The diagnosis of salivary gland neoplasms is a complex and difficult area of surgical pathology. Most of the salivary gland tumours present a varieted and pleomorphic morphology that make difficult the histopathological categorisation. In addition, there are no clinical and/or radiological features specific for each neoplasm. According to the latest WHO classification of the salivary gland tumours, there are more than 30 benign and malignant neoplastic entities, 1 15%-26% are malignant [2][3][4] and approximately 85% originate from the parotid gland. 5 Fine-needle aspiration (FNA) has been used for more than 50 years for the diagnosis of salivary gland tumours. 6 FNA is a safe, quick, less invasive, cost effective and relatively reliable diagnostic tool, especially when performed under the ultrasound guidance 7 and in experienced and skilful hands, 8 can be easily performed in the outpatient setting. In addition, it helps to plan the management and extent of parotid surgery. 8 However, FNA presents a high false positive rate, 9,10 and the data of its sensitivity, specificity and accuracy are controversial. FNA sensitivity presents a huge variability between 41.7% and 92.8%, and its specificity is 93.9%-98.5%. The overall diagnostic accuracy rates vary from 79% to 97%. 11,12 For malignant neoplasms, the FNA diagnosis is nondiagnostic in 26% of the cases. 11,13 In a series of 151 cases, FNA results were non-diagnostic/inconclusive in 18% of cases 14 and its sensitivity was 76%-92% for benign tumours and 53%-79% for malignant neoplasm. [15][16][17][18] FNA specimens are inadequate for diagnosis in 9%-12% of all cases and in 14% of malignant tumours. 18,19 It is worth mentioning that FNA is operator dependent technique and the results are strongly related to the experience of the clinicians and cytopathologists.
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