Salivary Gland Lesions Research Articles

Application of the Milan System for Reporting Pediatric Salivary Gland Cytopathology: Analysis of histologic follow-up, risk of malignancy, and diagnostic accuracy.

The diagnosis and management of salivary gland tumors in pediatric patients can be challenging. The utility of fine-needle aspiration (FNA) cytopathology and the performance of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) in this age group have not been systematically assessed. The paucity of data has contributed to the controversial role of FNA cytopathology in the presurgical management of these patients. The authors retrospectively analyzed 104 pediatric salivary gland FNAs (2000-2020). A correlation with the available histopathologic follow-up (n = 54) was performed. The distribution percentages, the risk of neoplasm (RON), and the risk of malignancy (ROM) were assessed for each category of the MSRSGC. The overall sensitivity, specificity, negative predictive value, and positive predictive value of pediatric salivary gland FNAs were 80%, 97%, and 92%, respectively. The RON values for the nondiagnostic, nonneoplastic, atypia of undetermined significance, benign neoplasm, salivary gland neoplasm of uncertain malignant potential, suspicious for malignancy, and malignant categories were 60%, 11%, 100%, 100%, 100%, 100%, and 100%, respectively, whereas the ROM values were 0%, 11%, 100%, 6%, 67%, 100%, and 100%, respectively. The percentage of nonneoplastic FNAs was greater in comparison with the adult population (52% vs 8%). All neoplasms in patients aged 0 to 10 years were malignant, whereas benign neoplasms occurred only in patients aged ≥11 years; this supported an inverse correlation between age and malignancy rate in salivary gland neoplasms. FNA cytopathology demonstrates excellent diagnostic performance in differentiating malignant and benign pediatric salivary gland lesions. The MSRSGC is a valuable tool for standardization of the reporting and preoperative risk stratification of these lesions.

Differentiating malignant from benign salivary gland lesions: a multiparametric non-contrast MR imaging approach

The purpose of this study is to determine whether multiparametric non-contrast MR imaging including diffusion-weighted imaging (DWI), arterial spin labeling (ASL), and amide proton transfer (APT) weighted imaging can help differentiate malignant from benign salivary gland lesions. The study population consisted of 42 patients, with 31 benign and 11 malignant salivary gland lesions. All patients were evaluated using DWI, three-dimensional pseudo-continuous ASL, and APT-weighted imaging on 3 T MR imaging before treatment. Apparent diffusion coefficient (ADC), tumor blood flow (TBF), and APT-related signal intensity (APTSI) values within the lesion were compared between the malignant and benign lesions by Mann–Whitney U test. For each parameter, optimal cutoff values were chosen using a threshold criterion that maximized the Youden index for predicting malignant lesions. The performance of ADC, TBF, APTSI, individually and combined, was evaluated in terms of diagnostic ability for malignant lesions. Diagnostic performance was compared by McNemar test. APTSI was significantly higher in malignant lesions (2.18 ± 0.89%) than in benign lesions (1.57 ± 1.09%, p = 0.047). There was no significant difference in ADC or TBF between benign and malignant lesions (p = 0.155 and 0.498, respectively). The accuracy of ADC, TBF, and APTSI for diagnosing malignant lesions was 47.6%, 50.0%, and 66.7%, respectively; whereas the accuracy of the three parameters combined was 85.7%, which was significantly higher than that of each parameter alone (p = 0.001, 0.001, and 0.008, respectively). Therefore, the combination of ADC, TBF, and APTSI can help differentiate malignant from benign salivary gland lesions.

