title: Value of fine needle aspiration cytology in head and neck lymphoma: experience in a head and neck cancer unit in the United Kingdom.
abstract: CONCLUSIONS
  In our experience, fine needle aspiration cytology (FNAC) combined with immunocytochemistry/flow cytometry in the investigation of lymphoma presenting in the neck is highly valuable. In our unit it has a sensitivity of 95.5% and a positive predictive value (PPV) of 96.8% and is the first-line investigation in suspected lymphoma. It enables planning of radiological and haematological investigations and obviates panendoscopy as part of the staging protocol.
  
  
  OBJECTIVE
  Lymphoma commonly presents to otolaryngologists. The aim of our study was to evaluate the accuracy of FNAC in lymphoma presenting in the neck at our institute.
  
  
  METHODS
  Data were collected retrospectively between 2003 and 2007. Separate searches for cytological and histopathological diagnosis of lymphoma on cervical lymph node biopsies were cross-referenced. Immunocytochemistry stains used were recorded.
  
  
  RESULTS
  A total of 121 cases met the inclusion criteria. The FNAC diagnosis of lymphoma was correct on lymph node biopsy in 68.6% (83/121). In 18 (14.9%) cases a false-negative result and in 3 (2.5%) cases a false-positive result was seen. In all, 17 (14.0%) cases were non-diagnostic (11 inadequate and 6 suspicious). In 16/20 (80.0%) cases of wrong diagnosis, immunocytochemistry had not been performed. Flow cytometry and immunocytochemistry were used in 67 cases and the FNAC diagnosis had a sensitivity of 95.5% and a PPV of 96.8% in this group.
authors.affiliation: Department of Otolaryngology, St Georges NHS Hospital Trust, Tooting, London, UK. ashley.hay@doctors.net.uk
authors.forename: Ashley
authors.initials: A
authors.lastname: Hay
authors.forename: Irumee
authors.initials: I
authors.lastname: Pai
authors.forename: Lisa
authors.initials: L
authors.lastname: Pitkin
authors.forename: Peter
authors.initials: P
authors.lastname: Williamson
authors.forename: Philip
authors.initials: P
authors.lastname: Wilson
authors.forename: Alastair
authors.initials: A
authors.lastname: Deery
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D005260:Female; D005434:Flow Cytometry; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008223:Lymphoma / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000473:pathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D006113:United Kingdom; D055815:Young Adult