COMPARISON OF CELL BLOCKS AND SMEAR EXAMINATION WITH FINE NEEDLE ASPIRATES IN THE DIAGNOSIS OF SUPERFICIAL PALPABLE HEAD AND NECK LESIONS
Main Article Content
Abstract
OBJECTIVE: To compare the findings of cell blocks and smear examination with fine needle aspirates (FNA) in the diagnosis of superficial palpable head and neck lesions taking histopathology as the gold standard.
METHODS: This cross-sectional comparative study was conducted at Pakistan Institute of Medical Sciences, Islamabad and Institute of Basic Medical Sciences, Khyber Medical University, Peshawar. Eighty patients of all age groups, having superficial clinically palpable lesions of head and neck region were recruited in the study from August 2014 to August 2015. FNA cytology, cell block and open biopsy were performed in all cases and compared with the histopathological examination. The data was recorded in a proforma and analyzed through SPSS Version-23.
RESULTS: Out of 80 patients, 44 (55%) were males and 36 (45%) females. The age of patients ranged from 01-81 years with a mean age of 45.68±20.43 years. Lesions involving lymph nodes (n=31; 38.8%) and salivary gland (n=24; 30%) were common in head and neck region. Tuberculosis (n=15: 48.38%) and pleomorphic adenoma (n=13; 54.16%) were the common lesions involving lymph nodes and salivary glands respectively. Overall, 49 (61.2%) cases were benign/reactive and 31 (38.8%) cases were malignant on histopathology. Sensitivity, specificity, positive predictive value and negative predictive value was 74.2%, 95.9%, 92% & 85.5% for FNA smears and 83.9%, 98%, 96.3% and 90.6% for Cell Block respectively in diagnosing head and neck lesions.
CONCLUSION: Cell block with better diagnostic accuracy can be used as adjunct to FNA smears in diagnosis of superficial palpable head and neck lesions.
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References
Desai KM, Angadi P V, Kale AD, Hallikerimath S. Assessment of cell block technique in head and neck pathology diagnoses: a preliminary study. Diagn Cytopathol 2019;47(5):445-51. https://doi.org/10.1051/mbcb/2019031.
Park JE, Lee JH, Ryu KH, Park HS, Chung MS, Kim HW, et al. Improved diagnostic accuracy using arterial phase CT for lateral cervical lymph node metastasis from papillary thyroid cancer. Am J Neuroradiol 2017;38(4):782-8. https://doi.org/10.3174/ajnr.A5054.
Ling W, Nie J, Zhang D, Yang Q, Jin H, Ou X, et al. Role of contrast-enhanced ultrasound (ceus) in the diagnosis of cervical lymph node metastasis in nasopharyngeal carcinoma (npc) patients. Front Oncol 2020;10:972. https://doi.org/10.3389/fonc.2020.00972.
Casasola RJ. Head and neck cancer. J R Coll Physicians Edinb 2010;40(4):343-5. https://doi.org/10.4997/jrcpe.2010.423.
Nagarkar R, Wagh A, Kokane G, Roy S, Vanjari S. Cervical Lymph Nodes: A Hotbed For Metastasis in Malignancy. Indian J Otolaryngol Head Neck Surg 2019;71(1):976-80. https://doi.org/10.1007/s12070-019-01664-4.
Akhtar A, Hussain I, Talha M, Shakeel M, Faisal M, Ameen M, et al. Prevalence and diagnostic of head and neck cancer in Pakistan. Pak J Pharm Sci 2016;29(5 Suppl):1839-46.
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin 2016;66(1):7-30. https://doi.org/10.3322/caac.21332.
Ibikunle DE, Omotayo JA, Ariyibi OO. Fine needle aspiration cytology of breast lumps with histopathologic correlation in Owo, Ondo State, Nigeria: a five-year review. Ghana Med J 2017;51(1):1-5. http://dx.doi.org/10.4314/gmj.v51i1.1.
Huang CG, Li MZ, Wang SH, Zhou TJ, Haybaeck J, Yang ZH. The diagnosis of primary thyroid lymphoma by fine-needle aspiration, cell block, and immunohistochemistry technique. Diagn Cytopathol 2020;48(11):1041-47 https://doi.org/10.1002/dc.24526.
Shetty SM, Basavaraju A, Dinesh US. A cytological study on metastatic lymphnode deposits in a tertiary care hospital. Indian J Pathol Oncol 2020;7(1):14-8. https://doi.org/10.18231/j.ijpo.2020.004.
Iwamoto N, Aruga T, Asami H, Horiguchi S. False-negative ultrasound-guided fine-needle aspiration of axillary lymph nodes in breast cancer patients. Cytopathology 2020;31(5):463-7. http://dx.doi.org/10.1111/cyt.12877.
Zhu Y, Song Y, Xu G, Fan Z, Ren W. Causes of misdiagnoses by thyroid fine-needle aspiration cytology (FNAC): Our experience and a systematic review. Diagn Pathol 2020;15(1):1. https://doi.org/10.1186/s13000-019-0924-z.
