DIAGNOSTIC VALUE OF FINE NEEDLE ASPIRATION CYTOLOGY IN DIAGNOSIS OF NON-THYROIDAL NECK MASSES

Objective: To determine the diagnostic value of fine needle aspiration cytology in the diagnosis of non-thyroidal neck masses. Methodology: This descriptive study was conducted at the Department of ENT, Lady Reading Hospital Peshawar from January to December 2009. Hundred patients with non-thyroidal neck masses fulfilling the inclusion criteria were included in the study. Fine needle aspirations were performed by the same cytopa thologist. Results: The findings were TB 31%, metastatic lymph node 19%, reactive lymphadenopathy 9%, lymphoproliferative disease 11%, pleomorphic adenoma 8%0, thyroglossal cyst 5%, carotid body tumour 4%0, lipoma and branchial cysts were 3% each, sialolithiasis 2% and one case each of dermoid, sebaceous cyst, adenoid cystic carcinoma, Kikuchiʹs disease and Ewingʹs tumour. Correlation of FNAC with biopsy was for TB; true positive, 64.5%, true negative 29.03%o, false positive 3.22%, false negative 3.22% and for metastatic lymph node true positive 57.89%, true negative 36.84%, false positive 5.26% and no case of false negative. The diagnostic yield of FNAC was for TB, accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 93.54%, 95.23%0, 90%, 95.23% and 90% respectively. Metastatic lymph nodes accuracy sensitivity, specificity, positive predictive value and negative predictive value were 94.73%,, 100%,, 87.5%,, 91.66%, and 100% respectively. Overall diagnostic value of FNAC in non-thyroidal neck masses with regard to accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 90%, 90%, 77.42%, 90.41%, 90.41%, and 88.89% respectively. Conclusion: Fine needle aspiration cytology for non-thyroidal neck masses has equal diagnostic yield to open biopsy.