Comparative study of Fine-Needle Aspiration Cytology and Histopathological diagnosis of salivary gland swelling
Abstract
Introduction: Fine-needle aspiration cytology (FNAC) of salivary gland swelling helps differentiate benign and malignant lesions, thereby allowing clinicians to plan proper management. Ultrasound-guided FNAC is more accurate than other methods of FNAC. It is simple and safe and lacks significant complications. It is also inexpensive and can be repeated if needed.Methods: This study is a prospective study of 80 patients subjected to FNAC followed by surgery and histopathological examination, from September 2017 to July 2019. Histopathology reports were compared with the preoperative FNAC reports. In all 80 cases, informed consent was obtained prior to surgery.
Results: True-positive, true-negative, false-positive, and false-negative rates for carcinomatous lesions of salivary gland swelling were assessed. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 81.82%, 97.10%, 81.82%, 97.10%, and 95%, respectively for FNAC when compared against histopathology.
Conclusion: FNAC is a sensitive, specific, and accurate diagnostic test used for the preoperative evaluation of patients with salivary gland swelling. FNAC is very commonly used as an initial routine investigation.
References
2. Nagarkar NM, Bansal S, Dass A, Singhal SK, Mohan H. Salivary gland tumors. Indian J Otolaryngol Head Neck Surg. 2004;56(1):31–34.
3. Epker BN, Henry FA. Clinical histopathologic and surgical aspects of intraoral minor salivary gland tumors. J Oral Surg. 1969;27(10):792–804.
4. Dudheon LS, Patrick CV. New method for the rapid microscopical diagnosis of tumors. Br J Surg. 1927;15:250–261.
5. Brennan PA, Davies B, Poller D, et al. Fine needle aspiration cytology (FNAC) of salivary gland tumors: repeat aspiration provides further information in cases with an unclear initial cytological diagnosis. Br J Oral Maxillofac Surg. 2010;48(1):26–29. doi:10.1016/j. bjoms.2008.12.014.
6. Parmar MD, Suri SK, Ghoghari DV. Role of fine needle aspiration cytology in salivary glands lesions. J Res Med Dent Sci. 2014;2(3):23–27. doi:10.5455/jrmds.2014236.
7. Schmidt RL, Narra KK, Witt BL, Factor RE. Diagnostic accuracy studies of fine needle aspiration show wide variation in reporting of study population characteristics: implications for external validity. Arch Pathol Lab Med. 2014;138(1):88–97.
8. Song IH, Song JS, Sung CO. Accuracy of core needle biopsy versus fine needle aspiration cytology for diagnosing salivary gland tumors. J Pathol Transl Med. 2015;49(2):136–143.
9. Tyagi R, Dey P. Diagnostic problems of salivary gland tumors. Diagn Cytopathol. 2015;43(6):495–509.
10. Wei S, Layfield LJ, Li Volsi VA, Montone KT, Baloch ZW. Reporting of fine needle aspiration (FNA) specimens of salivary gland lesions: a comprehensive review. Diagn Cytopathol. 2017;45(9):820–827.
11. David O, Blaney S, Hearp M. Parotid gland fine-needle aspiration cytology: an approach to differential diagnosis. Diagn Cytopathol. 2007;35(1):47–56.
12. Griffith CC, Pai RK, Schneider F. Salivary gland tumor fine needle aspiration cytology: a proposal for a risk stratification classification. Am J Clin Pathol. 2015;143(6):839–853.
13. Liu CC, Jethwa AR, Khariwala SS, Johnson J, Shin JJ. Sensitivity, specificity, and posttest probability of parotid fine needle aspiration: a systematic review and meta analysis. Otolaryngol Head Neck Surg. 2016;154(1):9–23.
14. Obaid MA, Yusuf A. Surgical management of epithelial parotid tumors. J Coll Physicians Surg Pak. 2004;14(7):394–399.
15. Akhter J, Hirachand S, Lakhey M. Role of FNAC in the diagnosis of salivary gland swellings. Kathmandu Univ Med J (KUMJ). 2008;6(2):204–208.
16. Ashraf A, Shaikh AS, Kamal F, Sarfraz R, Bukhari MH. Diagnostic reliability of FNAC for salivary gland swellings: a comparative study. Diagn Cytopathol. 2010;38(7):499–504.
17. Jain R, Gupta R, Kudesia M, Singh S. Fine needle aspiration cytology in diagnosis of salivary gland lesions: a study with histologic comparison. Cytojournal. 2013;10:5. doi: 10.4103/1742-6413.109547.
