Fine Needle Aspiration Cytology of Salivary Gland Lesions With Histopathological Correlation- A Two-Year Study

Abstract

BACKGROUND Salivary gland neoplasms are an interesting, diverse group of tumours with many associated factors that make their diagnoses and management challenging. The long natural history of these lesions, wide spectrum of biological activity they exhibit, the difficulty in diagnosis and high rate of recurrence attribute to difficulty in management of these lesions. Since the lesions of major and minor salivary gland lesions are easily accessible, they can be readily subjected to examination by fine needle aspiration cytology studies which help in predicting the nature of the lesions and thereby helpful in management of these lesions.The present study aims to determine the diagnostic accuracy of FNAC in categorising the salivary gland lesions and possible sources of errors. MATERIALS AND METHODSStudy Design-Descriptive study. The study was conducted on 250 patients who underwent fine needle aspiration cytology of salivary glands at Government Medical College, Trivandrum over a period of two years. Histopathological data was obtained in 115 cases. The study examines the sensitivity, specificity and diagnostic accuracy of FNAC of salivary gland lesions in comparison with histopathology. Inclusion Criteria-All patients with clinically palpable lesions in salivary glands-parotid or submandibular region. Exclusion Criteria-1. Acute inflammatory lesions of salivary glands; 2. Patients with other comorbidities. RESULTSOf the 250 patients who underwent FNA, 151 patients were males (60.4%) and 99 were females (39.6%). Age of patients ranged from 2 -77 years. Most common salivary gland involved was the right parotid gland. Neoplasms were more common (66.96%) than non-neoplastic lesions (33.04%). The sensitivity of FNAC in detecting malignancy was 64.3%, specificity 75.25%, accuracy 73.91%, positive predictive value 86.36% and negative predictive value 86.36%. CONCLUSIONFine needle aspiration cytology is a simple, cost effective, sensitive and specific technique for diagnosis of most salivary gland lesions. Hence, it may be used as a diagnostic modality in predicting the nature of salivary gland lesions pre-operatively and hence helpful in management of these lesions.