Cytopathologist-performed ultrasonography-guided fine-needle aspiration of head and neck lesions: the Weill Cornell experience.

INTRODUCTION

Ultrasonography-guided fine-needle aspiration (US-FNA) yields diagnostic material more often than palpation-guided FNA does. It is often performed by an interventional radiologist (IR) but rarely by a cytopathologist (CP). Herein we describe our method of performance and growing experience with this technique.

MATERIALS AND METHODS

Data from US-FNA of head and neck lesions performed over a 33-month period by both a CP and an IR were reviewed. Special attention was paid to cases for which histologic follow-up was available. Association in concordance between cytologic and histologic diagnoses was attempted using Fisher's exact test. Mean size of masses biopsied, number of passes performed, and passes needed to achieve adequacy were compared between groups using the Wilcoxon rank-sum test. Tests were 2-sided with P < 0.05 regarded as statistically significant.

RESULTS

Of the 175 US-FNAs performed, 108 (62%) were done by the CP and 67 (38%) by the IR. Fifty-eight patients had histologic follow-up; 37 (64%) for the CP and 21 (36%) for the IR. Mean mass size was significantly smaller for the IR at 2.11 cm versus 2.9 cm for the CP (P = 0.021). Adequacy was achieved after 1 pass in 70% of cases (26 of 37) by the CP and 67% (14 of 21) by the IR. Number of passes performed did not vary significantly between groups. A variety of masses were biopsied; however, the small sample size precluded meaningful evaluation of cytologic concordance to final histology.

CONCLUSIONS

CP-performed US-FNA has been successfully delivered to clinicians at our institution.