Practical significance of utilizing fine needle aspiration cytology as an adjunct diagnostic aid in the preoperative presumptive diagnosis of ameloblastoma

Abstract

Background:Cytological reports of ameloblastoma are relatively rare in the literature. Appropriate cytologic diagnosis may play a significant role in its preoperative presumptive diagnosis, especially when incisional biopsy findings are inadequate.Aim:To systematically study the detailed cytomorphologic features of ameloblastoma and to evaluate the role of fine needle aspiration cytology (FNAC) in its preoperative diagnosis.Materials and Methods:In this study, FNAC was done on 26 cases of intra-osseous jaw lesion, clinically diagnosed as odontogenic tumor or developmental odontogenic cysts and detailed cytopathological interpretation was carried out and the results were correlated with the corresponding histopathology.Results:Of the 26 cases, 15 were found to be ameloblastoma and sensitivity of FNAC in the diagnosis of ameloblastoma was found to be 86.6%. None of the intra-osseous jaw lesion was false positively diagnosed as ameloblastoma in FNAC and hence the specificity was found to be 100%.Conclusion:Presence of cohesive epithelial cell clusters exhibiting smaller basaloid cells with peripherally placed tall columnar cells and occasional large squamous cells either adjoining the basaloid epithelial clusters or in isolated group aids in the specific cytological diagnosis of ameloblastoma and FNAC offers an excellent diagnostic aid that may play a significant role in preoperative presumptive diagnosis of ameloblastoma along with incisional biopsy.

Diagnostic capability of fine‐needle aspiration cytology in assessment of intraosseous lesions of the jaws: A systematic review

“…From 390 studies identified after exclusion of duplicates, a total of 48 articles were considered eligible for full‐text reading, of which 40 were excluded (Appendix S2), and 8 were finally included (Figure ).…”

“…Overall judgment was “at risk of bias” for seven included studies, only the study of Kaliamoorthy et al was judged with an overall “low risk of bias.” Within domains assessed in the QUADAS‐2 tool, items regarding bias or applicability related to the index test and reference standard were scored as with “high” or “unclear” risk in the majority of studies. Concerns were due to lack of information or reportedly absence of blinding of personnel from histopathological analyses when performing FNAC evaluations.…”

“…Three included studies evaluated ameloblastomas exclusively . In the study of Üçok et al, participants were divided into two groups: (a) individuals clinically and radiographically diagnosed with ameloblastoma and (b) individuals not clinically diagnosed with ameloblastoma.…”

“…In the second group, a total of 16 lesions were assessed by both diagnostic methods, and a concordance rate of 93.75% was found. Kaliamoorthy et al investigated 15 cases of ameloblastoma, of which 86.7% presented concordant diagnosis between FNAC and histopathology. Chavarkar et al investigated 12 cases of ameloblastoma, of which 58.3% presented concordant diagnoses with both incisional and excisional biopsy histopathology.…”

Cytomorphological features of a cystic ameloblastoma of mandible

“…They have shown an overall cytological diagnostic accuracy of 58.3%. However, Kaliamoorthy et al have found a sensitivity of 86.6% and specificity of 100% of FNAC in the diagnosis of ameloblastoma. In our case the peripheral palisading of the tumor cells with reversal of nuclear polarity was quite evident, which is usually difficult to appreciate on cytosmears.…”