Rammeh Soumaya, Romdhane Emna, Sassi Asma, Belhajkacem Linda, Blel Ahlem, Ksentini Meriem, Lahiani Rim, Farah Faten, Salah Mamia Ben, Ferjaoui Mohamed
Department of Pathology, Charles Nicolle Hospital, Tunis, Tunisia.
Faculté de Médecine de Tunis, Université de Tunis El Manar, UR17ES15, Tunis, Tunisie.
Diagn Cytopathol. 2019 May;47(5):394-399. doi: 10.1002/dc.24120. Epub 2018 Nov 29.
Head and neck masses are a common presentation in daily practice and can be challenging to both clinicians and cytopathologists. Fine needle aspiration cytology (FNAC) is a widely used method for the diagnosis of head and neck masses. The aim of the study was to assess our institutional experience of the accuracy of FNAC in the diagnosis of head and neck masses.
A total of 1262 FNACs were conducted from January 2013 to December 2016 and subdivided into benign and malignant categories. The thyroid and salivary glands FNACs were classified according to the Bethesda System for Reporting Thyroid cytopathology and to the Milan System for Reporting Salivary Gland Cytopathology respectively. The measures of diagnostic accuracy of FNAC were determined taking histology as a gold standard.
A total of 7 false negative (FN) and 6 false positive (FP) FNACs were identified. Overall sensitivity and specificity of FNAC for a malignant diagnosis were 92% and 94.4%, respectively. Accuracy of FNACs of head and neck masses was 93.5% for all sites. The salivary gland group had the highest rate of FN (2.8%). All FP were reported in the thyroid group. These cases were cytologically classified suspicious for malignancy (n = 3) and papillary carcinoma (n = 3) and proved to be lymphocytic thyroiditis on final histology. Among the most common locations, cytology of lymph nodes provided the best sensitivity (98.2%). Salivary glands as well as lymph nodes had the best specificity (100%).
FNAC of head and neck masses has a high accuracy allowing a correct therapeutic management. However, this accuracy depends on the anatomic location of the mass.
头颈部肿块是日常临床实践中的常见表现，对临床医生和细胞病理学家来说都具有挑战性。细针穿刺抽吸细胞学检查（FNAC）是诊断头颈部肿块广泛使用的方法。本研究的目的是评估我们机构在头颈部肿块诊断中FNAC准确性的经验。
2013年1月至2016年12月共进行了1262例FNAC检查，并分为良性和恶性类别。甲状腺和唾液腺的FNAC检查分别根据甲状腺细胞病理学报告的贝塞斯达系统和唾液腺细胞病理学报告的米兰系统进行分类。以组织学为金标准确定FNAC的诊断准确性指标。
共识别出7例假阴性（FN）和6例假阳性（FP）的FNAC检查。FNAC对恶性诊断的总体敏感性和特异性分别为92%和94.4%。头颈部肿块FNAC检查在所有部位的准确率为93.5%。唾液腺组的FN率最高（2.8%）。所有FP均报告在甲状腺组。这些病例在细胞学上分类为可疑恶性（n = 3）和乳头状癌（n = 3），最终组织学检查证明为淋巴细胞性甲状腺炎。在最常见的部位中，淋巴结细胞学检查的敏感性最佳（98.2%）。唾液腺和淋巴结的特异性最佳（100%）。
头颈部肿块的FNAC检查具有较高的准确性，可实现正确的治疗管理。然而，这种准确性取决于肿块的解剖位置。