English

BACKGROUND Salivary gland lesions constitute less than 1 % of tumours and about 4 % of all epithelial neoplasms of head and neck region. These comprise of a wide variety of benign, malignant and non-neoplastic lesions which exhibits a difference in histological behaviour. There are no reliable criteria to differentiate on clinical grounds the benign from malignant ones. So morphological evaluation is necessary. We aim to study the frequency of various salivary gland lesions in sialoadenectomy specimens and categorise them into neoplastic and nonneoplastic lesions. METHODS It is a record based retrospective 5-year study carried out in the Government Medical College, Thiruvananthapuram, Kerala, from January 2014 to December 2018. RESULTS In this study a total of 329 histopathologically proven cases of salivary gland lesions were included. Neoplastic lesions and non-neoplastic lesions constituted 78.42 % and 21.58 % respectively. Pleomorphic adenoma was the most common neoplasm (50.54 %) trailed by Warthin’s tumour (9.73 %). Most common malignant neoplasm encountered in our study was mucoepidermoid carcinoma (9.73 %) among which low grade tumours showed predominance. We observed significantly higher incidence of benign and malignant lesions in the 5 th to 6th decade while non neoplastic lesions were seen more in the 4th to 5th decade. Average age of the patients with salivary gland tumours was 46.12  SD 15.57. Majority of cases of salivary gland lesions in our study were from parotid gland (75.68 %) followed by submandibular gland 24.01 %. CONCLUSIONS Pleomorphic adenoma was the most common benign tumour in our study and mucoepidermoid carcinoma the most common malignant tumour. Neoplastic lesions showed a predominance over non neoplastic lesions. Histopathological examination is the mainstay for diagnosis and clinical management. KEYWORDS Histopathology, Pleomorphic Adenoma, Mucoepidermoid Carcinoma

English

BACKGROUND Fine needle aspiration cytology (FNAC) is commonly used as a safe and minimally invasive diagnostic test in benign salivary gland lesions. Nevertheless, the capacity of aspiration cytology in diagnosing benign lesions in the salivary gland is still disputed because accurate tumour typing is dependent on the quality and yield of the aspirate, as well as the competence of the cytopathologist. We aim to assess the precision of fine needle aspirate in the pre-operative diagnosis of benign salivary gland lesions and compare it with the histopathological findings. METHODS This is a longitudinal study conducted among 45 patients with preoperative cytological diagnosis of benign salivary gland lesions, who were followed-up till surgery with subsequent histopathological examination in Government Medical College, Thrissur, from 1 st January 2013 to 30th June 2015. RESULTS Among the benign neoplasms, 29 out of 30 cases of pleomorphic adenoma were confirmed on histopathology and one was basal cell adenoma. Out of nine cases of Warthin’s tumour, only seven were confirmed by histopathology. Of the remaining two, one was found to be salivary duct carcinoma showing the typical comedo necrosis and the other was found to be low grade mucoepidermoid carcinoma. So, these two cases were found to be false negative. The statistical analysis showed an overall diagnostic accuracy of 95.5 % for benign salivary gland lesions. CONCLUSIONS FNAC is a minimally invasive technique useful in salivary gland lesions. In nonneoplastic lesions surgery can be avoided and in neoplasms appropriate surgery can be planned. An accurate cytological diagnosis is often possible but may sometimes require the expertise of the cytopathology and use of ancillary techniques KEYWORDS Salivary Gland, Fine Needle Aspiration Cytology, Benign Tumours, Pleomorphic Adenoma, Warthin’s Tumour, Mucoepidermoid Carcinoma, Salivary Duct Carcinoma

Two-Year Experience of the Implementation of the Milan for Reporting Salivary Gland Cytopathology at a Private Medical Laboratory.

This study aimed to present the 2-year experience of the implementation of the Milan System for Reporting Salivary Gland Cytopathology at Alpha Prolipsis Medical Laboratories, a private medical laboratory located in Athens, Greece. A totaI of 102 Fine Needle Aspirations (FNAs) performed since 2018 were included in the study. Reports were issued according to the Milan System for Reporting Salivary Gland Cytopathology. Aspirates were prepared with both conventional and liquid-based cytological methods and were evaluated by two or three Board-certified cytopathologists. Diagnostic reproducibility and accuracy were evaluated. All cases included in this study had histologic follow-up. The diagnostic accuracy of FNA for differentiating between benign and malignant disease according to MSRSGC classification was 93.3%, the specificity was 97.5% and the sensitivity was 82.2%. The positive and negative predictive values were 93.2 and 87.2%, respectively. Our results show that FNA is a valuable examination technique in the preoperative evaluation of salivary gland lesions. The integration of the 2018 Milan System for Reporting Salivary Gland Cytopathology is effective, with an overall accuracy around 95%.

