Clinicopathological study of salivary gland tumors: An observation in tertiary hospital of central India
Keywords:Salivary gland tumors, FNAC, WHO classification
Background: The salivary glands are one of the few tissues in the body that are subjected to diverse and heterogeneous range of tumors and tumor like conditions. The relative infrequency of these tumors makes their diagnosis and management quite complicated. Fine needle aspiration cytology (FNAC) is a useful diagnostic procedure which has a recognized role in the evaluation of salivary gland lesions. A pre-operative diagnosis about nature of lesion, whether benign or malignant, will help in making decision about proper management of patient.
Objective: Aim of this study was to know the epidemiology of salivary gland tumors in our region and to evaluate sensitivity, specificity and diagnostic accuracy of fine needle aspiration cytology taking histopathology as the gold standard.
Method: It was prospective observational study conducted in department of pathology in our institute. Total 100 cases were studied with particular reference to age, sex, site, cytologic details & histological types as per WHO classification. FNAC & histopathological examination was done in all cases. Correlation between cytological & histopathological diagnoses was assessed. Diagnostic accuracy of FNAC was evaluated by comparing cytological & histopathological diagnoses.
Results: Parotid gland was the most common site of involvement (70% cases). Maximum number of patients was in age range of 41-50 years & male to female ratio was 0.8:1. Most common benign & malignant tumors were pleomorphic adenoma (69.89% cases) & mucoepidermoid carcinoma (8.60% cases) respectively. On cytology, 93 cases while on histopathology 96 cases were diagnosed as neoplastic. Cytological diagnoses correlated with histopathological diagnoses in 94% cases. Sensitivity, specificity & diagnostic accuracy of FNAC were found to be 96.87%, 100% & 96% respectively.
Conclusion: FNAC in salivary gland masses is fairly reliable for correct preoperative diagnosis. Multiple sampling and special attention to cytologic features should help to minimize errors.
Ahmed S, Lateef M, Ahmed R. Clinicopathological study of primary salivary gland tumors in Kashmir. J-K practitioner. 2002;9:231-3.
Frable MA, Frable WJ. Fine needle aspiration biopsy of salivary galands. Laryngoscope. 1991;101: 245-9.
Cristallini EG, Ascani S, Farabi R, Liberati F, Maccio T, Peciarolo A. Fine needle aspiration biopsy of salivary gland 1985-1995. Acta Cytol. 1997;41:1421-25.
Stewart CJR, Mackenzie K, McGarry GW, Mowat A. Fine needle aspiration cytology of salivary glands: A review of 341 cases. Diagn Cytopathol. 2000; 22:139-46.
Rajwanshi A, Gupta K, Gupta N, Shukla R, Shrinivasan R, Nijhawan R. Fine needle aspiration cytology of salivary glands: Diagnostic pitfalls- Revisited. Diagn Cytopathol. 2006;34:580-84.
Agarwal RV, Solanki BR, Junnarkar RV. Salivary gland tumors. Ind J Cancer. 1967;4(2):209-13.
Potdar GG, Dabhoiwala NF, Golwala RM. Parotid tumors. Indian J Surgery. 1969;31:341-9
Thomas KM, Hutt MSR, Borgstein J. Salivary gland tumors in Malawi. Cancer. 1980;46:2328- 34.
Cajulis RS, Gokaslan ST, Yu GH, Frias-Hidvegi D. Fine needle aspiration biopsy of salivary glands A five-year experience with emphasis on diagnostic pitfalls. Acta Cytol. 1997;41:1412-20.
Boccato P, Altavilla G, Bladamura S. Fine needle aspiration biopsy of salivary gland lesions- a repraisal of pitfalls and problems. Acta Cytol. 1998;42:888-98.
Elagoz S, Gulluoglu M, Yilmazbayhan D, Ozer H, Arslan I. The value of FNAC in salivary gland lesions. J Otorhinol laryngol. 2007:69(1):51-6.
Gerhard S, Leslie HS. The World Health Organization’s histological classification of salivary gland tumours: a commentary on the second edition. Cancer. 1992;70:379-85.
Azzopardi J, Evans D. Malignant lymphoma of parotid associated with Mikulicz disease (benign lymphoepithelial lesion). J Clin Path. 1971;24:744-52.
Hyman GA, Wolff M. Malignant lymphomas of the salivary glands. Review of the literature and report of 33 new cases, including four cases associated with the lymphoepithelial lesion. Am J Clin Pathol. 1976;65(4):421-38.
Klijanienko J, Vielh P. Fine needle sampling of salivary gland lesions. Cytology and histology co-relation of 71 cases of Warthin’s tumor. Diagn Cytopathol. 1997;16:221-5.
Akhter J, Lakhay M, Hirachand S. Role of FNAC in the diagnosis of salivary gland swellings. Kathmandu Univ Med J. 2008:6(2):204-8.
Das DK, Petkar MA, Al-Mane NM, Mallik MK, Anim JT. Role of fine needle aspiration cytology in the diagnosis of swellings in the salivary gland regions: A study of 712 cases. Med Princ Pract. 2004;3:95-106.
Stow N. Fine needle aspiration cytology in the management of salivary gland tumors: an Australian experience. Ear, Nose and Throat Journal. 2004; 83(2):128-31.