Role of fine needle aspiration cytology and computed tomography in the diagnosis of parotid swellings

Abstract

Operations on the parotid gland present a considerable surgical challenge because the anatomy is delicate and the pathology diversel. Formal parotidectomy has become the preferred treatment for space-occupying lesions' ; this approach has evolved because pleomorphic adenoma is the commonest lesion. This operation can be technically demanding and the residual disabilities are serious in a significant number of patients. Facial nerve palsy is the single greatest problem, and can be temporary (1 1-82 per cent) or permanent (&17 per centI3. Masses of benign origin on the other hand require only enucleation and this has a lower morbidity4. Therefore, an accurate preoperative diagnosis would allow less radical surgery in some patients and should reduce complications. Patients and methodsThe case notes of 84 patients presenting with a lump in the parotid region over an 8-year period (1981-88) have been reviewed. Following clinical diagnosis of a lump in or related to the parotid gland two additional diagnostic methods have been used.Forty-four patients (34 men) were investigated by fine needle aspiration cytology (FNAC) using a standard technique. The age range was 17-8 1 years. The preoperative cytological diagnosis was compared with the final histopathological one after examination of the surgical specimen. In addition, the last 18 patients had a computed tomographic (CT) scan of the parotid region. ResultsThe results and accuracy of fine needle aspiration are shown in T a b l e l . The accuracy was 100percent with pleomorphic adenoma and 75 per cent with adenolymphoma with no false positive or false negative diagnoses of malignancy. Follow-up ranged from 4 to 96 months with a mean of 30, and there have been no local recurrences to date. Three patients had

Accuracy of Fine Needle Aspiration Cytology of Salivary Gland Lesions: Routine Diagnostic Experience in Bangkok, Thailand

“…However, the management of patients with salivary gland lesions should not be based on cytology alone. It's superior to the combination of physical examination and radiological findings (Owen et al, 1989;Stewart et al, 2000;Kraft et al, 2008). FNA of salivary gland lesions has been performed at various institutions.…”

Clinical importance of preoperative fine needle aspiration biopsy and computed tomography in parotid gland masses

“…Spiro suggests in his essay concerning salivary gland masses, published in 1995, that CT can be preferred to more expensive MRI [23]. Owen and his friends [21] stated, following their study in which they examined the usage of CT together with FNAB in parotid masses, as it is in our study, that both tests produced highly valuable information regarding preoperative histology and anatomy, and thus prevented occurrences of unnecessary procedures and complications.…”

“…Yalcin et al [21] stated, in their study consisting of 40 patients during which they examined assistant, diagnostic methods in parotid tumours, that USG, CT, and sialography are helpful in pre-operative staging, but not in benign-malign discrimination. McGuirt et al [22] suggest that pre-operative CT or MRI produced the appropriate response at a rate of 87% in benign-malign discrimination, and this rate was 69% in PET, and 78% in FNAB.…”

Punção aspirativa nos tumores das glândulas salivares: especificidade e sensibilidade

“…Apesar de Batsakis et al 9 terem observado alterações teciduais em neoplasias de glându-las salivares decorrentes da PAAF que podem dificultar o diagnóstico histopatológico, em nossa experiência não houve dificuldades ou impedimentos diagnósticos em conseqüência da PAAF.…”

“…O tratamento cirúrgico adequado depende, muitas vezes, do tipo histológico envolvido, principalmente quando se trata de lesões malignas 5 . Dessa maneira, o conhecimento do diagnóstico histológico pré-operatório auxilia em muito o planejamento terapêutico 7 , o esclarecimento e preparo adequado do paciente quanto à extensão da cirurgia 1 , principalmente nos tumores malignos em estádio precoce 7 , o que geralmente é difícil de se estabelecer baseado apenas nos achados da história, exame clínico e de imagem [8][9] .…”