Fine Needle Aspiration Biopsy and Histopathologic Diagnosis in the Head and Neck Mass / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Fine needle aspiration cytology (FNAC) is a safe and economical biospy technique which is widely applicable to palpable masses as a first-line procedure. Successful FNAC, however, demands high specimen quality and experience on the part of both the aspirator and the pathologist. We compared cytological diagnosis with histopathological diagnosis in the head and neck region, in order to increase accuracy and solve any discrepancy in the two types of diagnoses. MATERIALS AND METHODS: From July 1996 through to July 1998, FNAC were carried out in 830 cases in palpable mass of the head and neck region in the Department of Pathology, Chonnam University Hospital. The major target sites were lymph nodes (61.4%), soft tissues (22.2%), and salivary glands (16.4%). Histopathological diagnoses were performed in 267 cases by surgical methods. Cytological reports were classified into the following diagnostic categories: non-tumor, tumor (benign, malignant: primary or metastatic). RESULTS: In a series of 267 cases, there were 70 non-tumor lesions (26.2%), 197 tumor lesions (73.8%), (benign: 77, malignant: 120). Lymph nodes were the most common anatomic sites for FNAC. The overall diagnostic accuracy, sensitivity and specificity of FNAC were 95.5%, 98.8%, and 94.2% allowed an correct diagnosis between FNAC and histopathology. CONCLUSION: FNAC of the head and neck region is a sensitive and specific diagnostic tool, especially when diagnosing metastatic carcinomas. Four major causes of error were identified: material adequacy criteria, sampling technique, cytological interpretation and limitations in the procedure. In particular, attention must be paid to subtle morphological changes when making detailed clinical pathological observations; this may help avoid discrepancies and achieve the right diagnosis.

Variation of pH and Electrolyte in Nasal Secretum / 대한이비인후과학회지

BACKGROUND: Airway secretions partly arise from the interstitial fluid and partly from the secretory activities of respiratory epithelium and submucosal gland. The flow of water across the tracheobronchial epithelium is likely to be an important determinant of the efficiency of mucociliary clearance. Water movement across the epithelium is thought to follow active ion transport passively by means of the osmotic gradients created. OBJECTIVES: The aim of this study was to determine whether Na, K, and Cl are transported actively by the epithelium of nasal mucosa and to evaluate an effect of the tracheostomy on changes of pH and electrolytes in nasal secretum. MATERIALS AND METHODS: pH and Na, K, and Cl values were estimated in 35 samples (20 tracheostomized patients and 15 normal persons) of nasal secretum and plasma. RESULTS: On 15 normal persons, Mean pH value was 7.43, Na 143.2, K 4.2 and Cl 109.1(mEq/L) in plasma and Mean pH value was 7.81, Na 139.7, K 11.5 and Cl 127.5(mEq/L) in nasal secretion. On 20 tracheostomized patients, pH 7.49, Na 140.2, K 3.8, and Cl 108.7(mEq/L) in plasma were estimated, and pH 7.88, Na 128.5, K 12.0, and Cl 121.5(mEq/L) were estimated in nasal secretum. In nasal secretum pH, K, and Cl were higher than in plasma by +0.39, +8.2 and +12.8(mEq/L) respectively, while Na was lower -11.6(mEq/L). We had the same result on normal persons as on tracheostomized patients. The results show that pH, K and Cl were higher in nasal secretion and Na was lower than in plasma. CONCLUSION: Significant difference of pH and electrolyte values in nasal secretion was not observed between normal person and tracheostomized patient.