In a series of fine needle aspirations performed in 541 patients with visible and/or palpable lesions in the head and neck, histological results were available in 205 the of cases. The cytological and histological diagnoses were compared. In three of the 205 cases the smears were inadequate for diagnosis. Discrepancies were noted in 18 cases (8.7%), and ten false negatives (specificity 91.2) and eight false positives (sensitivity 92.5). The main diagnostic problem was to differentiate between malignant lymphoma and benign lymphadenopathy. Biopsy is therefore recommended when malignant lymphoma is suspected. In this series both the aspirations and the subsequent evaluation of the smears were carried out by a cytopathologist. We conclude that this model increases the accuracy and reliability of fine needle aspiration in head and neck tumours by reducing the number of non-representative smears.

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