Diagnostic Accuracy and Pitfalls in Fine Needle Aspiration Cytology Of Salivary Gland Lesions.

Authors

  • Crysle S Saldanha Assistant Professor, Dept of Pathology, Father Muller Medical College, Kankanady, Mangalore
  • Hilda Fernandes
  • Zeeshanali Fazalbhoy
  • Jayaprakash C S
  • Sumanth D
  • Reshma Kini

Keywords:

FNAC salivary gland, diagnostic accuracy, pitfalls

Abstract

BACKGROUND : Fine Needle Aspiration cytology (FNAC) is an essential diagnostic method used to evaluate salivary gland lesions. However, at times, diverse morphological patterns and overlapping features between benign and malignant lesions becomes challenging and difficult to give a definitive diagnosis.

Aim are to compare the findings of preoperative FNAC with their histopathological types and to discuss the causes for discordancy and identify the potential pitfalls in cytological diagnosis.

 

METHODS: An observational analytical study was carried out over a 4 year period to review the cases of patients with salivary gland lesions who underwent FNAC in a medical college, hospital. Taking histopathological diagnosis as gold standard, the cytological diagnosis of the cases was compared and the causes of discrepancies were evaluated. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value was calculated.

 

RESULTS: In the present study, out of 137 cases, cyto- histological correlation was available in 46 cases. Pleomorphic adenoma was the commonest lesion in the study. The diagnostic value of  FNAC was: Sensitivity 66.7%, Specificity 97.4%, Positive Predictive Value 80%, Negative Predictive Value 95% and Diagnostic Accuracy 93.3%. False positive diagnosis was rendered in warthin’s tumor whereas false negative diagnosis was given in mucoepidermoid carcinoma.

 

CONCLUSION: FNAC is useful in the preoperative diagnosis of salivary gland lesions. Pitfalls in cytologic diagnosis were due to errors in sampling, cystic lesions and interpretation of smears . 

 

DOI: 10.21276/APALM.1284

References

1. Aan NL, Tanwani AK. Pitfalls in Salivary Gland Fine-Needle Aspiration Cytology. International Journal of Pathology.2009;7(2):61-65.
2. Tahoun N, Ezza TN. Diagnostic Accuracy and Pitfalls of Preoperative Fine Needle Aspiration Cytology in Salivary Gland Lesions. Journal of the Egyptian Nat. Cancer Inst. 2008; 20(4):358-368.
3. Ersoz C, Uguz AH, Tuncer U, Soylu L, Kiroglu M. Fine needle aspiration cytology of the salivary glands: a twelve years’ experience. Aegean Pathology Journal. 2004;1:51–56.
4. Sangeetha N, Karthika V, Latha S. Cytological analysis of salivary gland lesions with histopathological correlation.IJPBS.2013;3(4):122-128.
5. Orell SR, Sterret GF, Whitaker D, editors. Fine Needle Aspiration Cytology, 5th ed. Edinburgh: Churchill Livingstone-Elsevier; 2005:53-69.
6. Al-Khafaji M, Nestok R, Katz L. Fine needle aspiration of 154 parotid masses with histololgic correlation. Cance Cytopathology.1998;84:153-159.
7. Ide F, Mishima K, Saito I. Mucoepidermoid Carcinoma with Spindle Cell Change: A Low-grade Lesion Potentially Mistaken for Sarcomatoid Dedifferentiation. Head Neck Pathol 2008 ; 2(3): 227–230.
8. Viguer JM, Vicandi B, Jiménez-Heffernan JA, López-Ferre P, González- Peramato P, Castillo C. Role of fine needle aspiration cytology in the diagnosis and management of Warthin’s tumour of the salivary glands. Cytopathology 2010; 21:164-9.
9. Chan JK, Tang SK, Tsang WY, Lee KC, BatsakiS JG. Histologic changes induced by fine-needle aspiration. Adv Anat Pathol 1996;3:71-90.
10. Veder LL, Kerrebijn JD, Smedts FM, Bakker MA. Diagnostic accuracy of fine-needle aspiration cytology in Warthin tumors. Head Neck 2010; 32: 1635-40.
11. Mukunyadzi P. Review of fine-needle aspiration cytology of salivary gland neoplasms, with emphasis on differential diagnosis. Am J Clin Pathol 2002; 118: 100-15.
12 .Faur A, Lazăr E, Cornianu M, Dema A, Vidita CG, Găluşcan A. Warthin tumor: a curious entity: case reports and review of literature. Rom J Morphol Embryol 2009; 50: 269-73.
13.Desai P, Ami shah. Diagnostic Accuracy of Fine Needle Aspiration Cytology (FNAC) and Histopathology in Salivary Gland Lesions. IJSR, 2014; 4 (11):433-434.
14. Yadi1 RR, Chetri SR, Arasi NE, Anunayi J, Sreedhar V. Diagnostic accuracy of fine needle aspiration cytology in salivary gland neoplasms-2 year study. IJRHS 2015; 3 (1) :99-110.
15. Mukunyadzi P. Review of Fine-Needle Aspiration Cytology of Salivary Gland Neoplasms, With Emphasis on Differential Diagnosis Am J Clin Pathol. 2002;118:100-115.
16. Stramandinoli RT, Sassi LM, Pedruzzi PAG et al. Accuracy, sensitivity and specificity of fine needle aspiration biopsy in salivary gland tumours: A retrospective study. Med Oral Pathol Cir Bucal. 2010;15: 32-7.
17. Iqbal M, Anwar K, Ihsanullah, Mohammad J, Khan IA, Hussain G. The diagnostic value of fine needle aspiration cytology in masses of the salivary glands. JPMI 2011; 25: 73-7.
18. Rehman H, Khan MS, Wahid F, Ahmad I. A profile of parotid gland tumours from a tertiary care hospital in Peshawar. JPMI 2011;25158- 62.
19. Klijanienko J, Vielh P. Fine-needle sampling of salivary gland lesions, II: cytology and histology correlation of 71 cases of Warthin’s tumor (adenolymphoma). Diagn Cytopathol.1997; 16:221-225.
20. Elagoz SY, Gulluoglu MG, Imazbayhan DW, Ozer HS. The value of fine-needle aspiration cytology in salivary gland lesions. J Otolaryngol Head & Neck Surg. 2007; 69: 51-56.
21. Ameli F, Baharoom A, Nurismah, Akmal SN. Diagnostic challenges in fine needle aspiration cytology of salivary gland lesions. Malaysian J Pathol 2015; 37(1) :11 – 18 .

Downloads

Published

13-06-2017

How to Cite

1.
Saldanha CS, Fernandes H, Fazalbhoy Z, C S J, D S, Kini R. Diagnostic Accuracy and Pitfalls in Fine Needle Aspiration Cytology Of Salivary Gland Lesions. Ann of Pathol and Lab Med [Internet]. 2017 Jun. 13 [cited 2024 Dec. 26];4(3):A274-278. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/apalm1284

Issue

Section

Original Article