Abstract
Background: FNAC is a cytodiagnostic method based on the morphological findings of individual cells, group of cells, and microparticles of tissue, acquired using a needle. The role of FNAC for the diagnosis of salivary gland masses is well documented. The traditional open biopsy is no longer justified because of the risk of tumor spillage and damage to the facial nerve.Subjects and Methods:FNAC procedure was explained to the patient and patient was placed in a comfortable position. They were then subjected to fine needle aspiration cytology. Aspirations were carried out with 21 or 22 gauge needles of varying lengths with 10 ml syringes in a syringe holder after careful clinical examination of the lesion.Results:Chronic sialadenitis was the most common non-neoplastic lesion (13.2%) followed by cystic lesions (5.3%), acute on chronic sialadenitis (3.9%) and chronic granulomatous inflammation (2.6%). Pleomorphic adenoma (57.9%) was the most common benign neoplasm. Warthin’stumour accounted for (6.6%). Mucoepidermoid carcinoma was the most common malignant lesion (5.3%) followed by acinic cell carcinoma (1.3%), carcinoma-ex pleomorphic adenoma (1.3%) and adenoid cystic carcinoma (2.6%).Conclusion: Fine needle aspiration cytology of the salivary gland is a safe and reliable technique in the primary diagnosis of salivary gland lesions. Although, limitations are encountered while predicting specific lesions on cytology, especially when dealing with cystic and some malignant lesions.
Highlights
The history of fine needle aspiration cytology (FNAC) goes back to the 1920s where it came into use simultaneously in Europe and the United states.[1,2]
FNAC is a cytodiagnostic method based on the morphological findings of individual cells, group of cells, and microparticles of tissue, acquired using a needle
There remains a proportion of problematic cases depending on level of experience, continued desire to better oneself and acceptance of limitations. In such cases the uncertainty must be openly conveyed to the surgeon, rather than issuing a misleading report that will lead to inappropriate surgery. These findings suggest that, fine needle aspiration cytology of the salivary gland is a safe and reliable technique in the primary diagnosis of salivary gland lesions
Summary
The history of fine needle aspiration cytology (FNAC) goes back to the 1920s where it came into use simultaneously in Europe and the United states.[1,2] FNAC is a cytodiagnostic method based on the morphological findings of individual cells, group of cells, and microparticles of tissue, acquired using a needle. The characteristic cytologic features of common salivary gland lesions have been welldelineated in literature.[9] there exist cytologic pitfalls and overlapping features that make an accurate diagnosis difficult in few cases This has led to a wide-range of sensitivities (62-97.6%) and specificities (94.3- 100%) of cytologic diagnosis.[10,11]the appropriate therapeutic management could be planned earlier, whether it was local excision for benign neoplasms, conservative management for non-neoplastic lesions, radical surgery for malignant tumours and chemotherapy or radiotherapy for metastasis and lymphoproliferative disorders.[12] The aim of this study was to evaluate the spectrum of salivary gland lesions in our setting and to assess the diagnostic accuracy of FNAC for salivary gland lesions. The rate of benign neoplasm was lower than other reports which ranged from 49 to 83%.[13,14,15,16] We observed the
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