Should FNAC be Restricted to an Elite Investigation- An Experience of 20,237 Aspirations Including More than 8000 Aspirations from Head and Neck Region?

Abstract

Objectives Cytological evaluations of a vast number of cases were presented in this study More than 2 5th of the cases were reported from head and neck region Our objectives were to prove the diagnostic value of FNAC and to judge its feasibility in peripheral health institutes Method this study was done in pathology department of Me - dical College Hospital Kolkata for a period of 10 years Aspirates were classified into one of the three interpretation groups easy moderately difficult and highly difficult according to set up criteria Cytohistological correlations were done in all possible cases Results out of total 20 237 cases undergoing cytological evaluation during study period 1774 cases 8 77 needed guidance for aspiration 3 16 of the rest 18 463 cases could not be reported for lack of adequate aspirate Rest 17879 cases were categorized in 3 interpretation groups as follows easy- 90 03 16098 cases moderately difficult- 6 72 1203 cases highly difficult- 3 25 578 cases Breast aspirates seemed comparatively easier to interpret whereas salivary aspirates were much difficult Cytohistological correlations were possible in 5807 cases yielding 84 78 correlation The study was alsoquite sensitive and specific in detecting malignancy with 14 93 false positive and 10 48 false negative results Conclusion it is evident from the present study that FNAC is not only a useful method of tissue diagnosis but also the only cheap method requiring moderately trained personnel for interpretation in majority of cases So its blessings should be extended to the block level