Saqi A. The state of cell blocks and ancillary testing: Past, present, and future. Arc Pathol Lab Med 2016;140(12):1318-22. https://doi.org/10.5858/arpa.2016-0125-RA.
Lindsey KG, Houser PM, Shotsberger-Gray W, Chajewski OS, Yang J. Young Investigator Challenge: A novel, simple method for cell block preparation, implementation, and use over 2 years. Cancer Cytopathol 2016;124(12):885-92. https://doi.org/10.1002/cncy.21795.
Obiajulu FJN, Daramola AO, Anunobi CC, Ikeri NZ, Abdulkareem FB, Banjo AA. The diagnostic utility of cell block in fine needle aspiration cytology of palpable breast lesions in a Nigerian tertiary health institution. Diagn Cytopathol 2020;48(12):1300-6. https://doi.org/10.1002/dc.24576.
Nambirajan A, Jain D. Cell blocks in cytopathology: An update. Cytopathology 2018;29(6):505-24. https://doi.org/10.1111/cyt.12627.
Walsh KA, Patel RT. Cell Block Preparation Techniques and Applications in Veterinary Medicine. In: Veterinary Cytology. Wiley; 2020. p. 73-8. https://doi.org/10.1002/9781119380559.ch8.
Balassanian R, Wool GD, Ono JC, Olejnik-Nave J, Mah MM, Sweeney BJ, et al. A superior method for cell block preparation for fine-needle aspiration biopsies. Cancer Cytopathol 2016;124(7):508-18. https://doi.org/10.1002/cncy.21722.
Maseki Z, Kajiyama H, Nishikawa E, Satake T, Misawa T, Kikkawa F. Is cell block technique useful to predict histological type in patients with ovarian mass and/or body cavity fluids? Nagoya J Med Sci 2020;82(2):225-35. https://doi.org/10.18999/nagjms.82.2.225.
Padia DB, Dhokiya DM. A study of FNAC of head and neck lesions at a tertiary care centre. Trop J Pathol Microbiol 2018;4(8):592-6.
Oberoi JS, Umap P, Patil SB, Agrawal SJ. Comparative study of fine needle aspiration and cell block technique in salivary gland lesions. Int J Approx Reasoning 2020;8(7):285-90.
Khetrapal S, Jetley S, Jairajpuri Z, Rana S, Kohli S. FNAC of head & neck lesions and its utility in clinical diagnosis: a study of 290 cases. Natl J Med Res 2015;5(1):33-8.
Banstola L, Sharma S, Gautam B. Fine needle Aspiration Cytology of various Head and Neck Swellings. Med J Pokhara Acad Heal Sci 2018;1(2):83-6. https://doi.org/10.3126/MJPAHS.V1I2.23398.
Bhowmik S, Chakrabarti I, Ghosh P, Bera P, Banik T. Comparative evaluation of cell block method and smear cytology in fine needle aspiration cytology of intra-abdominal mass lesions. Iran J Pathol 2018:13(2):179-87.
Dey S, Nag D, Nandi A, Bandyopadhyay R. Utility of cell block to detect malignancy in fluid cytology: Adjunct or necessity? J Cancer Res Ther 2017;13(3):425-9. https://doi.org/10.4103/0973-1482.177501.
Vinayakamurthy S, Manoli N, Shivajirao P, Manjunath, Jothady S. Role of cell block in guided FNAC of abdominal masses. J Clin Diagn Res 2016;10(3):EC01-5. https://doi.org/10.7860/jcdr/2016/17359.7422.
Mathew EP, Nair V. Role of cell block in cytopathologic evaluation of image-guided fine needle aspiration cytology. J Cytol 2017;34(3):133-8. https://doi.org/10.4103/joc.joc_82_15.
Guldaval F, Anar C, Polat G, Gayaf M, Yavuz M, Korkmaz A, et al. Contribution of cell block obtained by thoracentesis in the diagnosis of malignant pleural effusion. J Cytol 2019;36(4):205-8. https://doi.org/10.4103/joc.joc_99_18.
Mamoon N, Mushtaq S, Rathore MU. Endoscopic ultrasound guided aspiration cytology-a useful diagnostic tool. J Pak Med Assoc 2011;61(4):367-71.
Jahangir S, Loya A, Siddiqui M, Noreen N, Yusuf M. Accuracy of diagnosis of solid pseudopapillary tumor of the pancreas on fine needle aspiration: A multi-institution experience of ten cases. Cytojournal 2015;12:29. https://doi.org/10.4103/1742-6413.171140.
Naz S, Hashmi AA, Khurshid A, Faridi N, Edhi MM, Kamal A, et al. Diagnostic role of fine needle aspiration cytology (FNAC) in the evaluation of salivary gland swelling: An institutional experience. BMC Res Notes 2015;8:101. https://doi.org/10.1186/s13104-015-1048-5.
Sadaf S, Loya A, Akhtar N, Yusuf MA. Role of endoscopic ultrasound-guided-fine needle aspiration biopsy in the diagnosis of lymphoma of the pancreas: A clinicopathological study of nine cases. Cytopathology 2017;28(6):536-41. https://doi.org/10.1111/cyt.12442.