Abstract
Objective: To evaluate role of ultrasound guided FNAC for the diagnosis of parotid tumor.Methods: This cross sectional study was conducted in 39 patients with parotid tumor admitted in the ENT department of out door of Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital, and Sir Salimullah Medical College and Mitford Hospital Dhaka, during July 2013 to June 2014 were enrolled for surgical management. Conventional FNAC and ultrasound guided FNAC were done in all these patients and they were followed up from the admission upto the post operative tissue diagnosis of parotid tumor in respective pathology departments for histopathological correlation.Results: The highest incidence of parotid tumor was in 4th decade and male to female ratio was almost 1:1. The main clinical feature were 27(69.2%) had firm, 6(15.4%) soft, 1(2.6%) hard and 5(12.8%) over the parotid tail. The validity of histopathology evaluation for pleomorphic in USG FNAC sensitivity 95.7%, specificity 100.0%, accuracy 97.4%, positive predictive values 100.0%, negative predictive values 94.1%. Evaluation for Meucoepidermoid sensitivity 80.0%, specificity 97.1%, accuracy 94.9%, positive predictive values 80.0%, negative predictive values 97.1% in USG FNAC. In USG FNAC for identification Warthin sensitivity 100.0%, specificity 100.0%, accuracy 100.0%, positive predictive values 100.0%, negative predictive values 100.0%. Evaluation for Adenocystic in USG FNAC sensitivity 100.0%, specificity 100.0%, accuracy 100.0%, positive predictive values 100.0%, negative predictive values 100.0%.Conclusion: It can be concluded that Ultrasound guided FNAC has definite value in the diagnosis of tumours and can be regarded as a sensitive and specific imaging modality for pre-operative discrimination of the benign and malignant parotid tumours.Bangladesh J Otorhinolaryngol; April 2015; 21(1): 5-16
Highlights
Parotid gland masses include benign tumours, malignant tumours and chronic inflammatory diseases and the identification of these benign or malignant lesions is linked with management
Its inability to show part of the deeper parotid lobe is overcome by computerized tomography (CT) and/or magnetic resonance imaging (MRI) which can be useful, as complementary studies, for correct surgical planning
Fine-needle aspiration cytology (FNAC) is fairly reliable for the diagnosis of pleomorphic adenomas, but it has difficulty identifying carcinoma expleomorphic adenoma
Summary
Parotid gland masses include benign tumours, malignant tumours and chronic inflammatory diseases and the identification of these benign or malignant lesions is linked with management. Clinical presentation of parotid tumours, especially the malignant ones, depends on its involvement with the facial nerve, staging. A broad spectrum of pathologies that present themselves along with parotid swelling and extraglandular masses can mimic parotid lesions clinically. It is frequently difficult on clinical grounds alone to distinguish between neoplastic and non-neoplastic causes for a parotid mass and to reliably differentiate between benign and malignant neoplasms. If an accurate pre-operative diagnosis can be achieved using a combination of clinical, imaging cytology or histology, many nonneoplastic lesions will not require excision. After initial demonstration and characterization of a parotid lesion with imaging, usually with ultrasound or MRI, needle biopsy is used to confirm its nature if required.
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