**Question:** An edentulous 72-year-old man with a 50-year history of cigarette smoking presents with a nontender, hard mass in the lateral neck. The simplest way to establish an accurate histological diagnosis of a neck mass suspected to be cancerous is:

A. Fine-needle aspiration cytology (FNAC)
B. Computed tomography (CT) scan
C. Fine-needle biopsy (FNB)
D. Magnetic resonance imaging (MRI)

**Correct Answer:**

**Core Concept:** Establishing the histological diagnosis of a neck mass suspected to be cancerous involves obtaining a tissue sample for microscopic examination.

**Why the Correct Answer is Right:** Fine-needle aspiration cytology (FNAC) is the simplest and most accurate method to achieve this objective. FNAC involves the use of a thin, hollow needle to aspirate the cells from the mass. This minimally invasive technique provides a cellular sample that can be stained and examined under a microscope for the presence of cancerous cells.

**Why Each Wrong Option is Incorrect:**

A. Fine-needle aspiration cytology (FNAC) is the correct option because it allows for direct examination of cells and is less invasive compared to the other options listed.

B. Computed tomography (CT) scan and Magnetic resonance imaging (MRI) are imaging modalities used for assessing the size, location, and extent of the mass. They provide valuable information, but a CT or MRI report alone cannot confirm the histological nature of the mass.

C. Fine-needle biopsy (FNB) is less accurate than FNAC because it removes a small tissue piece, which might not be representative of the entire mass and can lead to misdiagnosis.

D. Magnetic resonance imaging (MRI) is a valuable imaging modality, but it is not the best method for obtaining a histological diagnosis as it provides information about the mass's characteristics but not its cellular nature.

**Clinical Pearl:** In cases of suspected neck cancer, FNAC is the preferred method for obtaining a histological diagnosis, followed by appropriate management. CT and MRI scans aid in planning surgical excision, but they cannot replace the need for histopathological examination of the mass.