Diagnostic accuracy of FNA cytology for diagnosis of salivary gland tumors in pediatric patients.

Abstract

Salivary gland tumors are rare in pediatric patients and include both benign and malignant types. Although fine-needle aspiration cytology is widely used to diagnose salivary gland tumors in adults, such diagnostic techniques in pediatric patients are still poorly applied and studied. Nevertheless, a preoperative diagnostic definition of salivary gland lesions is highly recommended to plan a correct surgical management and to avoid over-treatment of inflammatory or reactive lesions. The authors performed a retrospective analysis on a series of salivary gland lesions-both neoplastic and non-neoplastic-in pediatric patients who underwent fine-needle aspiration. When obtainable, the corresponding histological diagnoses were retrieved. The authors calculated the diagnostic sensitivity and specificity of fine-needle aspiration in this clinical setting and evaluated the diagnostic agreement between cytology and histology. The series included 34 cases of salivary gland lesions in patients aged <20years, including 21 benign neoplasms and 6 malignant neoplasms. Cytological samples were adequate for diagnosis in 32 of 34 cases, and a definitive cytological diagnosis was achieved in 29 of 34 cases. Cytology demonstrated a sensitivity of 0.92 and a specificity of 0.86 for the diagnosis of salivary gland tumors, and a comparison between the diagnostic performance of cytology and histology demonstrated statistically significant concordance between the 2 techniques. Fine-needle aspiration cytology shows high accuracy in the diagnosis of pediatric salivary gland tumors, with diagnostic sensitivity and specificity similar to those reported for adult patients.