Ultrasound guided Core Biopsy, Fine Needle Aspiration Cytology and Surgical Excision Biopsy in the diagnosis of metastatic squamous cell carcinoma in the head and neck: An eleven year experience

• Published in: European journal of radiology 2011-12, Vol.80 (3), p.792-795
• Main Authors: Saha, Shouvik, Woodhouse, Neil R, Gok, Gulcan, Ramesar, Keith, Moody, Andrew, Howlett, David C
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Biopsy, Needle - methods; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - secondary; Core biopsy; Dermatology; Female; Fine needle aspiration; Head and neck; Head and Neck Neoplasms - diagnosis; Humans; Male; Medical sciences; Middle Aged; Radiology; Reproducibility of Results; Sensitivity and Specificity; Squamous cell carcinoma; Surgery, Computer-Assisted - methods; Tumors of the skin and soft tissue. Premalignant lesions; Ultrasonography - methods
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2010.10.020

Abstract Introduction This study aims to review our 11 year experience of diagnosing metastatic squamous cell carcinoma presenting as head and neck lumps. The techniques of Ultrasound guided Core Biopsy (USCB), Fine Needle Aspiration Cytology (FNAC) and Surgical Excision Biopsy (SEB) are compared. Materials and methods All patients with metastatic squamous cell carcinoma (SCC) involving the lymph nodes of the head and neck or parotid gland, diagnosed at Eastbourne District General Hospital between January 1998 and November 2009 were identified. The following data items were collated: biopsy location (e.g. cervical lymph node or parotid), any history of likely primary SCC and site, type of biopsy used to establish a conclusive diagnosis (index diagnostic technique), previous biopsies, the technique and their results, subsequent histology results. Results A total of 90 patients were diagnosed with metastatic squamous cell carcinoma. The index diagnostic technique was USCB in 48 patients, FNAC in 29 and SEB in 13. In 72 (80%) patients the index biopsy was the sole tissue sample taken prior to surgery or other treatment. The remaining 18 patients underwent a total of 22 previous biopsies prior to the index biopsy. 95% (21/22) of these previous biopsies were non-definitive FNAC and 5% (1/22) was a non-definitive USCB. FNACs also demonstrated the highest non-diagnostic rate (42%). The accuracy of USCB and FNAC in correlating with final histopathology was 97% and 85% respectively. Conclusions USCB demonstrates excellent results in the diagnosis of metastatic SCC in the head and neck with higher accuracy and greater reliability than FNAC.