Role assessment of ultrasonography and fine needle aspiration cytology in evaluation of neck swellings-a study at a tertiary care teaching hospital in north india

Background: Ultrasonography of neck swellings is helpful, cost effective and radiation hazard free modality. The routine use of fine needle aspiration cytology (FNAC) in the assessment of thyroid nodules has reduced the number of patients subjected to thyroidectomy for benign diseases. Methods: A cross-sectional study was conducted at the department of Otorhinolaryngology of ASCOMS Jammu,60 patients with clinically palpable neck swellings who presented to the OPD were enrolled for the study. Patients of both sexes consenting for the study with clinically palpable neck swellings and also willing to (USG) and (FNAC)were included in the study. Patients with clinically undetectable neck swellings, previous history of neck trauma or neck surgeries, Swellings obscured by jaw bone were excluded. Results In this current study total numbers of male subjects were 22(36.6%) and females were 38 (63.4%). Patient age group above 21 years of age were included in the study Maximum number of cases were between 41–50-year age group followed by 31–40-year age group. Our study showed a total of 41 benign lesions in the neck and USG correctly diagnosed 37 of them. The Sensitivity, Specificity, PPV and NPV of US in this case was 96.5%, 90.3%, 87.6% and 97.1% respectively. The sensitivity of US in diagnosing malignant lesions of the neck in 60 patients with neck swellings was 86.5% with a specificity of 97.7%, PPV 92.3% and NPV 96.5%. Sensitivity of US in detecting thyroid malignancy in the present study was 84.3%. The sensitivity of US in diagnosing malignant lymph nodes in this study was 88.5%. Conclusions: Ultrasound is the prime modality for initial imaging for neck swellings. Thereafter according to requirement and Ultrasound findings, one can opt for further haematological investigations, Fine Needle Aspiration Cytology and Radiological investigations