Objective :
In this study, 50 patients with neck swelling were evaluated to compare clinical diagnosis with histopathological reports for diagnostic reliability.
Methods :
This cross-sectional study was conducted in the Department of Otolaryngology – Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, from July 2015 to June 2017. Fine needle aspiration cytology (FNAC), MRI, CT scan, and histopathological examination of postoperative specimens were performed. Data were analyzed using tables, graphs, and figures.
Results :
Among 50 cases, 19 were male and 31 were female, with a male-to-female ratio of 1:1.63. The age range was 4–60 years, with the highest frequency in the 4th decade.
Most patients were from low socioeconomic backgrounds. Clinical, cytological, and histopathological diagnoses were available for all cases and were compared.
Histopathology revealed tubercular lymphadenopathy in 12 cases, metastatic carcinoma and lymphoma in 5 cases each, nodular goiter in 12 cases, thyroid carcinoma in 5 cases, and the remaining cases were benign, congenital, or nonspecific inflammatory conditions.
FNAC provided correct diagnosis in 45 cases. In 5 cases, 2 smears were unsatisfactory, and 3 cases were reported as follicular neoplasm without definitive diagnosis. These were later confirmed by histopathology as follicular adenoma (1 case) and follicular carcinoma (2 cases).
FNAC sensitivity was 91% for tuberculosis, 100% for metastatic carcinoma and salivary gland tumors, 92% for nodular goiter, and 60% for thyroid malignancy. However, accuracy for papillary thyroid carcinoma was 100%.
Conclusion :
FNAC significantly reduces the need for open biopsy. Despite limitations in differentiating follicular adenoma from carcinoma, it remains a reliable diagnostic tool when combined with clinical judgment.