Texture analysis in the characterization of parotid salivary gland lesions: A study on MR diffusion weighted imaging

Background and PurposeParotid lesions show overlaps of morphological findings, apparent diffusion coefficient (ADC) values and types of time/intensity curve. This research aimed to evaluate the role of diffusion weighted imaging texture analysis in differentiating between benign and malignant parotid lesions and in characterizing pleomorphic adenoma (PA), Warthin tumor (WT), epithelial malignancy (EM), and lymphoma (LY). MethodsTexture analysis of 54 parotid lesions (19 PA, 14 WT, 14 EM, and 7 LY) was performed on ADC map images. An ANOVA test was used to estimate both the difference between benign and malignant lesions and the texture feature differences among PA, WT, EM, and LY. A P-value≤0.01 was considered to be statistically significant. A cut-off value defined by ROC curve analysis was found for each statistically significant texture parameter. The diagnostic accuracy was obtained for each texture parameter with AUC ≥ 0.5. The agreement between each texture parameter and histology was calculated using the Cohen's kappa coefficient. ResultsThe mean kappa values were 0.61, 0.34, 0.26, 0.17, and 0.48 for LY, EM, WT, PA, and benign vs. malignant lesions respectively. Long zone emphasis cut-off values >1.870 indicated EM with an accuracy of 81 % and values >2.630 revealed LY with an accuracy of 93 %. Long run emphasis values >1.050 and >1.070 indicated EM and LY with a diagnostic accuracy of 79% and 93% respectively. ConclusionsLong zone emphasis and long run emphasis texture parameters allowed the identification of LY and the differentiation between benign and malignant lesions. WT and PA were not accurately recognized.

Adenomatoid Hyperplasia: Case Report of a Rare Lesion in Uncommon Location

Adenomatoid hyperplasia is a rare lesion of the minor salivary glands recognized by localized swelling that mimics a neoplasm. This so called pseudotumor usually occurring in adults 4th to 6th decade of life mostly, in 80 percent, occurs as a unilateral swelling without ulcer on the hard and soft palate. The pathogenesis of this condition is not well known but local trauma might have a role. In this case report three cases of adenomatoid hyperplasia have been reported to bring attention to this lesion as it is clinically similar to many soft tissue lesions of oral mucosa so should be considered while making a clinical diagnosis. Also, Pathologists should investigate a proper sample size under a microscope not to confuse a normal salivary gland adjacent to salivary gland tumours with Adenomatoid hyperplasia.

Recurrent painless lump on lower lip in a girl; mucocele

A 10-year-old girl was admitted to pediatric rheumatology department due to recurrent painless lump on her lower lip. Her past medical history revealed that she had the lesions began within the last 4 months. The mother stated that these lesions started after her younger brother was born 4 months ago. She presented with the same complaint at another medical center 2 months prior, and she was diagnosed with stomatitis related to deficiencies of vitamins and zinc. Despite oral multi-vitamin and zinc supplementation, local steroid and anti-mycotic treatments, the lesions did not improve. Oral examination revealed there was a transparent liquid-filled lump around slightly hyperemic with the size 6x3 mm on the lower lip mucosa. On the right side there was a shrunken lump (Figure). The lower lip was dry. The other organ systems, growth and development parameters were normal. Regarding this typical image, the lesion on the lip of the patient was diagnosed mucocele which is cystic lesion of minor salivary glands on oral mucosa. Mucoceles are typically transparent or bluish, recurrent submucosal painless masses, and more frequent on lower lip. The most important cause of mucocele is habit of lip or cheek biting due to stress that can lead trauma and the saliva leaks from the damaged duct into the adjacent connective tissue (1). Herpes simplex labialis, exposure to an allergen should be considered in differential diagnosis. Herpes simplex labialis lesions which are caused by human herpes simplex virus are small blisters. The lesions are typically vesicular and recurrent. They usually occur around the mouth, lips, or nose. Before the appearance of herpes labialis; focal pain, burning, itching, or tingling may be observed in the affected area. The vesicles tend to merge, rupture, and then crust quickly in a few days. Herpes labialis improves completely within two weeks (2). Exposure to an allergen can cause lip inflammation followed by a lump. Allergens that can trigger a reaction on the lips include lipstick products (especially in preadolescents and adolescents), foods such as chocolate and strawberry (in younger children), and pet dandruff. Children with this type of reaction may often experience recurrent lip swelling and itchy lumps after exposure to the allergen. The clinical findings and medical history of the patient were not compatible with any of the above. When the anamnesis was detailed, it was understood that she showed beginning jealous behavior associated with birth of his brother 4 months ago. After birth of his brother, she has showed low academic performance in school compared to last year and a habit of lip biting has begun. Her mucocele excised surgically, and a child psychiatrist has been consulted. It is widely accepted that surgical excision and cryosurgery are effective treatments for childhood mucoceles (1).

