An Observational Study of Efficacy of Fnac in Diagnosing Benign and Malignant Salivary Neoplasm

Abstract

BACKGROUND Salivary gland tumours are quite uncommon. They constitute about 6% of all head and neck tumours. A neoplasm in the salivary gland region often presents as a diagnostic challenge with regards to its site of origin and whether it is benign or malignant. Most of these occur in the parotid glands; small percentages occur in the submandibular, sublingual and minor salivary glands. Parotid gland lesions are a histologically diverse group. Tumours of this region comprise 3% of all head and neck and 0.6% of all tumours of human body. FNAC of the salivary glands is a commonly accepted sensitive and specific tool in diagnosing benign and malignant salivary neoplasms.(1) The role of Fine Needle Aspiration Cytology (FNAC) for the diagnosis of salivary gland tumours is well documented. Large volume of salivary gland tumours studied by FNAC are being reported in world literature. Its main advantages are that it is safe, simple to do, causes little discomfort to the patient and carries a lesser number of complications. But still there are some diagnostic pitfalls to FNAC due to, 1) Histological complexity and morphological variability of the salivary gland tumours, which make interpretation difficult, 2) Sampling errors, etc. Hence, the effectiveness of FNAC in evaluation of salivary gland tumours is still considered controversial.The main aim of this study is to evaluate the efficacy of FNAC in diagnosing benign and malignant salivary neoplasms. Methods -A total of 33 patients with salivary gland lesions who had undergone preoperative FNAC and had been diagnosed by subsequent histopathological examination were included in this study. MATERIALS AND METHODS RESULTSFNAC -Of the 35 cases, FNAC categorised 28 cases (80%) as neoplastic lesions and 7 (20%) cases as non-neoplastic lesions. Of the 28 neoplastic cases, FNAC showed 25 cases (89.28%) to be benign and 3 cases (10.72%) to be malignant. HPE report -Of the 35 cases, HPE categorised 28 cases as neoplastic lesions (80%) and 7 cases (20%) as non-neoplastic lesions. Of the 28 neoplastic cases, HPE showed 24 cases (85.71%) to be benign and 4 cases (14.29%) to be malignant. CONCLUSIONSalivary glands are unique in their nature that they are histologically complex and morphologically variable. Unlike neoplasms in other sites where pre-operative biopsy is possible and treatment can be planned based on their reports, biopsy is not recommended in salivary neoplasms, especially parotid because of the fear of tumour spillage and nerve injury. The only acceptable biopsy in a parotid tumour is superficial parotidectomy. FNAC is a cheap, easy, simple and sensitive method for diagnosing salivary neoplasms and these salivary glands are easily accessible to FNAC. Hence, FNAC is being commonly used to diagnose salivary neoplasms.