Salivary Gland Fine-Needle Aspiration Cytology: A Single Institution Experience

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Introduction 208 FNA cytology diagnoses between 2008-2014 Materials and Methods • Computer search was used to identify salivary gland FNA performed in the 2008-2014 period. • Cytologic diagnostic categories for the analysis were malignant neoplasm, suspicious for malignancy, benign neoplasm, neoplasm NOS, non-neoplastic, atypical cells and nondiagnostic. • Cyto-histologic correlation was performed on patients who underwent surgical excision post FNA. Conclusion • Salivary gland FNAC is a valuable tool for distinguishing between benign and malignant neoplasms, and between neoplastic and nonneoplastic lesions. Introduction: Fine needle aspiration cytology (FNAC) is considered an important tool in the diagnosis of salivary gland lesions. However, the great variety and overlapping features of salivary gland tumors can make a precise diagnosis difficult. At our institution, FNAs are performed from salivary gland lesions to discriminate between neoplastic and non-neoplastic lesions and to guide clinical management. This study reviews FNAC of salivary gland lesions performed at our institution during the past 7 years. Materials and Methods: Computer search was used to identify salivary gland FNA performed in the 2008-2014 period. Palpable lesion FNAs were performed by cytopathologists and deep-seated lesions by radiologists with cytopathologistperformed onsite evaluation in most cases. Cytologic diagnostic categories for the analysis were malignant, suspicious for malignancy, benign neoplasm, neoplasm NOS, non-neoplastic, atypical cells and nondiagnostic lesions. Cyto-histologic correlation was performed on patients who underwent surgical excision post FNA. Results: 208 salivary gland FNAs were reviewed. FNAC diagnoses included 79 benign neoplasms, 21 malignant, 9 suspicious for malignancy, 16 neoplasms NOS, 74 non-neoplastic, 4 atypical and 5 nondiagnostic lesions. Eighty-five (41%) of 208 FNAs had histological correlation; 43/44 (97.7%) benign neoplasms, 8/9 (89%) malignant and 6/8 (75%) non-neoplastic lesions were correctly categorized. Concordant histologic subtype was found in 39/43 (90.7%) benign and in 5/8 (62.5%) malignant neoplasms. There was one false positive: 1 atypical pleomorphic adenoma (PA) diagnosed as metastatic carcinoma favor prostate primary; and one false negative, a myoepithelial carcinoma ex-PA diagnosed as salivary gland adenoma. Conclusions: Salivary gland FNAC is a valuable tool for distinguishing between benign and malignant neoplasms, and between non-neoplastic and neoplastic lesions. FNAC is highly accurate for specific histologic subtype of benign neoplasms, and less for malignant. Molecular markers may help overcome diagnostic pitfalls of cytomorphology. • Fine needle aspiration cytology (FNAC) is considered an important tool in the diagnosis of salivary gland lesions. • However, the great variety and overlapping features of salivary gland tumors can make a precise diagnosis difficult. • At our institution, FNAs are performed from salivary gland lesions to discriminate between neoplastic and nonneoplastic lesions and to guide clinical management. • This study reviews FNAC of salivary gland lesions performed at our institution during the past 7 years. Diagnoses No. (%)