Comparison of TRU-CUT, fine needle aspiration biopsy and excisional biopsy results made from the same LYMPH node in head and neck lymphadenopathy

Objective and Aim: It is of great importance to distinguish benign and malignant lymphadenopathies located in the head and neck region. The gold standard diagnostic method in this distinction is excisional biopsy. However, the fact that it often requires local or general anesthesia and that the head and neck region contains vital neurovascular structures increases the risk of complications. Combined with advances in molecular research techniques, Tru-cut biopsy and Fine Needle Aspiration biopsy offer a possible alternative to excisional biopsy. In our study, we aimed to determine the effectiveness of these methods in the diagnosis of cervical lymphadenopathies. Materials and methods: Our study was carried out among patients who applied to our otorhinolaryngology clinic with the complaint of swelling in the head and neck region and were found to have pathological lymph nodes in the imaging. 97 patients were included in the study. Surgical excision was planned for patients with suspected malignancy in clinical findings and imaging. Unlike other publications in the literature, samples were taken from surgically excised lymph nodes with Tru-cut and FNAB. The surgically excised lymph node was accepted as the gold standard, and the sensitivity, sensitivity, positive and negative predictive values of Tru-cut and FNAB methods were compared. Results: In the study, excisional biopsy was accepted as the reference test and FNAB and Tru-cut biopsy were compared with excisional biopsy diagnoses. In the differentiation of benign and malignant lesions, Tru-cut biopsy had a sensitivity of 94.7%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 96.6%. The sensitivity of the FNAB method was 89.5%, the specificity was 84.6%, the positive predictive value was 81%, and the negative predictive value was 91.7%. Conclusion: A higher rate of sensitivity and sensitivity was found in Tru-cut biopsy compared to FNAB. It can be used as the first diagnostic method in the approach to cervical lymphadenopathies.