Extensive squamous metaplasia in minor salivary gland neoplasm mimicking squamous cell carcinoma: Diagnostic dilemma in aspiration cytology

The surgical management of salivary gland lesions depends on cytology diagnosis, in conjunction with clinical findings and imaging studies. It is extremely important to differentiate benign and malignant salivary gland lesions preoperatively. The distinction can be challenging in aspiration cytology due to metaplastic changes, cystic changes, variable cellular components within the lesions, variants of neoplasms, and sampling issues. We are presenting the case of a 42-year-old female patient who presented with a nodular lesion in the hard palate. Fine-needle aspiration cytology of the lesion was cellular and showed sheets and singly scattered squamous cells with minimal cytological atypia. As the differential diagnosis included variety of lesions ranging from nonneoplastic lesions to benign and malignant neoplasms, surgery under frozen section control was advised. Frozen sections also showed extensive squamous areas. A minor component showing bilayered ductal pattern in a background of chondromyxoid stroma also noted. Diagnosis of a salivary gland neoplasm, possibly pleomorphic adenoma with extensive squamous metaplasia was given. Although squamous metaplasia has been reported in salivary gland neoplasms, it is extremely rare to find extensive squamous metaplasia enough to cause significant diagnostic confusion. The awareness of this extensive squamous metaplasia in benign salivary gland lesions help to distinguish it from malignant lesions and to avoid unnecessarily aggressive therapy.

Reporting Risk of Malignancy in Salivary Gland Cytopathology and Histopathology: A Cross-sectional Study

Introduction: For preoperative evaluation of patient with salivary gland lesion Fine Needle Aspiration Cytology (FNAC) is an effective technique, but due to lack of uniform system for reporting and also because of morphological heterogeneity and overlap between different lesions there are limitations, in its use. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was introduced which divides salivary gland lesions into six categories, guides in diagnosis and further management of Risk Of Malignancy (ROM) in different categories. Aim: The aim of the study was to classify salivary gland lesions according to MSRSGC and also evaluate for ROM in each category. Materials and Methods: This was a cross-sectional study looking at the data over a period of 3 years (2017 Jan to Dec 2019) in the Department of Pathology Chirayu Medical College and Hospital Bhopal. In this study salivary gland FNAC cases were categorised according to Milan System on cytopathology. Results: A total of 63 cases of salivary gland system FNAC were evaluated on cytology and classified according to MILAN system. Histopathological follow-up (correlation) was available in 47 cases. The risk of malignancy (ROM) in different categories was calculated. Category I Nondiagnostic constituted 25%, Category II Non-neoplastic comprised 0%, Category III Atypia of Undetermined Significance (AUS) showed 50% Category IV: (a) Benign showed 5.0% IV; (b) Salivary gland neoplasm of Uncertain Malignant Potential (SUMP) comprised 100%, Category V Suspicious for Malignancy (SM) comprised 100% and Category VI Malignant constituted 90%. Conclusion: MSRSGC is an evidence based effective system for salivary gland FNAC. It provides better communication with clinicians and improves over all patient care.

Rare Unilateral Submucosal Lipoma of the Oral Cavity: A Case Report

Introduction: Lipoma is a common benign tumour of soft tissue. Although a common occurence in the trunk and proximal portions of extremities. Aims: To signifies the importance of diagnosis and that lipoma should be ruled out in case of any facial swelling in general dental practice. Case Report: Only few cases of lipoma or its variants have been reported in the oral cavity. accounting to about 1 to 5 % of all the neoplasms of the oral cavity. Other benign connective tissue lesions such as granular cell tumour, neurofibroma, traumatic fibroma and salivary gland lesions (mucocele and mixed tumour) might be included in differential diagnosis. Discussion: We here describe this rare occurence, its clinical and histological presentation and emphasize on the possibility of a differential diagnosis for swelling in oral cavity. Conclusion: In this study the importance of diagnosis and that lipoma should be ruled out in case of any facial swelling in general dental practice and that lipomas may show an increase in size, if left untreated.

