Efficacy and pitfalls of fine needle aspiration in the diagnosis of neck masses.

BACKGROUND: Fine needle aspiration biopsy (FNAB) is now well established in the assessment of cervical masses. The purpose of the present study is to review the efficacy of this procedure, as well as to identify any pitfalls that may limit its usefulness.

METHODS: One hundred and ninety aspirations of neck masses performed over a recent five-year period were reviewed. The definitive diagnosis of the mass was determined in each case by review of the patients' case notes.

RESULTS: Thirty seven per cent of all neck lumps were malignant. The most common cause for a false-negative result, in the case of a carcinomatous mass when an adequate sample had been obtained, was a cystic neoplasm. One quarter of all cystic lateral cervical masses not considered suspicious for malignancy by FNAB turned out to be malignant.

CONCLUSION: Repeating FNAB in cases where the original result is negative for carcinoma may increase the sensitivity of FNAB in the detection of cystic carcinomas.