Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-26T22:02:15.852Z Has data issue: false hasContentIssue false
  • English
  • Français

Routine non-thyroid head and neck cytology in a large UK centre: clinical utility and pitfalls

Published online by Cambridge University Press:  08 July 2015

P V Kaye ,
M Pigera ,
M M Khan ,
P Hollows  and
N Beasley
P V Kaye*
Affiliation:
Department of Cellular Pathology, Nottingham University Hospitals, UK
M Pigera
Affiliation:
Department of Cellular Pathology, Nottingham University Hospitals, UK
M M Khan
Affiliation:
Department of Cellular Pathology, Nottingham University Hospitals, UK
P Hollows
Affiliation:
Department of Head and Neck, Nottingham University Hospitals, UK
N Beasley
Affiliation:
Department of Head and Neck, Nottingham University Hospitals, UK
*
Address for correspondence: Dr P Kaye, Department of Cellular Pathology, Queen's Medical Centre, Nottingham NG7 2UH, UK Fax: + 39 115 9709479 E-mail: philip.kaye@nuh.nhs.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

This study aimed to examine the performance of head and neck cytology at Nottingham University Hospitals between 2009 and 2010.

Methods:

Cases were extracted from the Winpath pathology reporting system and correlations were investigated between results and the histological and clinical outcomes. Specimen adequacy and the sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of the cytology tests were calculated.

Results:

In all, 19.7 per cent of aspirates were judged to be inadequate. The absolute and relative sensitivities of head and neck cytology were 87.0 per cent and 89.0 per cent, respectively, and the absolute and relative specificities were 99.0 per cent and 97.0 per cent, respectively. The positive predictive values were 99.0 per cent and 96.0 per cent and the negative predictive values were 92.0 per cent and 92.0 per cent for a diagnostic accuracy of 94.5 per cent and 93.0 per cent. The performance was consistent with previous reports and superior to that of a recent UK series. The high rate of inadequate samples is, however, a concern.

Conclusion:

Head and neck cytology is a robust technique at our institution, although there are certain problem areas. There is room for improvement in the technical quality of fine needle aspiration.

Keywords

CytologyHead and Neck NeoplasmsSensitivity and Specificity: Salivary GlandsLymph Nodes
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 7 , July 2015 , pp. 682 - 687
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Wakely, PE, Cibas, ESLymph Nodes. In: Cibas, ES, Ducatman, BS, eds. Cytology 3rd edn.Philadelphia: Saunders Elsevier, 2009;319–57CrossRefGoogle Scholar
2Steel, BL, Schwartz, MR, Ramzy, I. Fine needle aspiration biopsy in the diagnosis of lymphadenopathy in 1,103 patients. Role, limitations and analysis of diagnostic pitfalls. Acta Cytol 1995;39:76–81Google Scholar
3Sensitivity and Specificity Calculator. In: http://www.josephsunny.com/medsoft/sensitivity_specificity.html [11 December 2014]Google Scholar
4Howlett, DC, Harper, B, Quante, M, Berresford, A, Morley, M, Grant, J et al. Diagnostic adequacy and accuracy of fine needle aspiration cytology in neck lump assessment: results from a regional cancer network over a one year period. J Laryngol Otol 2007;121:571–9CrossRefGoogle ScholarPubMed
5Carr, S, Visvanathan, V, Hossain, T, Uppal, S, Chengot, P, Woodhead, CJ. How good are we at fine needle aspiration cytology? J Laryngol Otol 2010;124:765–6.CrossRefGoogle ScholarPubMed
6Mayall, F, Denford, A, Chang, B, Darlington, A. Improved FNA cytology results with a near patient diagnosis service for non-breast lesions. J Clin Pathol 1998;51:541–4CrossRefGoogle ScholarPubMed
7Burgess, C, Dias, L, Maughan, E, Moorthy, R. Neck lump clinics: is on-site assessment of fine needle aspirate diagnostic adequacy cost-effective? J Laryngol Otol 2013;127:1122–6CrossRefGoogle ScholarPubMed
8Witt, BL, Schmidt, RL. Rapid onsite evaluation improves the adequacy of fine-needle aspiration for thyroid lesions: a systematic review and meta-analysis. Thyroid 2013;23:428–35CrossRefGoogle ScholarPubMed
9Palpation Guided Fine Needle Aspiration: Training in Superficial FNA Procedure. Pathology Outlines, 2013 In: http://www.pathologyoutlines.com/topic/cytopathologypgfnatraining.html [1 January 2014]Google Scholar
10Nasuti, JF, Yu, G, Boudousquie, A, Gupta, P. Diagnostic value of lymph node fine needle aspiration cytology: an institutional experience of 387 cases observed over a 5-year period. Cytopathology 2000;11:18–31CrossRefGoogle ScholarPubMed
11Hay, A, Pai, I, Pitkin, L, Williamson, P, Wilson, P, Deery, A. Value of fine needle aspiration cytology in head and neck lymphoma: Experience in a head and neck cancer unit in the United Kingdom. Acta Otolaryngol 2011;131:1226–31CrossRefGoogle Scholar
12Tatomirovic, Z, Skuletic, V, Bokun, R, Trimcev, J, Radic, O, Cerovic, S et al. Fine needle aspiration cytology in the diagnosis of head and neck masses: accuracy and diagnostic problems. J BUON 2009;14:653–9Google ScholarPubMed
13Guidance on the reporting of thyroid cytology specimens, 2011. Royal College of Pathologists. In: http://www.rcpath.org/Resources/RCPath/Migrated%20Resources/Documents/G/g089guidanceonthereportingofthyroidcytologyfinal.pdf [11 December 2014]Google Scholar
14Al-Khafaji, BM, Nestok, BR, Katz, RL. Fine-needle aspiration of 154 parotid masses with histologic correlation: ten-year experience at the University of Texas M. D. Anderson Cancer Center. Cancer 1998;84:153–93.0.CO;2-P>CrossRefGoogle ScholarPubMed
15Salgarelli, AC, Capparè, P, Bellini, P, Collini, M. Usefulness of fine-needle aspiration in parotid diagnostics. Oral Maxillofac Surg 2009;13:185–90CrossRefGoogle ScholarPubMed
16Ballo, MS, Shin, HJ, Sneige, N. Sources of diagnostic error in the fine-needle aspiration diagnosis of Warthin's tumor and clues to a correct diagnosis. Diagn Cytopathol 1997;17:230–43.0.CO;2-G>CrossRefGoogle ScholarPubMed
17Veder, LL, Kerrebijn, JD, Smedts, FM, den Bakker, MA. Diagnostic accuracy of fine-needle aspiration cytology in Warthin tumors. Head Neck 2010;32:1635–40CrossRefGoogle ScholarPubMed