Role of Fine-Needle Aspiration Biopsy in the Management of Salivary Gland Masses

Abstract

Objective: Fine-needle aspiration biopsy (FNAB) is widely used in the management of salivary gland masses. Its main advantage is its ability to differentiate benign from malignant disease. In this study, we aimed to evaluate the diagnostic ability of FNAB in salivary gland masses. Methods:The records of patients who had undergone FNAB before parotidectomy or submandibular gland excision between 2005 and 2013 were retrospectively analyzed. FNAB results were classified as negative, positive, suspicious for malignancy, and non-diagnostic. Preoperative FNAB results were compared with definitive histopathological results. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of FNAB results were calculated.Results: A total of 285 patients were enrolled. Among them, 230 (80.7%) had parotid gland and 55 (19.3%) had submandibular gland masses. Following a definitive histopathological examination, the most common benign tumor was pleomorphic adenoma (52.6%), whereas malignant tumors were mucoepidermoid carcinoma (2%) and squamous cell carcinoma (2%). The sensitivity, specificity, PPV, NPV and accuracy of FNAB results were 76.9%, 95.4%, 75%, 95.9%, and 92.6%, respectively. The rate of a suspicious cytology was 5.2% (15 patients) and that of a non-diagnostic cytology was 8.8% (25 patients). Conclusion:FNAB is a safe and simple diagnostic tool for the diagnosis of salivary gland masses and has a relatively high sensitivity and specificity. It may provide valuable information for patient counselling and surgical planning. The major drawbacks include a lower sensitivity than specificity and a relatively high rate of non-diagnostic results.

Salivary gland tumors: a 15-year experience of a universıty hospital in Turkey

“…Pleomorphic adenoma accounted for 47% of benign tumors, while Warthin tumor accounted for 37% of them. In previous studies, pleomorphic adenoma has been reported to be the most common benign tumor in all salivary glands [5][6][7][8][9][10][11][12][13][14][15][16][17]. However, in our study, Warthin tumor was detected in the parotid gland more than pleomorphic adenoma, unlike the literature.…”

“…However, in our study, Warthin tumor was detected in the parotid gland more than pleomorphic adenoma, unlike the literature. In addition, among all salivary gland tumors, Warthin tumor rate was reported as between 6% and 21% in large series of studies conducted in different regions of the world [5][6][7][8][9][10][11][12][13][14][15][16], while it was found as 26.2% in our study. In the light of this information, it can be said that Warthin tumor is more frequently seen in our region compared to many parts of the world.…”

“…Submandibular gland and minor salivary gland tumors are seen at similar rates. In large series of studies on this subject, their incidence has been reported as between 61%-83% for parotid gland tumors, 10%-17% for submandibular gland tumors, and 3%-26% for minor salivary gland tumors [5][6][7][8][9][10][11][12][13][14][15]. Sublingual gland tumors account for less than 1% of all tumors.…”

“…Many studies have found the most common primary malignancy in the salivary glands to be mucoepidermoid Table 3. Metastatic tumors of the salivary glands carcinoma [6,7,9,[11][12][13][14]16]. However, there are also studies reporting that adenoid cystic carcinoma is seen more frequently [5,8,10,15,18].…”

Small extracellular vesicles in cancer

“…Accurate detection of malignancies at an early stage will not only ameliorate the survival rate but also contribute significantly to the quality of the patient's life. Currently, Biomedical Imaging techniques such as Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and pathological fine-needle aspiration biopsy are being used for detection of cancer [ 358 , 359 ]. However, aspiration tissue biopsy is invasive and can cause bleeding, squamous metaplasia, fibrosis, and necrosis during collection [ 360 ].…”