Fine Needle Aspiration of Salivary Gland Lesions- Diagnostic Pitfalls

Abstract

BACKGROUNDThe use of Fine Needle Aspiration Cytology (FNAC) in the diagnosis of salivary gland lesions has seen a significant rise. In majority of cases, FNAC is helpful in differentiating between benign and malignant lesions. However, many a times it becomes quite challenging to give a precise diagnosis. The sensitivity of diagnosis of malignant lesions is high, though specificity is low. Aims-Objectives-1. To study the cytomorphology of salivary gland lesions. 2. To examine the sensitivity, specificity and diagnostic accuracy of FNAC of salivary gland lesions by cytohistopathological correlation and to identify the discrepancies that contri bute to false diagnosis. MATERIALS AND METHODSFifty one salivary gland FNAC cases received at the Department of Pathology, A. J. Institute of Medical Sciences were reviewed to identify the cytological characteristics. A cytohistopathological correlation was done wherever available and discordant cases were analysed. RESULTSIn the present study, out of 51 cases majority were males (33 cases, 65%). Twenty (40%) were diagnosed non-neoplastic, eighteen (35%) were rendered benign, while thirteen (25%) were malignant on cytology. Pleomorphic adenoma was the most common benign tumour (77% of the benign lesions) and mucoepidermoid carcinoma was the most common malignant tumour (30% of the malignant lesions). Biopsy confirmation of the cytological diagnoses were available in twenty one (41%) cases; 42.8% of the total cases showed discordant diagnosis. CONCLUSIONFNAC is a reliable tool in distinguishing benign and malignant salivary gland lesions in the hands of an experienced cytopathologist. A specific cytological diagnosis is often possible. However, due to the diagnostic pitfalls in FNAC, a biopsy confirmation may be necessary.