Diagnostic role of fine needle aspiration cytology (FNAC) in the evaluation of salivary gland swelling: an institutional experience

BMC Research Notes

Mehmood Khan²  Anwar Kamal³  Muhammad Muzzammil Edhi¹  Naveen Faridi³  Amna khurshid³  Atif Ali Hashmi³  Samreen Naz³ 

[1] Liaquat National Hospital and Medical College, Karachi, Pakistan;Dhaka Medical College, Dhaka, Bangladesh;Department of Histopathology, Liaquat National Hospital and Medical College, Karachi, Pakistan

关键词: Submandibular gland;    Parotid gland;    Fine needle aspiration (FNAC);    Salivary gland;   

Others  :  1145815
DOI  :  10.1186/s13104-015-1048-5

 received in 2014-09-07, accepted in 2015-03-11,  发布年份 2015

【 摘 要 】

Background

Fine needle aspiration cytology (FNAC) is a cytodiagnostic method based on morphologic findings of individual and small group of cells aspirated using a fine needle. The aim of the present study is to evaluate the spectrum of salivary gland lesions in our setting and to assess the diagnostic accuracy of FNAC for salivary gland lesions.

Methods

The study involved 187 cases of parotid and submandibular swellings of patients who underwent FNAC at our institution. Thirty one (31) patients with a FNAC diagnosis of neoplastic lesion subsequently underwent excision biopsies. The results of FNAC and final histology were compared and accuracy of FNAC was determined.

Results

Mean age of patients was 42 (±21) years and male to female ratio was 1:1. Chronic sialadenitis was the most common non-neoplastic lesion (33.8%) followed by acute and chronic sialadenitis (29.7%) and chronic granulomatous inflammation (27.0%). Pleomorphic adenoma was the most common benign neoplasm and non-Hodgkin’s lymphoma was the most common malignant lesion (38.9%) followed by acinic cell (27.8%) and adenoid cystic carcinoma (16.7%). Total 31 patients subsequently underwent surgical excision, out of which 21 were benign and 9 were malignant, 20 cases (64.5%) were of pleomorphic adenoma, 3 cases (9.6%) of acinic cell carcinoma, 2 cases (6.4%) each of warthin tumor, adenoid cystic carcinoma and non-hodgkin lymphoma and 1 case (3.2%) each of mucoepidermoid carcinoma and mucinous adenocarcinoma. The overall accuracy of FNAC in our study was found to be 83.8% with 77.7% sensitivity and 86.3%, specificity. The revised sensitivity and specificity after adjusting verification bias were 68.5% and 91% respectively. False negative diagnosis was rendered in mucoepidermoid carcinoma and acinic cell carcinoma whereas false positive diagnosis was given in cases of pleomorphic adenoma.

Conclusion

We found a good concordance between FNAC and histology, however pleomorphic adenoma may impart a diagnostic challenge when inadequately aspirated and therefore we advice either immunohistochemical studies (if cell block material is available) or repeat aspiration in difficult cases.

【 授权许可】

   
2015 Naz et al.; licensee BioMed Central.

【 参考文献 】

• [1]Dudheon LS, Patrick CV: A new method for the rapid microscopical diagnosis of tumors. Br J Surg. 1927, 15:250-61.
• [2]Rajbhandari M, Dhakal P, Shrestha S, Sharma S, Shrestha S, Pokharel M, Shrestha I, Shrestha B, Makaju R: The correlation between fine needle aspiration cytology histopahology of head and neck lesion in kathmandu university hospital. Kathmandu Univ Med J (KUMJ) 2013, 11(44):296-9.
• [3]Poorey VK, Tyagi A: Accuracy of fine needle aspiation cytology in head and neck masses. Indian J Otolaryngol Head Neck Surg 2014, 66(2):182-6.
• [4]Diaz KP, Gerhard R, Domingues RB, Martins LL, Prado Ribeiro AC, Lopes MA, Carneiro PC, Vargas PA: High diagnistic accuracy and reproducibility of fine needle aspiration cytology for diagnosing salivary gland tumors : cytohistologic correlation in 182 cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2014, 118(2):226-35.
• [5]Huq AH, Aktaruzzaman M, Habib MA, Islam MS, Amin S: A comperative study between fine needle aspiration cytology findings and histopathological report of major salivary gland neoplasm in a tertiary hospital of bangladesh. Bangladesh Med Res Counc Bull 2013, 39(2):69-73.
• [6]Kechagias N, Ntomouchtsis A, Valeri R, Patrikidou A, Kitikidou K, Xirou P, Destouni C, Vahtsevanos K, Antoniades K: Fine needle aspiration cytology of salivary gland tumors: a 10 years retrospective analysis.”. Oral Maxilofac Surg. 2012, 16(1):35-40.
• [7]Singh Nanda KD, Meht A, Nanda J: Fine needle aspiration cytology : a reliable tool in the diagnosis of salivary gland lesions. J Oral Pathol Med 2012, 41(1):106-12.
• [8]Murai N, Taniguchi Z, Takahashi Y, Kuboshima F, Tateya I: A study of salivary gland aspiration cytology reporting: guideline validity. Nihon Jibiinkoka Gakkai Kaiho 2011, 114(7):615-9.
• [9]Piccioni LO, Fabiano B, Gemma M, Sarandria D, Bussi M: Fine needle aspiration cytology in the diagnosis of parotid lesions. Acta Otorhinolaryngol Ital 2011, 31(1):1-4.
• [10]Singh A, Haritwal A, Murali B: Correlation between cytology and histopathology of th salivary gland. Australas Med J 2011, 4(2):66-71.
• [11]Zerpa Zerpa V, Cuesta Gonzales MT, Agostini Porras G, Marcano Acuna M, EstellesFerriol E, Dalmau GJ: Diagnostic accuracy of fine needle aspiration cytology in parotid tumors. Acta Otorrinolaringol Esp 2014, 65(3):157-61.
• [12]Pastore A, Borin M, Malagutti N, Di Laora A, Becati D, Delazer AL, et al.: Preopertive assisment of salivary gland neoplasm with fine needle aspiration cytology and echography: a retrospective analysis of 357 cases. Int J Immunopathol Pharmacol 2013, 26(4):965-71.
• [13]Jain R, Gupta R, Kudesia M, Sing S: Fine needle aspiration cytology in the diagnosis of salivary gland lesions: a study with histologic comparison. Cytojournal. 2013, 10:5.
• [14]Kim BY, Hyeon J, Ryu G, Choi N, Baek CH, Ko YH, et al.: Diagnostic accuracy of fine needle aspiration cytology for high grade salivary gland tumors. Ann Surg Oncol 2013, 20(7):2380-7.
• [15]Fakhry N, Antonini F, Michel J, Penicaud M, Mancini J, Lagier A, Santini L, Turner F, Chrestian MA, Zanaret M, Dessi P, Giovanni A: Fine needle aspiration cytology in the management of parotid masses: evaluation of 249 patient. Eur Ann Otorhinolaryngol Head Neck Dis 2012, 129(3):131-5.
• [16]Ali NS, Akhtar S, Junaid M, Awan S, Aftab K: Diagnostic accuracy of fine needle aspiration cytology in parotid lesions. ISRN Surg. 2011, 2011:721525.