Fine-Needle Aspiration Cytology of Salivary Gland Tumors Before the Milan System: Ten Years of Experience at a Tertiary Care Center in Turkey.

ObjectiveThe role of fine-needle aspiration cytology (FNAC) is well established for preoperative evaluation of patients with salivary gland lesions. However, the lack of a uniform system for salivary gland FNAC has limited its effectiveness. In recent years, the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) has been in use around the world to report the cytology results. We aimed to investigate the efficacy and accuracy of FNAC examined according to pre-MSRSGC era dichotomous benign/malignant classification in salivary gland tumors.MethodsPatients who underwent surgery between January 2011 and December 2020 due to major salivary gland tumors were retrospectively analyzed. Two hundred and four patients were included in the analysis. Preoperative FNAC results and final histopatological diagnoses were grouped as benign or malignant. Final histopatological diagnoses were compared with the preoperative FNAC results. Also, sensitivity, specificity, and accuracy of the preoperative FNAC results, as well as the agreement between both tests were investigated.ResultsThe sensitivity, specificity, accuracy, positive and negative predictive values of the preoperative FNAC for the diagnosis of malignancy were 59.09%, 97.85%, 93.75%, 76.47%, and 95.29%, respectively. There was a moderate agreement between the preoperative FNAC results and final histopatological diagnoses.ConclusionThe accuracy of the preoperative FNAC and the information given about malignancy risk are the most important criteria for patient management and decision-making. The MSRSGC, which consists of a six-tiered classification rather than a dichotomous “yes/no” system, may contribute to patient management and decision-making by increasing the efficacy and accuracy of FNAC.

Histopathological Review of Diagnostic Categories of the Milan System for Reporting Salivary Gland Cytopathology - An Institutional Experience of 6 Years.

Introduction:Salivary gland malignancies account for 2 to 4% of head and neck cancers. Fine needle aspiration cytology (FNAC) is used in preoperative diagnosis of salivary gland lesions. Although FNAC is a highly reliable technique for preoperative diagnosis, there were no consensus on salivary gland cytopathology reporting. Recently, an international group has recommended a classification system for salivary gland FNAC reporting titled “Milan System for Reporting Salivary Gland Cytopathology” (MSRSGC). In this study, we aimed to evaluate the usability of the Milan System, its ability to determine the risk of malignancy for each category, with comparisons of inital cytologic and final histopathological diagnosis.Materials and Methods:We performed a retrospective analysis of salivary gland lesion FNAC in our department from 2013 to 2019. A total of 578 FNACs were performed in 514 patients. Of these, 85 cases had surgical follow-up (parotid gland, n = 73, submandibular gland, n = 12). The cytological samples were categorized according to the MSRSGC into six categories by two pathologists. The risk of malignancy (ROM) and diagnostic accuracy values were calculated for each diagnostic categories.Results:A total of 85 aspirates of the patients with follow-up, the MSRSGC diagnostic categories were as follows: non-diagnostic in 7 aspirates (8.2%), non-neoplastic in 3 (3.5%), atypia of undetermined significance (AUS) in 9 (10.5%), benign neoplasm in 43 (50.5%), salivary gland neoplasm of undetermined malignant potential in 7 (8.2%), suspicious for malignancy in 10 (11.7%), and malignant in 6 (7%). The ROM for each category was 28, 5%, 0%, 33%, 0%, 28.5%, 90%, and 100%, respectively.Conclusion:FNAC plays a critical role in the evaluation of patients with salivary gland lesions. The MSRSGC helps in the standardization of the process of diagnosis and clinical management of salivary gland lesions, especially of AUS and SUMP categories that are indeterminate categories in nature.

