Fine needle aspiration biopsy of cystic lesions of the head and neck, excluding the thyroid.
The occurrence of cystic lesions of the head and neck region (excluding the thyroid gland) and their diagnosis by fine needle aspiration (FNA) biopsy were reviewed for a two-year period. Of the 967 total aspirates of the region, 98 were cystic. The frequency of cysts was thus 10% in the total material, including 23% in parotid gland aspirates and 3% in lymph node aspirates. Salivary gland cysts occurred more often on the right side. The overall malignancy rate was the same for cysts and solid lesions (16%); however, 81% of cystic lymph node lesions were malignant. There was no difference in the frequency of nondiagnostic FNA material between solid and cystic lesions. A histologically correct diagnosis of benign or malignant was rendered by cytology in 85% of the cystic cases, with 4% false negatives and 2% false positives. This diagnostic accuracy was similar to that of the solid lesions. The FNA diagnostic problems were concentrated in the salivary gland lesions, with the false diagnoses illustrating the difficulties of interpreting atypical oxyphilic epithelium. The results suggest that a true neoplastic lesion should be seriously considered when a single population of oxyphilic epithelium is identified, even at the risk of overdiagnosing benign lesions.
Dejmek
A
A
Department of Clinical Cytology, Malmö General Hospital, Sweden.
Lindholm
K
K
D001707:Biopsy, Needle; D003560:Cysts / Q000175:diagnosis*; D004848:Epithelium / Q000473:pathology; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D008206:Lymphatic Diseases / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012468:Salivary Gland Neoplasms / Q000175:diagnosis