Dr. Debasish Datta Majumder

Dip. Otolaryngology–Head & Neck Surgery

Membership of the Royal College of Surgeons

Fine needle aspiration cytology (FNAC) is well accepted as a useful diagnostic technique in the management of adult patients with head and neck lumps(1-3). Until recently the application of FNAC to the pediatric population was largely ignored in the Indian and American pediatric literature. Previous reports have studied its utility in only small series of pediatric patients(4-6). The current study evaluates the role of FNAC as a diagnostic tool in investigation of head and neck lesions in children. Subjects and Methods During the period from July 1992 to June 1995, FNAC was carried out on 748 children (age 0-12 years) in the Departments of Pathology, Otorhinolaryngology and Pediatric Surgery at Lady Hardinge Medical College and associated Hospitals, New Delhi. Routine FNAC procedure was done using 21-24 G needle. Smears were stained by Giemsa and Paps stain and special stains were carried out as and when required(7). Results Out of 748 lesions, adequacy of material was achieved in 94% cases. Lymph node lesions predominated accounting for 605 cases (81%). Out of these, 60.6% were diagnosed as reactive and 30.5% as tuberculous lymphadenitis. The other lesions aspirated were from thryoid, salivary gland, miscellaneous surface lumps and orbital lesions comprising 3.2%, 2.1%, 7.6% and 0.2% respectively. The final diagnosis of the lesions aspirated according to the site is given in Table I. Of all the cases, 98.5% cases were reported as benign and 1.5% cases as malignant. All malignant cases were confirmed by surgical biopsy. The positive predictive value of a cytologically malignant FNAC was 100%.