Fine needle aspiration cytological findings in patients presenting with accessible head and neck masses at Kenyatta National Hospital

Abstract

Background: Clinical evaluation of solitary head and neck masses poses a challenge because of many differential diagnoses in this area. This study was done to narrow the differential diagnosis of head and neck lesions at Kenyatta National Hospital.
Objectives: To determine the cytomorphological patterns of head and neck lesions amenable to FNA at KNH and to determine the extent to which FNA can preclude the requirement for a diagnostic open surgical biopsy.
Methods: Following the FNA procedure, a small drop of the aspirated material was used to produce two thin smears. The smear for Papanicolaou staining was wet fixed using 95% alcohol while the one for Giemsa staining was air dried. Independent t- test was used to compare the mean age between patients with neoplastic and non-neoplastic lesions. A p-value <0.05 was regarded as statistically significant.
Results: A total of 92 patients were recruited. Patient age range was 2- 80 years with a mean (SD) age of 34.5 (17.7) years. Reactive lymphoid hyperplasia (18.5%) was the most common diagnosis followed by, colloid goitre (17.4%), granulomatous lymphadenitis (10.9%), metastatic carcinoma (7.6%) and pleomorphic adenoma (7.6%). The mean age of patients with non-neoplastic and neoplastic lesions were significantly different, p value < 0.001. FNA during this study potentially reduced the need for surgery of head and neck masses by 69.4%.
Conclusions: Non-neoplastic (inflammatory) and benign lesions are the most common types of lesions seen at KNH. FNA can minimize the need for surgery in close to 70% of head and neck masses.