Salivary gland tumors: Features not to be missed on cytology. A study of five cases

Abstract

Abstract Fine needle aspiration cytology (FNAC) plays a crucial role in the diagnosis of salivary gland lesion and hence advantageous to patient and treating surgeon since it is safer and faster than excision biopsy. Interpretation of cytological findings is difficult in salivary gland tumors because of many pitfalls like uncertainty as to the site, aspiration material, lack of architectural patterns and mainly overlapping cytological features. In our study we have discussed pitfalls of FNA cytology of salivary gland tumors in five discordant cases. We discuss five such cases were cytological diagnosis was missed due to numerous factors. An insight into technical and interpretational factors is discussed. Keywords: Cytology, Salivary gland tumors, Pitfalls in cytology. Introduction Fine Needle Aspiration Cytology (FNAC) of salivary gland has a wide-range of diagnostic sensitivity (62-97.6%) and specificity (94.3-100%).[1]Because of superficial location and easy accessibility, FNAC is a simple and inexpensive technique for diagnostic evaluation of these tumours.[2] Owing to lack of characteristic clinical and radiological features that are specific for particular diagnosis, FNAC assumes greater significance in diagnosing salivary gland tumors.[1] Factors such as uncertainty of site, tissue actually aspirated, aspiration of minimal material, lack of architectural pattern in smears have a huge impact on specific cytological diagnosis.[3]The aim of the present study is to discuss cytological pitfalls in specific diagnosis of some types of salivary gland tumors. Institutional ethical clearance was taken before start of the study. At our centre routinely tumour aspirations were performed by the standard procedure using 21gauge - 23 gauge needle and 10 ml syringe. Patients were subjected to repeat aspiration if initial aspirate was found to be inadequate for interpretation. Air dried smears were stained with Giemsa stain and alcohol fixed smears wer