Fine-needle aspiration in squamous cell carcinoma of the head and neck

Cytological examination of fine-needle aspiration (FNA) specimens from patients with known or suspected squamous cell carcinoma of the head and neck at the University of Virginia, Charlottesville, between 1979 and 1982 was reviewed. Of 229 aspirates, 187 were of cervical or submandibular sites and 42 were of oral cavity sites. The accuracy of cytological diagnoses was determined by histological comparison and clinical follow-up. There were no false-positive aspirates (specificity, 100%) and one false-negative aspirate (sensitivity, 99%). Twenty-one (9%) contained insufficient cellular material for adequate cytological diagnosis. Seventy-eight percent of histologically confirmed aspirations were malignant. Proper use requires close communication between an experienced cytologist and a head and neck surgeon knowledgeable in the indications and limitations of the technique. This study demonstrates that FNA is a highly accurate, safe, predictive, and valuable technique in the management of squamous cell carcinoma of the head and neck.