Diagnostic Accuracy of Fine Needle Aspiration Cytology in Lesions of Oral Cavity and Salivary Glands: A Clinico-Pathological Study.

Shubhangi Shalley,Varuni Yadav,Amit Aggarwal,Laxmi Narayan Garg,Aashit Yadav,Nasib Chand

doi:10.2174/1745017901814010782

Abstract

Objective:Fine Needle Aspiration Cytology (FNAC) is a rapid, reliable and safe diagnostic tool used for various lesions of the oral cavity and salivary glands. The present study was undertaken to categorize the cytomorphology of the oral cavity and salivary gland lesions on FNAC and to assess the accuracy of FNAC in arriving at a diagnosis.Materials and Methods:A prospective study on oral cavity swellings and salivary gland aspirates was done during a 2 year period from August 2015 to July 2017 in which a total of 70 FNAC’s were performed. There were 12 aspirates obtained from oral cavity swellings and 58 aspirates were obtained from salivary glands. Histopathological evaluation of 65 lesions was done and was considered as gold standard. Only the lesions undergoing histopathological confirmation were included in the study. The sensitivity, specificity, diagnostic accuracy and clinical utility index were evaluated for accuracy of FNAC.Results:Hard palate (33.33%) was the predominantly aspirated site in the oral cavity. Parotid gland was the predominant gland aspirated (60.32%) among the involved salivary glands. Non-neoplastic lesions constituted 18.47% cases whereas neoplastic lesions were 81.53% (60.00% benign and 21.53% malignant). Pleomorphic adenoma (28.65%) was the most common benign lesion in the oral cavity involving hard palate and as salivary gland neoplasm (70.54%). Squamous cell carcinoma (60%) was the most common malignant lesion of oral cavity involving the tongue and buccal mucosa and adenoid cystic carcinoma (44.45%) was the commonest malignancy in salivary gland malignant neoplasms. The overall sensitivity, specificity and accuracy of FNAC in the present study were 89.5%, 100% and 85% respectively.Conclusion:FNAC is a safe, cost-effective and reliable technique effective in diagnosing the spectrum of different lesions in the oral and maxillofacial region.

Highlights

The oral cavity is affected by a wide variety of pathologic lesions that need an accurate diagnosis for guiding further management [1, 2]
The prospective study was done on Fine Needle Aspiration Cytology (FNAC) slides obtained from 70 cases of oral cavity swellings and salivary glands lesions analyzed by light microscopy (Nikon clinical microscope) in the cytology section of pathology department from August 2015 to July 2017 and 65 cases underwent histopathological assessment, which were included in the study
All the swelling cases of Oral Cavity and salivary glands reporting to the Department of Oral Medicine and Radiology were clinically diagnosed by a trained Oral Physician and the cases were referred to the Department of General Pathology for confirmation by FNAC and biopsy

Summary

Introduction

The oral cavity is affected by a wide variety of pathologic lesions that need an accurate diagnosis for guiding further management [1, 2]. Fine Needle Aspiration Cytology (FNAC) is shown to be a safe and reliable method that overcomes these problems by providing a minimally invasive means to rapid diagnosis of intraoral lesions, and if necessary, a re-aspiration can be done immediately [2, 4]. This technique has rarely been used to diagnose oral and pharyngeal lesions but has become a diagnostic test of choice for salivary gland lesions [2 - 4]. FNAC differentiates nonneoplastic lesions from neoplastic lesions eliminating the need for surgical intervention in these lesions which can be treated conservatively [4]

Methods

Results

Discussion

Conclusion