individual neoplastic and lymphoid cells was seen in 18 (33.3%) cases. Finally, 11 (20.4%) cases showed cohesive epithelial clusters (cohesive pattern) without relevant cellular dissociation or lymphoid cells. Squamous-cell differentiation was seen in three of these cases. Most single neoplastic cells presented as large, pleomorphic naked nuclei. Other interesting findings were granulomas (n = 3), prominent eosinophilic infiltrates (n = 4), and suppurative changes (n = 5). In most smears with mixed and dissociated patterns, a nasopharyngeal origin could be suggested. On the contrary, those smears with a cohesive pattern were indistinguishable from other head and neck carcinomas. The presence (on cervical lymph nodes) of a dissociated or mixed (single cells and groups) architectural pattern of large, anaplastic cells and naked nuclei accompanied by an abundant lymphoid component is highly suggestive of undifferentiated NPC. Cytology offers a rapid diagnosis, establishes the necessity of a complete cavum examination, and helps in avoiding unnecessary and harmful biopsies.
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Affiliation(s)
- José M Viguer
- Department of Pathology, University Hospital La Paz, and Faculty of Medicine, Universidad Autonoma, Madrid
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11
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12
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Kyrmizakis DE, Papadakis CE, Manios AG, Simandirakis CJ, Mastorakis EM, Amanakis ZE. Efficacy of 'two-man' FNAB technique in the assessment of patients with non-thyroid neck masses. Auris Nasus Larynx 2001; 28:329-31. [PMID: 11694377 DOI: 10.1016/s0385-8146(01)00095-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To show the superiority of 'two-man' FNAB technique comparing to the standard FNAB technique, in order to identify the cause of non-thyroid neck masses. METHODS Over an 18 months period, a consecutive paired study was conducted in the tertiary referral Venizelion General Hospital. Forty-four cytologic examinations were performed in patients with non-thyroid head and neck masses. The samples were taken from the same side using both techniques the standard FNAB technique and the 'two-man' FNAB technique (for which two persons carried out the procedure). The slides were seen by the pathologist and were defined as diagnostic, suggestive or inconclusive. The diagnosis was confirmed in any case by definite histology after surgical treatment or open biopsy. RESULTS From 44 samples taken with the 'two-man' technique, 34 were diagnostic (all true) verified by histopathology, seven suggestive (five true and two false) and three inconclusive (6.82%). The correct diagnosis was confirmed in 39 cases (88.64%). From 44 samples of standard technique, 22 were diagnostic (all true), 12 suggestive (five true and seven false) and 10 inconclusive (22.72%). The correct diagnosis was confirmed in 27 cases (61.36%). The accuracy of diagnosis with the standard FNAB technique was 0.79 (SE=0.07), while with the 'two-man' FNAB technique was 0.95 (SE=0.03), a significant statistical difference (Fischer exact test, P=0.041). CONCLUSIONS 'Two-man' FNAB technique proved to be as safe and patient friendly as the standard FNAB, but more accurate and may be easier to perform than this. The 'two-man' FNAB technique could become the preferred method for fine-needle cytology, particularly for difficult to reach areas of the head and neck.
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Affiliation(s)
- D E Kyrmizakis
- Department of Otolaryngology, Venizelion Hospital, Heraklion, Crete, Greece.
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Lee WY, Hsiao JR, Jin YT, Tsai ST. Epstein-Barr virus detection in neck metastases by in-situ hybridization in fine-needle aspiration cytologic studies: an aid for differentiating the primary site. Head Neck 2000; 22:336-40. [PMID: 10862015 DOI: 10.1002/1097-0347(200007)22:4<336::aid-hed4>3.0.co;2-t] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Nasopharyngeal carcinoma (NPC) is strongly associated with Epstein-Barr virus (EBV). The metastasis to cervical lymph nodes represents a frequent initial manifestation of NPC. The usefulness of EBV detection by polymerase chain reaction (PCR) in the diagnosis of occult NPC with cervical metastasis has been reported. Our previous study showed that EBER1 in-situ hybridization was somewhat more sensitive and specific than PCR in detecting EBV in the evaluation of specimens from a population at high risk for NPC. METHODS Fine-needle aspiration cytologic specimens of neck masses from 30 patients were investigated, including 10 NPC primary tumors, 19 squamous cell carcinomas from other sites of the head and neck (9 oral cavity, 2 paranasal sinuses, 2 oropharynx, 3 larynx, and 3 hypopharynx), and 1 diffuse large-cell lymphoma. EBER1 in-situ hybridization was performed on direct smears made from aspirates. RESULTS EBER1 signals were detected in all neck metastases from the nasopharynx but none of the specimens from other primary sites. CONCLUSIONS This study suggests that EBER1 in-situ hybridization can be used as a supplemental tool for differential diagnosis whenever fine-needle aspiration cytologic examination is presented with a neck metastasis without knowing the primary site.