Application of Milan System for Reporting Salivary Gland Cytopathology: A 7 Year Study

Introduction: Salivary gland shows various pathological conditions ranging from cystic, inflammatory, tumor like and neoplastic lesions. Fine needle aspiration cytology (FNAC) plays an important role in evaluating salivary gland (SG) tumors. Salivary gland tumors are one of the most heterogeneous groups of neoplasms with cytopathological features overlapping among the entities and making it difficult to assign to specific category. Due to these facts, salivary gland cytopathology is one of the most challenging areas of cytology. The lack of a uniform reported guidelines in salivary gland cytopathology leads to inter-observer variability and disagreements. The present study was undertaken to assess the degree of inter-observer reproducibility for diagnostic categorization of salivary gland lesions utilizing MSRSGC among pathologists with varying experience along with its role in providing a framework for reporting salivary gland lesions. Materials and Methods: In this cross sectional study, total of 44 cases of salivary gland lesions subjected to FNAC over a period of 7 year were studied. The cases were critically reviewed by 2 pathologists and a pathology resident with variable experience in cytopathology using MSRSGC in our institution. Inter-observer variability was assessed by comparing the agreement between two cytopathologists and pathology resident by using Cohen’s kappa statistics (Io score) and interpretation of the results was done using scale of Landis and Koch. Results: All the salivary gland aspirates were categorized according to MSRSGC.Out of 44 cases, maximum cases 22 (50%) were classified under IVA (BN) followed by 27.27% to 29.5% cases classified under II (NN), 2.27-4.55% of cases under Category IVB (SUMP), 4.55% under category V( SM) and 6.82% cases under category VI ( M). Inter-observer variability (IOV) was calculated for individual category in Milan system using Cohens kappa test, which was found to be in the almost perfect agreement range as per Landis and Koch, for categories II, IVA, V, VI ( Io score 0.89- 1). Kappa score ranged from 0.645 - 1 for category I (ND), which showed substantial to an almost perfect agreement. Whereas, category IVB (SUMP) showed variable results, with substantial agreement (Io score 0.656) to no agreement (Io score 0) between different observers.The overall IOV showed an almost perfect agreement with a kappa score of 0.861(obs1 vs 2) ,0.896 (obs1 vs R), 0.965 (obs 2 vs R). The data was found to be statistically significant (p=< .0001). Conclusion: MSRSGC is a very efficient system and has the potential to standardize salivary gland FNA diagnoses, providing clear prognostic and management information to clinicians and surgeons. This system can be used with good reproducibility between observers with variable cytopathology experience. Placing lesions in categories using MSRSGC can result in optimal management of discordant cases without using a specific diagnosis. Application of MSRSGC has immense value for standardization of reporting of salivary gland FNAC.Hence we recommend the use of Milan system for reporting salivary gland cytopathology.

Immunohistochemical expression of OCT4 and CD44 in major and minor salivary gland neoplasms.

The aim of this study was to identify tumor parenchyma cells exhibiting immunohistochemical profile of stem cells by evaluating the immunoreactivity of OCT4 and CD44 in a number of cases of salivary gland neoplasms. The sample consisted of 20 pleomorphic adenomas, 20 mucoepidermoid carcinomas, and 20 adenoid cystic carcinomas located in major and minor salivary glands. The expression of OCT4 and CD44 was evaluated by the percentage of positive cells and the intensity of expression. All studied cases showed positive expression of OCT4 and CD44 and higher values than the control groups. For OCT4, luminal and non-luminal cells were immunostained in the case of pleomorphic adenomas and adenoid cystic carcinomas. Moreover, the immunoreactivity of CD44 was particularly evident in the non-luminal cells of these lesions. In mucoepidermoid carcinomas, there was immunoreactivity for both markers in squamous and intermediate cells and absence of staining in mucous cells. For both markers, a significantly higher immunostaining was verified in neoplasms located in the major salivary glands compared with lesions in minor salivary glands (p<0.001). In the total sample and in minor salivary glands, malignant neoplasms exhibited higher immunoreactivity for OCT4 than pleomorphic adenoma. A significant moderate positive correlation (r = 0.444 and p ≤ 0.001) was found between OCT4 and CD44 immunoexpression in the total sample. The high expression of OCT4 and CD44 may indicate that these proteins play an important role in identifying tumor stem cells.

