Fine Needle Biopsy: Comparison of Aspiration versus Nonaspiration Techniques in Head and Neck Tumors

Abstract

Objectives:

Fine needle aspiration (FNA) has been adopted as a simple and cost-effective method for cytological studies of head and neck tumors. Recently the fine needle nonaspiration (FNNA) is reported to provide good specimens. In this study, we compare the efficacy of the two techniques.

Methods:

During a 3-year period, 297 cytological examinations were conducted in patients with head and neck tumor. Sites of biopsy studied included thyroid tumor (n=200), lymph node (n=75), and salivary tumor (n=22). Fine needle biopsies were performed in each lesion with 23-gauge needles, and results were analyzed by a single pathologist.

Results:

Overall, specimens from 21 patients (7.1%) of 297 were inadequate with both techniques together. Forty-three (14.5%) were insufficient specimens with FNA alone and 33 (11%) with FNNA alone. Insufficient specimens were obtained at 30 (15%) and 21 (10.5%) of 200 thyroid tumors and 2 (9.1%) and 1 (4.5%) of 22 salivary tumors with and without aspiration, respectively. The inadequacy rates were the same (14.6%) in the lymph nodes with each technique. The causes of insufficient specimens were blood contamination with FNA and the absence of cellular material with FNNA. No statistically significant difference was noted in the diagnostic yield between the two techniques.

Conclusions:

We concluded that FNNA is equal to FNA in the cytological studies in head and neck tumors. Double sampling may reduce inadequacy rates to low levels and be useful as a routine policy.