Introduction: Fine needle aspiration cytology (FNAC) is a straightforward, dependable, cost-effective, minimally invasive tool commonly utilized in the diagnosis and assessment of palpable head and neck lesions. There is a scarcity of studies on cytological findings of head and neck swelling in rural areas. This research aims to assess cytological findings in a rural setting and categorize the nature of swelling utilizing a standardized international reporting system when necessary. Methodology: This observational study was conducted in the pathology department of a tertiary centre in a rural area hospital from December 2022 to June 2024. Fine needle aspiration cytology (FNAC) was performed on all palpable head and neck swellings referred by clinicians to the pathology department and diagnoses were made with the use of standardized international reporting system. Result: Total of 592 cases were analyzed, with lymph node lesions representing 53.7% of the cases, emerging as the most prevalent site. Following closely were thyroid lesions at 31.0%, miscellaneous cases at 11.6%, and salivary gland lesions at 3.7%. The most frequent non-neoplastic lesion identified was reactive lymphadenitis, while colloid goitre of the thyroid and metastasis of squamous cell carcinoma in lymph nodes were the most common benign neoplastic and malignant neoplastic lesions, respectively. Conclusion: FNAC is a cost-effective, reliable and minimally invasive diagnostic tool for palpable swellings, especially advantageous for masses in the head and neck region due to nearby anatomical structures. Well-received by patients with a fear of surgery.

FNAC, Fine needle aspiration cytology, lymphadenitis, metastasis, head and neck swelling