Fine-Needle Aspiration Cytology versus Direct Laryngoscopic Biopsy in Suspicious Laryngo-Hypopharyngeal Masses

Abstract

Objectives:

Evaluate the feasibility and performance of ultrasound-guided fine needle aspiration cytology (FNAC) of suspicious laryngo-hypopharyngeal masses.

Methods:

Cross-sectional study (2012-2013). After routine clinical and radiological evaluation, patients with advanced laryngo-hypopharyngeal masses were included in the study. Early lesions and vascular masses were excluded. In all patients, ultrasound guided FNACs were performed with a free-hand technique by a single radiologist and direct laryngoscopic biopsies were done on the subsequent day.

Results:

A total of 10 patients met the criteria for the study. Nine patients were primary cases and one was recurrent. There were 8 males and 2 females in the age group of 40-73 years. Ultrasound guided FNAC reported squamous cell carcinoma in 8 patients, atypical cells in one patient and the remaining one had inadequate specimen. There was no complication following the procedure. In direct laryngoscopic biopsies 8 patients were positive for squamous cell carcinoma and two were negative. Ultrasound guided FNACs in these two negative cases were positive for squamous cell carcinoma. One case was a recurrent tumor and in the other, direct laryngoscopic biopsies were done twice. Both the patients were inoperable due to advanced disease and palliative treatments were planned based on FNAC reports.

Conclusions:

Although biopsy under direct laryngoscopy remains the gold standard technique, ultrasound guided FNAC can be used to diagnose advanced laryngo hypopharyngeal lesions. It is simple, safe, cost effective, and done as an out-patient procedure. It seems to be more beneficial in deep seated submucosal tumors.