Fine needle aspiration cytology: the Auckland experience

Fine needle aspiration cytology is a widely recognized and yet sensitive technique which can provide diagnosis in lesions in the head and neck, enabling appropriate management plans for individual patients to be made. One hundred and eighty-seven fine needle aspirates from head and neck masses in 128 patients seen at Green Lane Hospital were studied. The ages ranged from 9 to 87 years with a median of 63 years. Ninety-five fine needle aspirates were of malignant lesions, mainly squamous cell carcinoma and lymphomas and 94 were nonmalignant. Comparisons were made between the fine needle aspirate cytology and the histological and clinical diagnosis. Overall, the sensitivity was 81%, specificity 89%, positive predictive value 91% and negative predictive value 78%. With respect to 72 lymph node aspirates there were no false positive values resulting in a sensitivity of 84%, specificity 100%, positive predictive value 100% and negative predictive value 65%. With respect to salivary gland lesions, there were no false positive or false negative fine needle aspirates. It was noted that diagnostic accuracy improved with experience and good communication between the cytopathologist and the clinician. Most of the non-diagnostic smears occurred during the early part of the study. The study confirms the useful application of fine needle aspiration cytology in managing head and neck disease appropriately.