Jain, D. Agarwal, A. Reprint requests: Prof. Manuscript received: November 17, ; Initial review completed: December 10, ; Revision accepted: March 18, Fine needle aspiration cytology FNAC is well accepted as a useful diagnostic technique in the management of adult patients with head and neck lumps Until recently the application of FNAC to the pediatric population was largely ignored in the Indian and American pediatric literature.
Previous reports have studied its utility in only small series of pediatric patients The current study evaluates the role of FNAC as a diagnostic tool in investigation of head and neck lesions in children. Smears were stained by Giemsa and Paps stain and special stains were carried out as and when required 7. Out of these, The other lesions aspirated were from thryoid, salivary gland, miscellaneous surface lumps and orbital lesions comprising 3.
The final diagnosis of the lesions aspirated according to the site is given in Table I. Of all the cases, All malignant cases were confirmed by surgical biopsy. Reactive Euthyroid colloid goiter 12 Chronic sialadenitis 4 Tubercular abscess 2 Lymphangioma Epidermal. Smears consisting of only caseous material predominated out of all cytomorphological appearances. AFB positivity was observed in Thirty per cent patients with AFB negativity were followed up and they responded to antitubercular treatment.
All cases of FNAC were subsequently confirmed either by follow up for a minimum of 12 months or by surgical biopsy wherever needed. Overall the procedure was simple and rapid obviating the need of surgical intervention. No procedure related complications were encountered in this series. The cytologic diagnostic accuracy in various head and neck lesions in present series varied from The use of FNAC is popular for super-ficial and deep masses in adults 1,2,8.
However, in children there are few studies regarding FNAC and these too are mostly elaborating its use in areas other than head and neck 9, Unsatisfactory aspirates have been reported in various studies in the range of 9. Unsatisfactory aspirates in the previous studies were the result of poor handling of the aspirated material and the lack of trained cytopathologists whereas inadequacy in the present study was attributable to the small size of the lesions and poor handling of aspirated material.
Lymph node lesions predominated followed by other sites which is comparable to the previous studies 5,12, In consonance to earlier reports 5,14 we also observed a predominance of benign lesions. However, in other series 2,15 malignancy predominated over benign conditions.
These differences may be related to the age composition of the sample surveyed. Earlier work 5 has shown the predictive value of cytologically malignant FNAC to be only Therefore with increasing cost of medical facilities any technique which speeds up the process of diagnosis, limits the physical and psychological trauma to the patient and saves the expenditure of hospitalization, will be of tremendous value.
It may also help the surgeon to select, guide and modify surgical planning in patients requiring surgery. To conclude FNAC is a very simple and expeditious procedure which can be carried out with ease in children without encountering much problems.
The objective of this descriptive study was to see the frequency of various pathological conditions detected on FNAC in patients presenting with neck swellings coming to Surgical Outpatient Department of Postgraduate Medical Institute, Lady Reading Hospital Peshawar.
Patients below 18 years of age were excluded. Patients' data were recorded. Samples of FNAC were sent to the cytologist and results recorded. Frequency of various pathologies was determined. Results: The study included 50 patients with neck swellings. There were 16 male and 34 female patients with an age range of years.
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