Classification of salivary gland lesions using Milan system for reporting salivary gland cytopathology (MSRSGC) - A Six-year retrospective study in our institution

Classification of salivary gland lesions using Milan system for reporting salivary gland cytopathology (MSRSGC) - A Six-year retrospective study in our institution

Study on role of cytology in diagnosis of head and neck lesions in a tertiary care hospital

Background: Head and neck lesions are commonly encountered in patients across all age groups. This region encompasses a multitude of congenital, inflammatory or neoplastic lesions. FNAC is a clinically appropriate procedure associated with minimal trauma and complications for patients for analysis of head and neck swellings because of factors such as easy approachability of the target site, increased compliance and helping to avoid surgery in non-neoplastic lesions, inflammatory conditions and also some tumors. Objective: This study is undertaken to assess the accuracy of cytopathological diagnosis of head and neck lesions by FNAC and to correlate and analyze FNAC of head and neck lesions with that of histopathological study. Material and Methods: The present study was Laboratory based Cross sectional descriptive type of observational study. A total of 100 cases undergoing FNAC among the head and neck lesion were enrolled for present study. FNAC was done using 10 cc disposable syringe and 22/23 gauge needle taking all aseptic precautions. Both aspiration and non-aspiration techniques were used wherever required. Smears were stained with PAP, Haematoxylin-Eosin stain and Leishman stain. Zeihl-Neelsen staining for acid fast bacilli was done in suspected tubercular lesions. Results: Out of 100 patients lymph node lesions (46%) was the predominant site of FNAC. Out of 46 lesions of Lymph node; tubercular lymphadenitis was the most common pathological findings. Among 28 thyroid lesion Colloid goitre (45.5%) was the predominant finding. Out of 18 salivary gland lesions the most common lesion was pleomorphic adenoma. Out of 14 soft tissue and miscellaneous lesions benign lesions were commonest finding. Conclusion: FNAC is a simple, rapid and cheap diagnostic tool that can be done as an outpatient procedure with overall accuracy rate of more than 90 % which differentiates non-neoplastic lesions from neoplastic lesions thus avoiding unnecessary surgeries.

A comparative study to assess diagnostic efficacy of fine needle aspiration cytology versus histopathology in diagnosis of salivary gland lesions

A comparative study to assess diagnostic efficacy of fine needle aspiration cytology versus histopathology in diagnosis of salivary gland lesions

Fine needle aspiration cytology-based spectrum of salivary gland lesions at a teaching institute in north India

Introduction: Salivary gland swellings can occur because of inflammation, cyst or neoplastic process. Neoplasms of salivary glands are relatively rare comprising less than 2% of all human tumors. Prevalence of salivary of gland lesions differ from place to place. There are more than 30 morphologically different types of salivary gland neoplasms; majority of which can be diagnosed on fine needle aspiration cytology with expertise. Material and methods: This was a retrospective observational study spanning over 5 years carried out in the department of Pathology, Shaheed Hasan Khan Mewati Government Medical College, Nalhar. Hundred and forty-seven patients with salivary gland swelling were included in the study. Result: Benign salivary gland neoplasm was the most common lesion (54.42%) followed by inflammatory lesions (20.40%). Pleomorphic adenoma (90%) was the most common benign tumor affecting predominantly female patient and mostly involving the parotid gland. Mucoepidermoid carcinoma was the most common malignant tumor (36.85%) followed by poorly differentiated carcinoma (26.31%). Benign tumors were more common in females, whereas malignant tumors occurred more frequently in males. Conclusion: Fine needle aspiration cytology is fast, reliable and relatively accurate method to give tissue-based diagnosis of salivary gland swellings. It helps the clinician to plan the treatment modality for the patients in short time.

Prevalence of oral mucocele among outpatients at saveetha dental hospital, india.

Oral mucoceles are the most common benign minor salivary gland lesions. It is of interest to document the prevalence of oral mucocele among outpatients at the Saveetha Dental Hospital, India. We used patient data (12 case records) with mucocele occurrence for this analysis. Data included age, gender, diagnosis, lesion duration and relevant dental history. Data shows that oral mucocele were seen predominantly in males (66%) when compared to females (34%). The most affected site in the oral cavity was the lower lip (58%). Thus, data shows that oral mucocele was predominantly seen in males compared to females. Data also shows that the lower lip is often affected.