Tükürük Bezinde Pleomorfik Adenoma Tanısında Hangi Sitolojik Özellikler Önemli?

Abstract

Objective: The aim of this present study is to evaluate which cytologic features of fine needle aspiration cytology (FNAC) are important in the diagnosis of pleomorphic adenoma (PA) in salivary gland. Material and Methods: May-Grunwald-Giemsa stained smears, and hematoxylin and eosin stained paraffin sections of 60 FNAC of parotid (n= 55), submandibular (n= 3) glands and palate (n= 2) were reviewed. Sixty patients, who have both biopsies and FNACs were included in the study. We analyzed eight cytological and three architectural features in a series of 32 FNACs from PA which were correctly diagnosed cytologically (Group A) and compared them with 14 FNACs from non-PA lesions and tumors which were correctly diagnosed cytologically (Group B) and with 14 FNACs from salivary gland tumors or lesions in which, cytological/histological diagnosis were different (Group C). The specimens were evaluated according to the presence or absence of the cytologic features; plasmocytoid appearance and abundant cytoplasm (PAAC), chondromyxoid matrix (CMM), intermingled CMM and tumor cell, spindle cell, oncocytic cell, squamoid cell, bipolar/multipolar or reniform nucleus, and cellular arrangement; acinus formation, large loose clusters with irregular edges, and tumor groups with arborising vascular pattern. Results: The cell which was PAAC, CMM and a mixture of epithelial cells with CMM were selected as the three most predictive parameters of differentiating of non-PA lesions and tumors from PA. Conclusion: In the 60 patients who were suspected of having PA, a correct diagnosis was made by a combination of the above features. The sensitivity of this procedure for PA was 100%, and the specificity was 92%.