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MESH Headings
- Biopsy, Needle
- Carcinoma/pathology
- Carcinoma/secondary
- Carcinoma/virology
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/secondary
- Carcinoma, Squamous Cell/virology
- Cell Nucleus/pathology
- Cell Nucleus/virology
- Head and Neck Neoplasms/pathology
- Head and Neck Neoplasms/virology
- Herpesviridae Infections/complications
- Herpesviridae Infections/diagnosis
- Herpesvirus 4, Human/isolation & purification
- Humans
- In Situ Hybridization
- Lymphatic Metastasis
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- Nasopharyngeal Neoplasms/pathology
- Nasopharyngeal Neoplasms/virology
- Neoplasms, Unknown Primary/virology
- Polymerase Chain Reaction
- Reproducibility of Results
- Sensitivity and Specificity
- Taiwan
- Tumor Virus Infections/complications
- Tumor Virus Infections/diagnosis
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Affiliation(s)
- W Y Lee
- Department of Pathology, National Cheng Kung University Medical College, Tainan, Taiwan
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14
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The role of operator experience in fine needle aspiration cytology of head and neck masses. Int J Oral Maxillofac Surg 1999. [DOI: 10.1016/s0901-5027(99)80057-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Over a 32-month period at the University Hospital, Kuala Lumpur, we were able to study the cytological appearance of metastatic nasopharyngeal carcinoma (NPC) in 17 cases. This comprised 14 males and three females of which 13 were Chinese, three were Malay, and one was Indian. Their ages ranged from 27 to 64 years. Histological correlation was available in all the patients in the form of nasopharyngeal biopsies, and they were classified as per the World Health Organization classification into types I, II, and III NPC. Smears from type II NPC showed good cellularity with mainly clustered and occasionally dissociated cells, with focal columnar appearance, vesicular nuclei, prominent nucleoli, and variable amounts of cytoplasm. Clusters of malignant cell closely associated with lymphoid cells and dissociation of malignant cells were more characteristic of type III NPC. FNA cytology is now applied extensively to the diagnosis of head and neck tumours and knowledge of the cytomorphology of NPC would greatly aid in pinpointing the primary of this tumour which is notorious for presenting with early nodal metastasis.
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Affiliation(s)
- G Jayaram
- Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Filopoulos E, Angeli S, Daskalopoulou D, Kelessis N, Vassilopoulos P. Pre-operative evaluation of parotid tumours by fine needle biopsy. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 1998; 24:180-3. [PMID: 9630856 DOI: 10.1016/s0748-7983(98)92895-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIMS Although fine needle biopsy (FNB) is a well established diagnostic technique there continues to be controversy concerning its use in the pre-operative assessment of intraparotid masses. The purpose of this study was to evaluate the diagnostic accuracy, specificity and sensitivity of FNB in parotid tumours and consequently to asses its clinical value. METHODS Over a 6-year period, 129 consecutive patients with parotid masses underwent pre-operative FNB evaluation and in 121 of these cases the cytological diagnosis was confirmed. RESULTS Out of the 86 cases cytologically diagnosed as benign, two false negative results were obtained by FNB, whereas out of the 38 cytological diagnoses of malignant tumours one case was found histologically to be Warthin's tumour. In the FNB results of the two cases suspicious for malignancy, one was confirmed histologically as malignant. Three cases of FNB with inadequate material were found to be benign lesions. In this trail, the diagnostic accuracy of FNB was 96.7%, the specificity, 97.6% and the sensitivity, 95%. CONCLUSIONS Our results show that FNB is a valuable examination technique in the pre-operative evaluation of parotid masses.
