Role of FNAC in the Preoperative Diagnosis of Salivary Gland Lesions

Abstract

intrOductiOnSalivary gland swellings can result from tumours, an inflammatory process or cysts. It can sometimes be difficult to establish as to whether pathology arises from the salivary gland itself or from adjacent structures such as lymph nodes, soft tissues or skin. Fine Needle Aspiration Cytology (FNAC) is a widely used, safe and relatively nontraumatic procedure that can quickly provide important information. The main goal of doing FNAC of salivary gland lesions is to assist clinicians in the management of patients who present with mass lesions. The characteristic cytologic features of common salivary gland lesions have been well-delineated in literature [1]. However, there also exist cytologic pitfalls and overlapping features that make an accurate diagnosis difficult in few cases. This has led to a wide-range of sensitivities (62-97.6%) and specificities (94.3-100%) of cytologic diagnosis [2-5].The present study was designed to compare the cytologic findings of salivary gland lesions with their histologic diagnoses, in order to assess the sensitivity, specificity and diagnostic accuracy of FNAC, with an emphasis on discordant cases. MAteriAls And MethOdsThis study was performed on patients with suspected salivary gland swellings, who were referred for FNAC to the Department of Pathology of a medical college and hospital. This was done over a period of three years, on patients of either sex or any age, after obtaining written consents from them. Relevant clinical details were elicited in all the cases and findings of local examinations done were noted. All the patients underwent FNAC with use of a 23 G needle, with suction being provided by a 10 ml syringe. The characters of aspirates were noted, routine smears were prepared and they were stained with May-Grünwald's-Giemsa and Papanicoloau's stains. Pathology sectionThe cytologic interpretation was done as it has been described in standard textbooks of cytology. Histologic correlations were done wherever it was possible. A histologic diagnosis was considered as the gold standard for assessment of sensitivity and specificity of FNAC. A cyto-histologic correlation was done and appropriate statistical tests were applied.

Fine needle aspiration cytology-based spectrum of salivary gland lesions at a teaching institute in north India

“…Ziehl-Neelsen stain was done in all cases of granulomatous lymphadenitis but none of them revealed the presence of acid-fast bacilli. [11] reported the rate of sialadenosis as 16.12% (29/180), whereas Fernandes H et al [12] observed the rate of sialadenosis as 9.09% (8/88) and that of cystic lesion as 11.36% (10/88) in their study of 80 patients with salivary gland swellings.…”

“…These tumors were further categorized as benign (54.42%) (Figure 2), suspicious for malignancy (1.36%) and malignant (12.92%) ( Figure 3) which is in accordance with Gupta S et al [9] who reported the benign tumor as 54.94% (50/91) and malignant tumor as 15.38% (14/91) in their study, based on salivary gland aspirates from 91 cases. Rate of occurrence of benign tumors in various studies ranged from 29% to 80% and that of malignant tumors from 4.44% to 26.66% [3][4][5][6][9][10][11][12][13][14][15][16][17][18]. Most common benign tumor in the present study was pleomorphic adenoma (90%) with maximum no of cases in 21-40 years age group predominantly affecting the females, with male to female ratio of 1:1.66.…”

Study of the Cytomorphology of Salivary Gland Lesions Using the Milan System of Reporting in a Tertiary Care Hospital

“…These findings are consistent with those of several other studies. 8,[12][13][14][15] Amongst the benign neoplasms, pleomorphic adenoma was most commonly seen and muco-epidermoid carcinoma was the most frequently encountered malignant neoplasm. 3,14,16 Chronic sialadenitis was the most commonly diagnosed lesion of salivary gland.…”

Salivary Gland Swellings: A Retrospective Study of Cytological Findings

“…They consist of parotid, submandibular, sublingual, and the minor glands that are numerous and widely distributed throughout the mouth and oropharynx. [1][2] Salivary gland disorders can arise from infection, inflammation, cystic changes, degenerative process and neoplastic etiologies. [3][4] Most common conditions of salivary gland disease arise from acute infection and inflammation.…”