Is fine needle aspiration biopsy reliable in the diagnosis of parotid tumors? Comparison of preoperative and postoperative results and the factors affecting accuracy

Altın, Fazilet; Alimoğlu, Yalçın; Açıkalın, Reşit Murat; Yaşar, Hüsamettin

doi:10.1016/j.bjorl.2018.04.015

Cited by 29 publications

(36 citation statements)

References 22 publications

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“…As for determining the "malignant" category, we think that pre-MSRSGC era dichotomous benign/ malignant classification is insufficient to make a differential diagnosis. The sensitivity rate we reported for the diagnosis of malignancy remains low, which is consistent with the literature 26,27 .…”

Section: Discussionsupporting

confidence: 92%

Fine-Needle Aspiration Cytology of Salivary Gland Tumors Before the Milan System: Ten Years of Experience at a Tertiary Care Center in Turkey

Yıldız¹,

Şeneldir²,

Karaca³

et al. 2021

MMJ

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Objective: The role of fine-needle aspiration cytology (FNAC) is well established for preoperative evaluation of patients with salivary gland lesions. However, the lack of a uniform system for salivary gland FNAC has limited its effectiveness. In recent years, the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) has been in use around the world to report the cytology results. We aimed to investigate the efficacy and accuracy of FNAC examined according to pre-MSRSGC era dichotomous benign/malignant classification in salivary gland tumors. Methods: Patients who underwent surgery between January 2011 and December 2020 due to major salivary gland tumors were retrospectively analyzed. Two hundred and four patients were included in the analysis. Preoperative FNAC results and final histopatological diagnoses were grouped as benign or malignant. Final histopatological diagnoses were compared with the preoperative FNAC results. Also, sensitivity, specificity, and accuracy of the preoperative FNAC results, as well as the agreement between both tests were investigated. Results: The sensitivity, specificity, accuracy, positive and negative predictive values of the preoperative FNAC for the diagnosis of malignancy were 59.09%, 97.85%, 93.75%, 76.47%, and 95.29%, respectively. There was a moderate agreement between the preoperative FNAC results and final histopatological diagnoses. Conclusion: The accuracy of the preoperative FNAC and the information given about malignancy risk are the most important criteria for patient management and decision-making. The MSRSGC, which consists of a six-tiered classification rather than a dichotomous “yes/no” system, may contribute to patient management and decision-making by increasing the efficacy and accuracy of FNAC.

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Section: Discussionsupporting

confidence: 92%

Fine-Needle Aspiration Cytology of Salivary Gland Tumors Before the Milan System: Ten Years of Experience at a Tertiary Care Center in Turkey

Yıldız¹,

Şeneldir²,

Karaca³

et al. 2021

MMJ

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“…In our study, the most common benign tumor was pleomorphic adenoma while the most common malignant was squamous cell carcinoma in compatible with Bachar et al [32]. However, Naeem et al [28] and Altin et al [30] reported mucoepidermoid carcinoma as the most common malignant tumor.…”

Section: Discussionsupporting

confidence: 89%

“…Along Suzuki et al's study, sensitivity, specificity, and accuracy were calculated as 82.3%, 98.7%, and 95.9% respectively [29]. Altin et al showed sensitivity, specificity, and accuracy of 68.96%, 89.63%, and 86.52% [30]. Feinstein et al showed sensitivity of 75% and specificity of 95.1% [31].…”

Section: Discussionmentioning

confidence: 98%

Role of FNAC in diagnosis of parotid lesions

Youssef

Cope

Alsedra

et al. 2021

Egypt J Otolaryngol

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Background Salivary gland masses are considered challenging for diagnosis regarding its origin and whether benign or malignant. Unique features of FNAC as a safe and easy diagnostic procedure with little discomfort to the patient made it a favorable primary diagnostic tool. Information regarding the nature of parotid lesions whether being benign or malignant is the main objective of FNAC. We have done a restrospective study for FNAC for parotid masses performed in John Hunter hospital (Newcastle, NSW, Australia) along the peroid from 2014-2018. Histopathological correlation was done in 74 cases to test the accuracy of FNAC in diagnosis of parotid lesions. Results Of the total 74 FNAC done for parotid lesions in which a histopathological correlation was done, we get 46 (62.2%) benign lesions (37 neoplastic and 9 non-neoplastic) while 28 (37.8%) were malignant tumor. Pleomorphic adenoma was the most common in benign tumor side (45.7%) while SCC is the most common in malignant group (53.6%). Compatibility between FNAC and histological diagnosis was found in 74% (55/74), of which 78.3% in benign lesions (36/46) and in 68% of malignant lesions (19/28). FNA cytology was true positive in 21/74 cases (28.4%) and true negative in 41/74 (55.4%) cases. We have 5 (6.8%) false-negative and 7 (9.5%) false-positive results. As a result, we get sensitivity of 81%, specificity of 85%, and accuracy of 84%. Conclusion The role of FNAC in diagnosis of primary salivary gland pathology is considered with some debate about sensitivity/specificity; however, sometimes it should be repeated or correlated with clinical/histopathological confirmation.

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“…The diagnostic difficulty was also caused by the malignant component being too small and elusive in gross specimen even in histopathological examination (5). Another retrospective study by Verma further underscores this pitfall concerning fine needle cytology among malignant parotid tumors (7)(8)(9)(10).…”

Section: Discussionmentioning

confidence: 99%

“…This study reported a false negative rate of 15% among parotid malignancies in post operative histopathological diagnosis however there was no variant of MECxPA in this study. Role of core biopsies in parotid neoplasm are dealt with caution as the high risk of tumor seeding or tumor spillage renders grave prognosis hence the advocacy for parotidectomy with adequate margins in suspected malignancies (9).…”

Section: Discussionmentioning

confidence: 99%

Mucoepidermoid Carcinoma Ex-Pleormorphic Adenoma of Parotid Gland: A Rare Variant with Cytodiagnostic Handicap

2019

GMJ

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Carcinoma ex pleomorphic adenoma is a rare malignant tumor predominantly arising from salivary glands. Mucoepidermoid carcinoma ex pleormorphic adenoma (MECxPA) is a rare subtype with only ten cases reported in literature. This is a case report of a 53-year-old female with three years history of parotid swelling mimicking clinical features of a benign tumor and even eluding fine needle cytology as pleormorphic adenoma. Histopathological examination reported malignancy of MECxPA variant following superficial parotidectomy. This cytodiagnostic pitfall has been widely reported in literature hence warranting a high index of suspicion and aggressive management in addressing parotid tumors to ensure prompt and adequate treatment.

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Is fine needle aspiration biopsy reliable in the diagnosis of parotid tumors? Comparison of preoperative and postoperative results and the factors affecting accuracy

Cited by 29 publications

References 22 publications

Fine-Needle Aspiration Cytology of Salivary Gland Tumors Before the Milan System: Ten Years of Experience at a Tertiary Care Center in Turkey

Fine-Needle Aspiration Cytology of Salivary Gland Tumors Before the Milan System: Ten Years of Experience at a Tertiary Care Center in Turkey

Role of FNAC in diagnosis of parotid lesions

Mucoepidermoid Carcinoma Ex-Pleormorphic Adenoma of Parotid Gland: A Rare Variant with Cytodiagnostic Handicap

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