Cytologic diagnosis of parotid gland Warthin tumor: Systematic review and meta‐analysis

Abstract

It is important to define the accuracy of fine-needle aspiration cytology (FNAC) in the diagnosis of Warthin tumor (WT). This systematic review and meta-analysis evaluated the accuracy of FNAC in the diagnosis of WT in the parotid gland and WT growth rate. For determination of FNAC accuracy, 17 studies, encompassing 1710 cases, were included. Pulled random model estimates of sensitivity, specificity, PPV, and NPV were 93.7% (95%CI: 92.1, 95.3), 97.9% (95%CI: 97, 98.9), 93.3% (95%CI: 91.5, 95.1), and 97.4% (95%CI: 96.4, 98.4), respectively. FNAC is highly reliable for the diagnosis of WT of the parotid. The high PPV value suggests that patients with a cytological diagnosis of WT of the parotid may be assigned to active surveillance.

Cystic lesions in the salivary gland. Pitfalls to be avoided on cytology

“…The average duration of symptoms is 21 months. [72][73][74][75][76] Despite typically being a benign neoplasm, there is a very small possibility of malignant transformation (< 0.1%), sometimes postradiation therapy, which could be epithelial (eg MEC, squamous carcinoma, adenocarcinoma, oncocytic carcinoma, Merkel cell carcinoma, undifferentiated carcinoma) or lymphoid (eg MALT lymphoma, small lymphocyte lymphoma, follicular lymphoma).…”

“…WT (also known as papillary cystadenoma or adenolymphoma) is the second most common benign neoplasm of the parotid gland, after PA 72–76 …”

“…It develops almost exclusively in the parotid gland and rarely in the minor salivary glands (submandibular gland 2.3%; minor salivary glands of the buccal mucosa, hard palate, lip and oropharynx 0.1%–1.2%), and it is bilateral in 5%‐30% of patients and multicentric in 12%‐30% 73–76 …”

“…The etiopathogenesis is not yet clear; the prevailing theory is that it originates from heterotopic salivary parenchymal or ductal inclusions trapped within intra‐ and peri‐parotid lymphoid tissue or from an inflammatory reaction 72–76 …”

“…Nine per cent of patients experience otalgia, tinnitus, hearing loss or deafness, and facial irritation, while facial paralysis is rare. The average duration of symptoms is 21 months 72–76 …”