Cervical node fine needle aspiration: Factors influencing the failure rate

Introduction. We had for aim to study the factors influencing the rate of non satisfactory (NS) cervical node fine needle aspirations (CNFNA). Materials and methods. We prospectively included 272 CNFNA, performed over 2 years (2010-2012). NS results were studied according to the following criteria: age, size and location of the node, number of punctures performed, and the operating physician's experience. Results. Fifty-six (20.6%) of the 272 CNFNA were NS because they were acellular or paucicellular. The rate of NS CNFNA was not correlated with the patient's age: 63.6% for small lymph nodes (<= 1 cm: P = 0.01). Submandibular and jugulodigastric locations were observed in 28% of NS CNFNA and in 5% of satisfactory ones (P = 0.001). The rate of NS CNFNA was 67% if 1 or 2 punctures were performed; it decreased to 18% for 3 or more punctures (P = 0.01). This rate was 77% for the first study semester, and 8% for the fourth semester (P = 0.001). CNFNA has been repeated for 19 patients. The second CNFNA was contributive for 14 patients. Repeating the CNFNA increased its efficiency by 73.7% (14/19). Discussion. The rate of NS CNFNA depends on the size and location of the lymph node, and the operating physician's experience. Repeating the CNFNA significantly improves its efficiency. (C) 2014 Elsevier Masson SAS. All rights reserved.