Fine-Needle Aspiration Cytology Can Be Used to Diagnose Carotid Body Tumors with Good Accuracy

Abstract

Objectives:

(1) Name the 4 most common locations of head and neck paragangliomas (HNPGs). (2) Describe 2 pathological and 2 radiological tools used in the diagnosis of HNPGs (with their respective diagnostic accuracy rates).

Methods:

The purpose of this study was to record the diagnostic accuracy of fine needle aspiration cytology (FNAC) in the diagnosis of different types of HNPG. We retrospectively collected data on all HNPGs diagnosed in our institution between January 1986 and April 2013. We recorded patient demographic factors along with diagnostic and clinical details.

Results:

Altogether 35 HNPGs were seen and treated in our institution in the studied period. In 15 (43%) cases FNAC was used as the first line diagnostic tool with or without ultrasound (USS) guidance. Radiological imaging (USS/computed tomography/magnetic resonance imaging) always accompanied FNAC. In the remaining 57%, clinical assessment alone or in combination with core biopsy accompanied radiological imaging. Eight (53%) out of 15 HNPGs were diagnosed correctly with FNAC; all those were carotid body tumors (CBTs). Of the rest, 1 false diagnosis of microfollicular oncolytic thyroid lesion was histologically a combined thyroid paraganglioma (PG) and Hurtle cell adenoma. One patient was treated conservatively and 4 inconclusive samples were histologically a laryngocele, a CBT, a jugular PG, and a combined CBT + contralateral PG with intracranial extension. For 1 patient full FNAC details were not available.

Conclusions:

FNAC can diagnose CBTs with good diagnostic accuracy. HNPGs arising in other regions of the head and neck can be challenging to diagnose without histopathologic and immunohistochemical tools.