Accuracy of fine needle aspiration cytology in the preoperative diagnosis of malignant non‐odontogenic tumors of the orofacial region

Abstract

Background This study aims to determine the association between preoperative cytopathological diagnosis and the histopathological diagnosis of orofacial non‐odontogenic tumors. It is also, to determine the sensitivity, specificity and accuracy of fine needle aspiration cytology (FNAC) in the preoperative diagnosis of orofacial malignant non‐odontogenic tumors in a Nigerian population. Methods A 9‐month prospective study in which preoperative FNAC followed by open biopsy for confirmatory histopathological evaluation was performed for consenting patients with orofacial swellings. Patients histopathologically diagnosed as non‐odontogenic tumors were selected for the study. Results There were 40 (83.3%) histopathologically diagnosed non‐odontogenic tumors. The female to male ratio was 1.7:1 and the patients' mean age was 36 + 21.9 years. The mandible (n = 4, 10.0%) and the preauricular area (n = 4, 10.0%) were the most common sites affected. The cytopathological diagnosis showed 28 (70.0%) of the lesions were malignant, 7 (17.5%) were benign neoplasms and 5 (12.5%) were reactive/inflammatory swellings. The histopathological diagnosis was predominantly malignant (n = 29, 72.5%), consisting mostly of non‐Hodgkin's lymphoma (n = 12, 30.0%). There was significant association (P = .000) between cytopathological diagnosis and histopathological diagnosis of the malignant orofacial non‐odontogenic tumors. The sensitivity of FNAC to detect malignant orofacial nonodontogenic tumors was 93.1%, the specificity was 90.9%, the positive predictive value was 96.4%, the negative predictive values was 83.3% and the accuracy was 92.5%. CONCLUSION The accuracy of FNAC in the diagnosis of orofacial malignant non‐odontogenic orofacial tumors is high and hence recommended as a routine preoperative diagnostic tool.