Value of rapid assessment cytology in the surgical management of head and neck tumors in a Nigerian mission hospital

✍ Scribed by Jeffrey S. Mueller; Stephen Schultenover; Jean Simpson; Kim Ely; James Netterville

• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: English
• Weight: 187 KB
• Volume: 30
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.20843

✦ Synopsis

Abstract

Background

Fine‐needle aspiration (FNA) or touch preparation with rapid assessment is a valuable diagnostic tool with a reported accuracy of diagnosis similar to intraoperative frozen section consultation. The Nigeria Christian Hospital partners with health care professionals from the United States to provide surgical care for rural residents of Aba, Nigeria. Frozen section diagnosis is impractical in this setting because of very limited resources. Therefore, intraoperative rapid assessment FNA or touch preparation to guide surgical management was performed on all mass lesions, and the results were evaluated.

Methods

FNA was performed just before surgery using a 22‐gauge needle attached to a 10‐mL syringe and/or an intraoperative touch preparation was performed on biopsies of lesions that failed to yield cellular aspirates. Smears were prepared and stained with hematoxylin and eosin, and an immediate diagnosis was rendered. Tissue samples from the same resected/biopsied cases were fixed in 10% formalin and later transported to Vanderbilt University Medical Center Department of Pathology for processing. Cytologic and histologic correlations were then performed.

Results and Conclusions

More than 100 patients underwent surgery for head and/or neck masses during the 2‐week periods between November 2002 and November 2003. Of these patients, 98 had either preoperative FNA and/or intraoperative touch preparation performed. Twenty‐seven patients were male and 71 were female; the ages ranged from 2 months to 70 years. Sites sampled included the following: thyroid (n = 40); facial/jaw area (n = 19); parotid/submandibular gland (n = 13); scalp/skull region (n = 7); cervical lymph nodes (n = 5); neck (n = 5); other (n = 4); supraclavicular lymph nodes (n = 3); and oral cavity (n = 2). On cytologic analysis, there were 79 benign diagnoses, 17 malignant diagnoses, and 2 nondiagnostic samples. A benign versus malignant cytologic diagnosis was accurate in 97 of 98 cases. In conclusion, rapid assessment cytology was invaluable in the surgical treatment of many of the patients. © 2008 Wiley Periodicals, Inc. Head Neck, 2008