From 1992 to 1995, 313 tumorous lesions in the head and neck area were examined by ultrasound-guided fine needle aspiration cytology (FNA). We compared the preoperative cytological findings with the postoperative pathologic results for 78 lesions from patients who underwent surgery or open biopsy. Of these 78 cases, 39 (50%) were diagnosed postoperatively as malignant tumors. Six of 42 cases (14.3%), which were diagnosed as class I or II according to cytological classification, were revealed to be malignant by pathologic examination. Two of 31 cases (6.5%), which were diagnosed as class N or V, were shown to be benign. Four of 5 cases (80%), which were diagnosed as class IQ were shown to be malignant. The accuracy of cytological diagnosis was 83.3%. Among five biopsy sites (thyroid gland, parotid gland, submandibular gland, lymph node, and other cervical mass), the accuracy of the thyroid gland cytological diagnosis was the highest (92.3%), and that of other cervical masses was the lowest (69.2%). Parotid gland tumors and soft tissue tumors were difficult to diagnose accurately by FNA. Among the patients examined by FNA, there were no complications such as tumor seeding, metastasis, hematoma, or infection. Unsatisfactory material for cytological analysis was obtained in only 15 of 313 cases (4.8%). We conclude that FNA can be used not only to distinguish benign tumors from malignant tumors of the head and neck, and to detect lymph node metastasis, but also to suggest their pathological types.
