Brief Answer:
Large swelling:if FNAC inconclusive then open biop

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day

Dear Ms,

The decision of complete excision/Open Biopsy depends on clinico-Radiological assessment of the pre- auricular swelling.

I would like to have additional information about the swelling

1. How long has the swelling been present?
2. Was Ultrasound/MRI scan done?
3. Is the swelling associated with pain/erythema of overlying skin?
4. Has the swelling ever decreased in size in response to any treatment?

Following are the indications for doing open biopsy by complete excision

1. Clinical differentiation between Pre-auricular lymph node or Parotid gland swelling not possible
2. Clinically suspicious lesion
3. The swelling progressively increasing in size
4. FNAC inconclusive
5. Suspicious of malignacy

With size a big swelling , Ultrasound has to be done followed by FNAC: if FNAC is not conclusive then open biopsy would definitely be indicated.

Kindly get back to me with the details


Take Care
Best Regards
Dr Deepak Kishore
MBBS,MS,MCH

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Brief Answer:
Open biopsy is only sure diagnostic test

Detailed Answer:
Hi
Greetings
FNAC is not a confirmatory test. It is subjected to sampling error. When there is swelling, the pathology could be present in one part of swelling. So FNAC may not always be conclusive.
When the swelling is persistently present and if the age of individual is more than 40years. It's necessary to consider for doing open biopsy, in order to avoid missing any lesion which could have been missing by FNAC. Complete excision biopsy is the only confirmatory way of telling for sure what is cause of the enlargement.

Do get back to me if you need any further assistance, will be glad to assist you.

Take care
Regards
Deepak

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