Correlation between fine needle aspiration cytology with histopathology of non-thyroidal head and neck lesions: first report from Somalia.
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BACKGROUND: Fine needle aspiration cytology (FNAC) is a widely recognized, cost-effective, and minimally invasive diagnostic technique employed for the assessment of head and neck masses. Despite its worldwide utilization, no prior research from Somalia has evaluated the diagnostic precision of FNAC in non-thyroidal head and neck lesions. OBJECTIVE: To assess the diagnostic accuracy, sensitivity, specificity, and predictive characteristics of fine needle aspiration cytology (FNAC) by matching cytological results with histological diagnoses in non-thyroidal head and neck masses. METHODS: This retrospective study encompassed 265 patients with non-thyroidal head and neck lesions who had fine-needle aspiration cytology (FNAC) followed by histological analysis at a tertiary hospital in Somalia during a five-year period. FNAC outcomes had been compared with the relevant biopsy data. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were determined utilizing histology as the gold standard. RESULTS: A total of 265 patients underwent both fine needle aspiration cytology (FNAC) and histological assessment for non-thyroidal head and neck lesions. Among these, 145 (54.7%) were men and 120 (45.3%) were females, resulting in a male-to-female ratio of 1.2:1. Lymph node lesions constituted the predominant group of cases (60.8%), followed by salivary gland lesions (36.2%) and other soft tissue/cystic masses (3.0%). FNAC demonstrated the highest sensitivity for lymph node lesions (99%) and the highest specificity and accuracy for salivary gland lesions (98.8% and 98%, respectively). The overall sensitivity, specificity, and accuracy were 97.1%, 96.7%, and 98.5%, respectively. Lymphomas constituted the predominant malignancy identified, while the majority of salivary gland lesions were benign, with pleomorphic adenoma being the most prevalent. CONCLUSION: FNAC exhibits superior diagnostic efficacy in assessing non-thyroidal head and neck lesions, affirming its position as a primary diagnostic instrument, particularly in resource-limited environments such as Somalia.