Fine Needle Aspiration of Salivary Glands

Abstract

To investigate 5 years' experience with fine needle aspiration (FNA) of salivary glands at a single academic center.A total of 191 salivary gland FNAs were performed at Louisiana State University Health Science Center from 2003 to 2007, and all were done on major salivary glands except for 1 case.The cytologic diagnoses included 17 malignancies, 6 atypia, 73 neoplasms, 87 negative and 18 nondiagnostic. Eighty-six cases had histologic follow-up (45.0%). There were 5 false negatives: 2 adenoid cystic carcinomas, 1 acinic cell carcinoma, 1 polymorphous low grade adenocarcinoma and 1 metastatic basaloid squamous cell carcinoma. The only false positive was a pleomorphic adenoma misdiagnosed as adenoid cystic carcinoma. Four reactive processes were diagnosed as benign neoplasms, including 2 granulomatous inflammation and 2 chronic sialadenitis. Five benign neoplasms were interpreted as reactive processes, including 2 Warthin's tumors, 2 sebaceous lymphoadenomas and 1 pleomorphic adenoma. The overall accuracy in distinguishing benign from malignant lesions was 79.1%, and the sensitivity for salivary neoplasia was 89.4%.Our results are consistent with the literature that salivary gland FNA has good sensitivity, specificity and accuracy in the diagnosis of salivary neoplasms. FNA can play a significant role in triaging patients with onsite cytologic interpretation and can reduce many unnecessary surgeries.