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Affiliation(s)
- E Filopoulos
- Department of Surgical Oncology, St. Savas Regional Anticancer-Oncologic Hospital of Athens, Greece
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Fulciniti F, Califano L, Zupi A, Vetrani A. Accuracy of fine needle aspiration biopsy in head and neck tumors. J Oral Maxillofac Surg 1997; 55:1094-7. [PMID: 9331232 DOI: 10.1016/s0278-2391(97)90288-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Fine-needle aspiration biopsy (FNAB) is frequently used in the diagnosis of lesions occurring in the head and neck region. This study evaluated the correlation between the findings on FNAB and the histological findings observed after surgery. MATERIALS AND METHODS A review of 218 patients who underwent FNAB of a head or neck tumor was performed. Cytological reports were classified into the following diagnostic categories: negative or positive for malignant cells and unsatisfactory. False-positive, false-negative, true-positive (sensitivity), and true-negative (specificity) rates were calculated. RESULTS Twelve specimens did not allow an adequate diagnosis (5.5%). Among benign tumors, 96.2% of the cases were correctly diagnosed, and 3.8% were nondiagnostic specimens. Among malignant tumors, 86.4% of cases were correctly identified. There were two (3.4%) false-negatives and six (10.2%) nondiagnostic specimens, with a total false-negative rate of 13.6%. CONCLUSIONS Sampling errors present a minor problem with FNAB. Most nondiagnostic or incorrect specimens were caused by nonhomogenous lesions, with poor placement of the needle and an insufficient amount of aspirated material. FNAB is a useful modality for the diagnosis of head and neck masses.
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Affiliation(s)
- F Fulciniti
- Faculty of Medicine and Surgery Federico II University of Naples, Italy
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Mui S, Li T, Rasgon BM, Hilsinger RL, Rumore G, Puligandla B, Sawicki J. Efficacy and cost-effectiveness of multihole fine-needle aspiration of head and neck masses. Laryngoscope 1997; 107:759-64. [PMID: 9185732 DOI: 10.1097/00005537-199706000-00010] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
To determine whether the specimen from fine-needle aspiration (FNA) biopsy of head and neck masses has greater diagnostic accuracy when using multihole needles than when using conventional, single-hole needles, we did a prospective, randomized, single-blinded study comparing diagnoses obtained using both types of needles in FNA biopsies of head and neck masses. Eighty-eight patients served as their own controls and had 91 FNA biopsies with both multihole and single-hole, 22-gauge needles. Order of biopsy was randomized and was unknown to the cytopathologist. No statistically significant differences were noted in quantity of specimen material obtained, quality of fixation, or diagnostic value between the multihole and conventional needle. We found no advantage in using the more costly multihole needle in FNA biopsy of head and neck masses.
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Affiliation(s)
- S Mui
- Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente Medical Center, Oakland, California 94611-5693, U.S.A
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Abstract
Three patients presenting with parotid, submandibular, and/or lymph node masses were subjected to fine-needle aspiration cytology. Smears showed dissociated and clustered endothelial cells, eosinophils, lymphocytes, and Warthin Finkeldey giant cells. In two cases a diagnosis of Kimura's disease was suggested from the FNA cytologic smears. In the third case the presence of mononucleate cells with prominent nucleoli led to a suspicion of Hodgkin's disease. Excision biopsy and histopathologic study established a diagnosis of Kimura's disease in all three cases.
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Affiliation(s)
- G Jayaram
- Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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20
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Abaza NA, Miloro M. FINE-NEEDLE ASPIRATION IN ORAL AND MAXILLOFACIAL DIAGNOSIS. Oral Maxillofac Surg Clin North Am 1994. [DOI: 10.1016/s1042-3699(20)30762-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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21
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Barnard NA, Paterson AW, Irvine GH, Mackenzie ED, White H. Fine needle aspiration cytology in maxillofacial surgery--experience in a district general hospital. Br J Oral Maxillofac Surg 1993; 31:223-6. [PMID: 8399037 DOI: 10.1016/0266-4356(93)90143-k] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
101 fine needle aspirations of 82 head and neck masses in 72 patients performed in one maxillofacial unit over a 5-year period were studied retrospectively. Satisfactory reports were obtained for 69 masses. Fifty six (81.2%) were confirmed histologically and 13 (18.8%) by clinical follow up of at least 6 months' duration. The sensitivity was 96.7% and specificity 100% with a positive predictive value of 100%. No complications were recorded. Provided the unsatisfactory specimens are correctly recognised this technique provides a useful aid in the management of head and neck masses.
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Affiliation(s)
- N A Barnard
- Southmead Hospital, Westbury-on-Trym, Bristol
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22
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