Cytologic Evaluation of the Enlarged Neck Node: FNAC Utility in Metastatic Neck Disease

Introduction: Fine Needle Aspiration Cytology not only confirms the presence of metastatic disease, but also gives clues regarding the nature and origin of the primary tumour. Study Design: The study material comprised of all aspirates (1978 aspirates from 1255 patients) from the neck lymph nodes during the period January 2003 to December 2003. All hematolymphoid neoplasms were excluded. The FNA results were reviewed, the morphology of the individual cells and their patterns in the smears were studied in detail and the FNA diagnosis was correlated with the histology. Results: Cytology results were unsatisfactory in 184 specimens (9%), negative or reactive in 495 specimens (25%) and suspicious or positive for malignancy in 1299 specimens (65.67%). The most common metastasis to the neck nodes was of squamous carcinoma arising in the oral cavity. Conclusion: FNA of head and neck masses proved to be a useful tool in diagnosing metastasis with good certainty.