18. Gudmundsson JK, Ajan A, Abtahi J. The accuracy of fine-needle aspiration cytology for diagnosis of parotid gland masses: a clinicopathological study of 114 patients. J Appl Oral Sci. 2016;24(6):561–567.
19. Zafar A, Shafi M, Hassan SH, Malik S. Fine needle aspiration cytology in parotid lumps. J Pak Med Assoc. 1997;47(7):188–190.
20. Mihashi H, Kawahara A, Kage M. Comparison of preoperative fine-needle aspiration cytology diagnosis and histopathological diagnosis of salivary gland tumors. Kurume Med J. 2006;53(1–2):23–27.
21. Chakrabarti S, Bera M, Bhattacharya PK. Study of salivary gland lesions with fine needle aspiration cytology and histopathology along with immunohistochemistry. J Indian Med Assoc. 2010;108(12):833–836.
22. Zurrida S, Alasio L, Tradati N, Bartoli C, Chiesa F, Pilotti S. Fine needle aspiration of parotid masses. Cancer. 1993;72(8):2306–2311.
23. 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.
24. Cajulis RS, Gokaslan ST, Yu GH, Frias-Hidvegi D. Fine needle aspiration biopsy of the salivary glands. A five-year experience with emphasis on diagnostic pitfalls. Acta Cytol. 1997;41(5):1412–1420.
25. Pratap V, Jain SK. Sonographic evaluation of salivary gland tumors - a hospital-based study. Inter J Sci Study. 2014;1(4):32–36.
26. Panchal U, Shah GH. A cytological and histological comparative study of salivary gland lesions at tertiary health care centre. Int J Biomed Adv Res. 2015;6(6):470–474.
27. Rajat G, Deepika D, Dinesh K, Jyotsna S. Fine needle aspiration cytology (FNAC) of salivary gland lesions with histopathological correlation in a district hospital of Jammu region. Indian J Pathol Oncol. 2016;3(1):32–37.
28. Rice DH. Malignant salivary gland neoplasms. Otolaryngol Clin North Am. 1999;32(5):875–886.
29. Klijanienko J, El-Naggar AK, Servois V. Mucoepidermoid carcinoma ex pleomorphic adenoma. Nonspecific preoperative cytologic findings in six cases. Cancer. 1998;84(4):231–234.
30. Naz S, Hashmi AA, Khurshid A. Diagnostic role of fine needle aspiration cytology (FNAC) in the evaluation of salivary gland swelling: an institutional experience. BMC Res Notes. 2015;8:101.
31. Sikdar N, Sriram V, Ivan EA. Cytological and histopathological correlation of salivary gland lesions. JMSCR. 2018;6(7)127–139.
32. Poudel A, Shrestha B, Regmi S. Evaluation of salivary gland lesions by fine needle aspiration cytology at a tertiary care hospital, Western Nepal. Pathol Lab Med Int. 2020;12:9–17.
33. Hayat Ullah Khan, Kamran Khalid, Imran Yousuf. Diagnostic accuracy of fine needle cytology in salivary gland lesions – experience at a tertiary care hospital. JFJMU. 2017;11(4):24-29.
34. Ihrler S, Guntinas-Lichius O, Haas C, Mollenhauer M. Updates on tumors of the salivary glands: 2017 WHO classification. Pathologe. 2018;39(1):11–17.
35. Qizilbash AH, Sianos J, Young JE, Archibald SD. Fine needle aspiration biopsy cytology of major salivary glands. Acta Cytol. 1985;29(4):503–512.
36. Khandekar MM, Kavatkar AN, Patankar SA. FNAC of salivary gland lesions with histopathological correlation. Indian J Otolaryngol Head Neck Surg. 2006;58(3):246–248.
37. Kotwal M, Gaikwad S, Patil R, Munshi M, Babhate S. FNAC of salivary gland – a useful tool in preoperative diagnosis or a cytopathologist’s riddle. J Cytol. 2007;24(2):85–88.
38. Klijanienko J, El-Naggar AK, Vielh P. Fine–needle sampling findings in 26 carcinoma ex pleomorphic adenomas: diagnostic pitfalls and clinical considerations. Diagn Cytopathol. 1999;21(3):163–166.

This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright and Open Access Policy
This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.
JSSN applies the Creative Commons Attribution (CC BY) license to all works we publish. Under the CC BY license, authors retain ownership of the copyright for their article, but authors allow anyone to download, reuse, reprint, distribute, and/or copy articles in JSSN, so long as the original authors and source are cited. No permission is required from the authors or the publishers.
Article by JSSN is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.jssn.org.np/index.php?journal=jssn.