SUMMARYFine-needle aspiration cytology guided by ultrasound imaging is a widely used diagnostic tool to evaluate neoplastic or inflammatory lesions of salivary glands. From February 2002 to February 2008 all the parotid lesions removed surgically in our Unit of Otolaryngology were reviewed. Study focused on sensitivity, specificity, accuracy, predictive values, likelihood ratios, and Kappa statistics for fine-needle aspiration cytology vs histological diagnosis in 176 cases. Fine-needle aspiration cytology sensitivity and specificity were 81% and 99%, respectively. Accuracy for malignancy was 97%, accuracy for benignity was 83%; positive and negative predictive values were 93% and 98%, respectively; likelihood ratio of positive and negative test results were 100.3 and 0.19, respectively ("positive" was used to define "malignant"). The prevalence of malignancy was 0.114. Kappa statistics for the degree of agreement between fine-needle aspiration cytology and histological results were 0.85 (95% CI = 0.71-0.99). Pre-operative fine-needle aspiration cytology diagnosis improves surgical treatment of parotid masses.

Case reporta 72-year-old woman presented at our division with a 12 months history of bilateral parotid swelling. apart from the habit of smoking, her medical history was normal. Clinical examinations confirmed bilateral mobile, painless swelling, without intra-oral lesions. Facial nerves function was normal. Ultrasonography (US) showed multifocal bilateral parotid nodules, so magnetic resonance imaging (Mri) was programmed.Mri revealed four bilateral nodular lesions of the parotid glands: three nodules in the right parotid gland and one nodule in the left gland. They were well defined and rounded in appearance, with mild enhancement after administration of intravenous contrast medium (Figure 1). the left nodule measured 2 cm in diameter and it was in the superficial lobe. In the right parotid gland, the bigger nodules measured 2.2 cm and 2.1 cm in maximum dimension, while a minor nodule had a 1 cm diameter. the 2.1 cm nodule was in the deep lobe of right parotid gland.Fine-needle aspiration biopsy (FnaB), under ultrasonography guidance, was carried out on the bigger right nodule and on the left nodule. it was indicative of Warthin tumors.