Procedures Surgeries - FNAC in ENT

What is fine needle aspiration cytology?

Fine needle aspiration cytology (FNAC) is one of the single most important investigation in ENT. FNAC helps to diagnose lesions in the oral cavity, floor of mouth, tongue, palate, tonsils and posterior pharyngeal wall.

What are the common indications for fine needle aspiration cytology (FNAC)?

Most common indications for fine needle aspiration cytology are:

1) Salivary gland swelling:

FNAC of the salivary glands is helpful because it often differentiates benign from malignant swellings. It thus changes the management.

Common salivary gland swellings are:

  • Pleomorphic adenoma
  • Acinic cell carcinoma
  • Adenoid cystic carcinoma

Findings:

A normal FNAC of the salivary gland would show:

  • Acinar cells
  • Ductal epithelial cells

2) Lymph nodes:

Advantages:

  • Does not require anaesthesia
  • False positive result is rare
  • No scar left behind
  • Often the site of primary lesion can be diagnosed on FNAC
  • Avoids surgery if not indicated

Common lymph node conditions:

  • Tuberculous lymphadenitis
  • Chronic inflammatory lymphadenitis
  • Secondary metastatic lymph nodes
  • Malignant lymphoma
  • Burkitt's lymphoma
  • Hodgkin's lymphoma

3) Thyroid swellings:

FNAC of thyroid has been established as an important diagnostic test for evaluation of benign and malignant thyroid swellings.

Major indications:

  • Diagnosis of diffuse non-toxic goiters
  • Confirmation of clinically obvious thyroid malignancy
  • Diagnosis of solitary thyroid nodule
  • Acute suppurative thyroiditis
  • Follicular neoplasm
  • Papillary carcinoma of thyroid
  • Medullary carcinoma
  • Cyst / haemorrhage in thyroid gland
  • Medullary carcinoma

4) FNAC can also be done for oral, oropharyngeal, buccal, and tongue lesions.

What are the complications of fine needle aspiration cytology?

Complications of fine needle aspiration cytology (FNAC) are:

  • Hemorrhage
  • Vasovagal shock
  • Haematoma
  • Tracheo-oesophageal puncture
  • Damage to major blood vessels in the neck


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