title: Role of fine needle aspiration cytology in the preoperative investigation of branchial cysts.
abstract: BACKGROUND
  Successful preoperative diagnosis of a branchial cyst requires a systematic approach. The aim of this study was to evaluate methods of investigation of a lateral neck swelling suspicious for a branchial cyst, and to highlight cases where a less benign cause for the swelling should be suspected and therefore management altered appropriately.
  
  
  METHODS
  A retrospective case study of 24 patients with presumed branchial cysts managed operatively was undertaken. Demographic, clinical, imaging, cytology and histopathological data were analysed to formulate an approach to the work-up of a lateral neck swelling suspected to be a branchial cyst.
  
  
  RESULTS
  All 24 patients presented with a lateral neck mass thought to be a branchial cyst preoperatively underwent preoperative fine-needle aspiration cytology. The overall accuracy of cytology in predicting a benign branchial cyst histopathologically was 83.3% (20 out of 24).
  
  
  CONCLUSIONS
  Successful preoperative diagnosis of a branchial cyst requires a combination of imaging and cytology. If there is concern that a lateral neck swelling is not a branchial cyst on clinical, imaging or cytological features, then a full preoperative work-up, including computed tomography scan of the neck and upper aero-digestive tract endoscopy should be performed, prior to an excisional biopsy.
authors.affiliation: Breast, Endocrine and General Surgical Unit, The Alfred Hospital and Monash University, Commercial Road, Melbourne, Victoria, Australia.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Slater
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Serpell
authors.forename: Stacey
authors.initials: S
authors.lastname: Woodruff
authors.forename: Simon
authors.initials: S
authors.lastname: Grodski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D001935:Branchioma / Q000473:pathology* / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D012189:Retrospective Studies; D055815:Young Adult