Role of Fine Needle Aspiration Cytology (FNAC) as a Diagnostic Tool in Paediatric Head and Neck Lymphodenopathy.

A neck mass that is present for longer than a week might be pathological requiring rapid and thorough evaluation. This study aims to evaluate the positive role Fine needle aspiration cytology plays in the diagnosis of pediatric patients with lymphadenopathy in the head and neck region. Fine needle aspiration of lymph nodes was carried out, fixed and stained by cytopathologists for 56 patients at the Jos University Teaching Hospital, 43 (76.8%) were inflammatory and 13 (23.2%) malignant. Reactive hyperplasia (72.1%), acute suppurative (18.6%) and tuberculosis (9.3%) constituted the inflammatory lesions. Non Hodgkins lymphoma was the commonest malignant lesion (76.9%) followed by Hodgkins lymphoma (15.4%), the least being Rhabdomyosarcoma (7.7%). Age range 10-14 years had the highest number of cases (46.4%). Males were 36 (64.3%) while females were 20 (35.7%). All malignant cases diagnosed by FNAC had to undergo confirmation/characterization by histology and had 100% concordance. Thus there were no false positives and specificity was 100%, sensitivity 100%. Of the 43 diagnosed as inflammatory by FNAC, 12 cases which did not resolve after treatment or where patients condition worsened had to undergo surgical biopsy. Out of these only 1 (8.3%) case of fungal infection was misdiagnosed by FNAC. The lymph nodes were generalized 4 (7.1%) and localized in 52 (92.9%). Maximum number of cases 53 (94.6%) had Cervical Lymphadenopathy followed by axillary 2 (3.6%) and inguinal 1 (1.8%). Out of the cervical group of nodes, the upper anterior and upper posterior deep cervical nodes were involved in majority of cases (95%).

Clinicopathological profile of malignant tumors of the oropharynx: a case series.

BACKGROUND: Due to recent lifestyle changes, the worldwide incidence of malignant oropharyngeal tumors is on the increase. This study focuses on the clinical and pathological profile of malignant tumors of the oropharynx as seen in a north-central Nigerian teaching hospital. METHODS: This is a descriptive retrospective analysis of the clinical and pathological profile of this disease. RESULTS: Six patients aged between 37 years and 78 years had malignant oropharyngeal tumors. There were 5 (83.3%) males and 1 (16.7%) female. All patients presented with cervical swelling, dysphagia, odynophagia and muffled voice with dental caries and visible masses filling up the oral cavity and oropharynx. Four (66.7%) patients presented with dyspnea and 3 (50%) with otalgia and deafness. Three (50%) patients had histologic diagnosis of non-Hodgkin's lymphoma (centroblastic), 1 had lymphoepithelioma and 2 had squamous cell carcinoma. Two (33.3%) patients died during treatment, 2 (33.30%) defaulted and 1 (16.7%) is being followed up for 5 years and is tumor free. CONCLUSION: Oropharyngeal cancer has a poor prognosis in the tropics due to late presentation. Proper health education aimed at early detection and treatment in our environment is required.

Surgery of parotid gland tumours in lagos: a 12 year review.

BACKGROUND/AIM: Tumours of the parotid gland are not common. Parotid tumours can pose a challenge both in diagnosis and treatment. Various factors contribute to the management difficulties of parotid tumours for the Head neck surgeon. The aim of the study is to determine the presentation and management of parotid tumours requiring surgery at the Burns and Plastic and Otolaryngology (ORL) units of the hospital. MATERIALS AND METHODS: This is a retrospective study carried out at the Lagos University Teaching Hospital from January 1994- December 2005. The medical case notes were reviewed for information on age, sex, clinical presentation, surgical management, histological diagnosis and outcome. RESULTS: A total of 58 patients with parotid tumours were seen with ages ranging from 25-65 years. Male to Female ratio was 1.4:1. Forty-two (72.4%) presented with firm preauricular swelling, 1.7% as dumb bell tumour and post surgical recurrence tumour respectively, 6.8% as tail of parotid tumour and 3.5% as bilateral disease. 93.13% had superficial parotidectomy. Histological diagnosis confirmed 65.5% as pleomorphic adenoma, 20.72% as carcinomas of which adenoidcystic and mucoepidermoid tumours were the commonest,3.45% as lymphoma and 1.7% as Sjogrens syndrome, oxyphil and Warthins tumour respectively. Immediate post surgical facial nerve palsy was seen in 69% and recovery was seen in 62% within 3-9months. Post surgical radiotherapy was given to 8.6%. CONCLUSION: The commonest parotid salivary gland tumour requiring surgery is pleomorphic adenoma, presenting as a pre-auricular mass and the commonest post- surgical complication was facial nerve palsy involving the mandibular branch. A good knowledge of the surgical anatomy of the gland, clinical behaviour and biologic nature of the tumours will ensure better surgical management.