Title: A Study on Cytological Spectrum of Salivary Gland Lesions with Emphasis on Diagnostic Pitfalls in Interpretation of Cystic Lesions
Authors: Priya MG, Sheela KM
DOI: https://dx.doi.org/10.18535/jmscr/v8i5.94
Abstract
Background: Fine needle aspiration cytology has gained wide clinical acceptance as a direct approach to morphological diagnosis of salivary gland lesions. Salivary gland neoplasms are a heterogenous diverse group of tumours with many associated factors that make their diagnosis by cytology difficult. Limited cellularity and morphological lesion heterogenicity can pose diagnostic challenges, although many of the salivary gland lesions can be diagnosed with ease on fine needle aspiration cytology.
Materials and Method: This descriptive retrospective study was under taken at Pathology Department, Government Medical College, Thiruvananthapuram over a period of 18 months. The study was conducted on 250 patients who underwent fine needle aspiration cytology of salivary glands at Government Medical College, Thiruvananthapuram. Histopathological data was obtained in 115 cases.
Results: Parotid gland was the most commonly involved salivary gland. Age group ranged from 2-77 years. Out of 250 patients who underwent fine needle aspiration cytology, 151 patients were males (60.4 %) and 99 were females (39.6 %). Neoplasms were common (66.9 %) than non neoplastic lesions.
Diagnostic accuracy of fine needle aspiration cytology was 73.91 %, Sensitivity 64.3 %, Specificity 75.25 %, Positive predictive value 86.36 % and Negative predictive value 86.3 %.
Conclusion: Fine needle aspiration cytology is useful, quick, cost effective, reliable diagnostic modality for rapid diagnosis of salivary gland lesions.
Keywords: FNAC, salivary glands, cytologic spectrum, diagnostic pitfalls, mucoepidermoid carcinoma, cystic salivary gland lesions.
References
- Moshy J, Owibinegire S , Mwakyoma H. Intra-oral minor salivary gland neoplasms-The pattern and management. Prof Med J 2010;17:483-9.
- Berge T, Sodenstrom N. Fine needle cytological biopsy in diseases of salivary glands. Acta Pathol Microbiol Sc 1963;58 (1):1-9.
- Daneshbod Y, Daneshbod K, Khademi B. Diagnostic difficulties in the interpretation of fine needle aspirate samples in salivary lesions: Diagnostic pitfalls revisited.Acta cytol.2009;53:53-70
- Schindler S, Nayar R, Dutra J et al. Diagnostic challenges in aspiration cytology of the salivary glands. Semin Diagnostic Pathol 2001;8(2):124-46.
- Olide D, Saad B, Mathew H. Parotid Gland Fine Needle Aspiration cytology: an approach to differential diagnosis .Diag Cytopathol 2006;35:47-56.
- Klinjaniecko J, Vielh P.Fine Needle sampling of salivary gland lesions IV: review of 50 cases of mucoepidermoid carcinoma with histologic correlation. Diagn Cytopathol 1997; 17:92-8
- Orell SR , Sterret GF , Walters MI, Whitaker D.The salivary gland lesions In: Manual and atlas of fine needle aspiration cytology- Churchill Livingston 2005.
- May KM, Chan et al: Cyto diagnosis of 112 salivary gland lesions: Acta cytol. May- Jun 1992:36(3);353-363.
- Mukunyadzi P. Review of fine needle aspiration cytology of salivary gland neoplasms with emphasis on differential diagnosis. Am J Clin Pathol. 2002; 118: S100- 15[pub Med ][Google Scholar]
- Piccinio LO, Fabiano B, Gemma M, Saradria D, Bussi M.Fine needle aspiration cytology in the diagnosis of parotid lesions. Acta Otorhinolaryngol Ital 2011;31:1-4.
- Klinjanieko J, Vielh P. Fine needle sample of salivary gland lesions V:Cytology of 22 cases of acinic cell carcinoma with histologic correlation. Diag Cytopathol 1997; 17:347-352.
- 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.
- Arul P, Akshatha C , Masilamani S , Jonathan S. Diagnosis of salivary gland lesions by fine needle aspiration cytology and its histopathological correlation in a tertiary care centre of South India .J Clin Diagn Res 2015;9:7-10.
- Munoz – Palza C ,Cordero – Jimenez A , Tenor- Serrano R , Garcia – Mata R et al. Cytohistopathological correlation of parotid gland tumours Acta Otorhinolaryngol ESP 2010;61:184-188.
- Jayaram N, Ashim Das, Rajwanshi A , Radhika S Banerjee CK: The value of fine needle aspiration biopsy in the cytodiagnosis of salivary gland lesions: Diagn Cytopathol 1969;5.