Spectrum of Salivary Gland Lesions in Western Odisha with the Diagnostic Value of F.N.A.C. Correlating with Histomorphology

Abstract

Background: Salivary gland tumour accounts for less than 5 % of all head and neck tumours. Fine needle aspiration cytology (FNAC) is a useful method for evaluating suspicious salivary gland lesions due to its low cost, minimum morbidity, rapid turnaround time, high specificity, and high sensitivity. On the basis of cytological examination, lesions can be divided into inflammatory, benign, or malignant. If possible, specific diagnosis is given which helps the clinicians in planning the management of the lesion. The objective of the present study is to evaluate spectrum of salivary gland lesions in our set up and to access the diagnostic accuracy and efficacy of FNAC with correlation to histomorphology in spectrum salivary gland lesions. Methods: Present study being both prospective and retrospective, was carried out in department of pathology, VIMSAR, Burla, Odisha. The patients who came to cytology -preoperatively were subjected to FNAC to establish preoperative diagnosis. Postoperatively, the histomorphology was correlated with cytological diagnosis. The study was conducted over 3-year period (December 2014 to November 2017) in which 100 patients were observed. In the present study, 100 cases of salivary gland swelling are included . Salivary gland lesions were studied under the three groups, including non-neoplastic lesions, benign and malignant tumours. Results: In the present study, non-neoplastic lesions accounted for 56%(56/100), followed by benign tumour 29%(29/100) and malignant 15%(15/100). The most common gland involved was parotid (72%), followed by submandibular gland (25%) and minor salivary glands (03%), whereas no case of sublingual salivary gland lesion was observed in the present study. Chronic sialadenitis was the most common lesion (71.4%, 40/56). In benign tumours, pleomorphic adenoma accounted for maximum number of cases (86.21%, 25/29). In malignant lesions, mucoepidermoid carcinoma was the most common malignant tumour (66.67%, 10/15). In the present study, both cytology and histology were carried out in 73 cases out of 100 in which correlation was done for sensitivity, specificity, and diagnostic accuracy. The diagnostic accuracy of FNAC for the non-neoplastic lesions, benign tumours, and malignant tumours was 97.5%, 84.2%, and 85.71%, respectively, and overall diagnostic accuracy was 91.78%. Conclusion: The FNAC technique is accurate, technique sensitive, and specific especially when used as screening method. Preoperative cytology is a useful, quick and reliable diagnostic technique for rapid diagnosis which helps in early diagnosis and can prevent unnecessary surgeries on patient.

Frequency and pattern of salivary gland lesions at a tertiary care centre

“…Pleomorphic adenoma was the commonest benign neoplastic lesion in our study. Our findings are in accordance with a recent study by Mahmood et al 16 Parotid gland was the most common site of Pleomorphic adenoma in 67.7% of cases followed by submandibular gland in 17.6% of cases, a finding in line with the results of recently published studies from India 18 and the Netherland 19 . Though Warthin's tumor was found as a rare entity among benign salivary gland lesions in the present study; it has been reported as the second and the third most common benign tumor secondary to pleomorphic adenoma in two earlier studies 12,20 A recent study in Greece by Kadletz et al 21 reported a rising incidence of Warthin's tumor in recent years that has been correlated with obesity, alcohol consumption, and cigarette smoking.…”