Diagnostic role of FNAC in Salivary gland lesions and its histopathological correlation

Abstract

Background: Fine needle aspiration cytology (FNAC) is the established first line investigation of mass lesions in the body. Kun was the first to describe the diagnostic use of FNAC in 1847. About 2-6.5% of all head and neck region neoplasm in adults are from salivary glands which are usually accessible for FNAC. It helps to distinguish salivary glands lesion as inflammatory, benign and malignant hence allowing proper planning for management. Material and Methods: It was a retrospective study carried for the period of Feb 2014 to Feb 2016. 68 cases of salivary gland swelling were included in which cytological and histological studies were done. 22 cases were excluded from the study on view of inadequate material or lack of either FNAC or histology correlation. All the patients were clinically evaluated and FNAC was done using 10 ml disposable syringe and 23/24-gauge needle without using local anesthesia. We classified our FNAC results as true-negative, true-positive, false-negative and false-positive. We also compared the histopathology of the surgical specimens and cytology of the FNAC specimens and evaluated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV). Results: Parotid gland was commonest affected site. Out of 46 neoplastic lesions 39 (84.7%) were benign and 07 (15.3%) were malignant. An overall of 86.9% (40/46) concordance between FNAC and final histological diagnosis was established. A sensitivity of 97.4% and specificity was 71.4%, were observed with 93.4 % of accuracy. The positive and negative predictive values were 95% and 83.3%, respectively. Conclusion: FNAC is a safe and accurate diagnostic tool. Surgeon can plan treatment according the preoperative FNAC diagnosis and avoid unnecessary surgeries. Keywords: Cytology, FNAC, Parotid gland