Diagnostic Accuracy of Fine Needle Aspiration Cytology in Lesions of Oral Cavity and Salivary Glands: A Clinico-Pathological Study

Abstract

Objective:Fine Needle Aspiration Cytology (FNAC) is a rapid, reliable and safe diagnostic tool used for various lesions of the oral cavity and salivary glands. The present study was undertaken to categorize the cytomorphology of the oral cavity and salivary gland lesions on FNAC and to assess the accuracy of FNAC in arriving at a diagnosis.Materials and Methods:A prospective study on oral cavity swellings and salivary gland aspirates was done during a 2 year period from August 2015 to July 2017 in which a total of 70 FNAC’s were performed. There were 12 aspirates obtained from oral cavity swellings and 58 aspirates were obtained from salivary glands. Histopathological evaluation of 65 lesions was done and was considered as gold standard. Only the lesions undergoing histopathological confirmation were included in the study. The sensitivity, specificity, diagnostic accuracy and clinical utility index were evaluated for accuracy of FNAC.Results:Hard palate (33.33%) was the predominantly aspirated site in the oral cavity. Parotid gland was the predominant gland aspirated (60.32%) among the involved salivary glands. Non-neoplastic lesions constituted 18.47% cases whereas neoplastic lesions were 81.53% (60.00% benign and 21.53% malignant). Pleomorphic adenoma (28.65%) was the most common benign lesion in the oral cavity involving hard palate and as salivary gland neoplasm (70.54%). Squamous cell carcinoma (60%) was the most common malignant lesion of oral cavity involving the tongue and buccal mucosa and adenoid cystic carcinoma (44.45%) was the commonest malignancy in salivary gland malignant neoplasms. The overall sensitivity, specificity and accuracy of FNAC in the present study were 89.5%, 100% and 85% respectively.Conclusion:FNAC is a safe, cost-effective and reliable technique effective in diagnosing the spectrum of different lesions in the oral and maxillofacial region.

The role of transoral fine needle aspiration in expediting diagnosis and reducing risk in head and neck cancer patients in the coronavirus disease 2019 era: a single-institution experience

“…Its use is also well documented in the literature, with high levels of sensitivity and specificity reported. [17][18][19][20][21][22][23][24][25] Indeed, Deng et al used intra-oral FNA in 28 patients with benign and malignant oral and oropharyngeal lesions. The authors recorded sensitivity, specificity and accuracy values of 100 per cent, 95 per cent and 97 per cent, respectively.…”

“…This is particularly pertinent where additional information (beyond cytomorphology alone) is required, such as human papillomavirus (HPV) status in oropharyngeal squamous cell carcinoma cases, which requires P16 immunohistochemical staining of a cell block. 22,23,27 The Journal of Laryngology & Otology…”

Pathologist‐performed palpation‐guided fine needle aspiration cytology of lingual actinomycosis: A case report and review of literature

“…It helps in avoiding surgical procedures in conditions such as nonneoplastic or inflammatory lesions and metastatic tumors 30‐32 . However, this technique has rarely been used in oral lesions 33‐37 . And to our knowledge, only two lingual actinomycosis cases have been reported diagnosed on FNAC and one by abscess drainage 4,13,17 .…”

Diagnostic accuracy of fine-needle aspiration cytology in head and neck lesions from a tertiary health facility in Southwestern Nigeria

“…Since its introduction in 1930, fine-needle aspiration cytology (FNAC) has gained acceptance over the years as a useful tool in the preliminary investigation of various lesions at different sites of the body. 1 2 3 This is largely due to its positive attributes, namely: relatively painless, easy to perform, can be employed in variety of patients including children and debilitated adult patients, it may not require anesthesia and associated complications are rare. 4 It is also relatively cheap, has high specificity and results are rapidly available making it an indispensable diagnostic and screening tool in resource scarce countries like Nigeria.…”

“… 5 6 Despite these advantages and usefulness, however, it's been suggested that FNAC cannot replace histopathological examination (HPE) since the biological material obtained does not provide precise cellular architectural details, making HPE to be regarded as the gold standard for the diagnosis of a number of lesions. 2 7 …”