Cytopathological study of salivary gland lesion in patients at a tertiary care centre, Indore: a one-year study
Keywords:Benign, FNAC, Malignant, Salivary gland tumours, Sensitivity, Specificity
Background: Fine needle aspiration cytology (FNAC) is being increasingly used in the diagnosis of salivary gland lesions. However, the diagnosis is still difficult sometimes. Salivary gland lesions account for 2-6.5% of all the neoplasms of the head and neck. The objective of this study was to evaluate the diagnostic accuracy and the sensitivity and specificity of FNAC in various salivary gland lesions and their histological correlation wherever possible.
Methods: A total of 123 FNACs were done on salivary gland swellings in the Department of Pathology, M.G.M. Medical College, Indore, Madhya Pradesh, India. The PAP stained cytological and H and E stained histopathological slides were studied and correlated.
Results: On FNAC, slides were studied and analyzed and the following lesions were observed: Inflammatory lesion (69), Inflammatory cystic lesion (1), Pleomorphic adenoma (29), monomorphic adenoma (1), Warthin’s tumour (2), Benign Cystic lesion (4), Benign lesion (not specified) (4), Adenoid cystic carcinoma (3), Mucoepidermoid carcinoma (2), Metastatic carcinoma (3), and malignant tumour (unspecified) (5). Histopathological correlation was available in 41 cases and studied respectively.
Conclusions: The overall sensitivity, specificity and the diagnostic accuracy were 90.2%, 97.6%, and 90.2%, respectively. Hence, the appropriate therapeutic management could be planned earlier. This study documents that FNAC of the salivary gland tumours is accurate, simple, rapid, inexpensive, well tolerated and harmless procedure for the patient.
Mavec P, Eneroth CM, Franzen S, Moberger G, Zajicek J. Aspiration biopsy of salivary gland tumours. Acta Otolaryngol. 1964;58:471-84.
Persson PS, Zettergren L. Cytological diagnosis of salivary gland tumours by aspiration biopsy. Acta Cytol. 1973;17:351-4.
Cohen MB, Fisher PE, Holly EA, Ljung BM, Lowhagen T, Bottles K. Fine needle aspiration biopsy diagnosis of mucoepidermoid carcinoma. Statistical analysis. Acta Cytol. 1990;34:43-9.
Jerzy K. Head and neck; salivary glands. In: Orell SR, Strett GF, Whitaker D (eds.) Fine Needle Aspiration cytology. 4th ed. Churchill Livingstone. Elseiver; 2005.
Suen KC. Atlas and Text of Aspiration Biopsy Cytology. Baltimore, Md: Williams and Wilkins; 1990.
Dutta1 NN, Baruah R, Das L. Adenoid cystic carcinoma - clinical presentation and cytological diagnosis. Indian J Otolaryngol Head and Neck Surg. 2002:54(1):62-4.
Zhao YF, Jia Y, Chen XM, Zhang WF. Clinical review of 580 ranulas, Endodontol. 2004;98(3):281-7.
Chidzonga MM, Mahomva L. Ranula: experience with 83 cases in Zimbabwe. J Oral Maxillofac Surg. 2007;65(1):79-82.
Nitin MN, Sandeep B, Arjun D, Surinder K. Singhal HM. Salivary gland tumors - our experience. Indian J Otolaryngol Head Neck Surg. 2004;56(1):31-4.
Cristallini EG, Ascani S, Farabi R, Liberati F, Macciò T, Peciarolo A, et al. Fine needle aspiration biopsy of salivary gland, 1985-1995. Acta Cytol 1997;41:1421-5.
Boccato P, Altavilla G, Blandamura S. Fine needle aspiration biopsy of salivary gland lesions: a reappraisal of pitfalls and problems. Acta Cytol. 1998;42:888-98.
Cajulis RS, Gokaslan ST, Yu GH, Frias-Hidvegi D. Fine needle aspiration biopsy of the salivary glands: a five-year experience with emphasis on diagnostic pitfalls. Acta Cytol. 1997;41:1412-20.
Atula T, Grénman R, Laippala P, Klemi PJ. Fine-needle aspiration biopsy in the diagnosisof parotid gland lesions: evaluation of 438 biopsies. Diagn Cytopathol. 1996;15:185-90.
Yang GCH, Kuhel WI. Uncommon tumors of the salivary gland in fine needle aspiration biopsies: A surgeon’s perspective. Acta Cytol. 1997;41:1015-22.
Mavec P, Eneroth CM, Franzén S, Moberger G, Zajicek J. Aspiration biopsy of salivary gland tumors. I. Correlation of cytologic reports from 652 aspiration biopsies with clinical and histologic findings. Acta Otolaryngol. 1964;58:471-84.
Frable WJ, Frable MAS. Thin needle aspiration biopsy: The diagnosis of head and neck tumors revisited. Cancer. 1979;43:1541-8.
Lampe HB, Cramer HM. Advances in the use of fine-needle aspiration cytology in the diagnosis of palpable lesions of the head and neck. J Otolaryngol 1991;20:108-16.
Chan MKM, McGuire LJ, King W, Li AKC, Lee JCK. Cytodiagnosis of 112 salivary gland lesions: Correlation with histologic and frozen section diagnosis. Acta Cytol. 1992;36:353.
Masanja MI, Kalyanyama BM, Simon EN. Salivary gland tumours in Tanzania. East Afr Med J. 2003;80:429-34.
Schneider AB, Lubin J, Ron E, Abrahams C, Stovall M, Goel A, et al. Salivary gland tumors after childhood radiation treatment for benign conditions of the head and neck: Dose-response relationships. Radiat Res. 1998;149:625-30.
Ito FA, Jorge J, Vargas PA, Lopes MA. Histopathological findings of pleomorphic adenomas of the salivary glands. Med Oral Patol Oral Cir Bucal. 2009;14:E57-61.
Lima SS, Soares AF, de Amorim RF, Freitas Rde A. Epidemiologic profile of salivary gland neoplasms: analysis of 245 cases. Braz J Otorhinolaryngol. 2005;71:335-40.
Faur A, Lazar E, Cornianu M, Dema A, Vidita CG, Galuscan A. Warthin tumor: a curious entity - case reports and review of literature. Rom J Morphol Embryol. 2009;50:269-73.
Teymoortash A. Head and neck: salivary gland tumors: Warthin's tumours. Atlas Genet Cytogenet Oncol Haematol. 2009;13(4):312-5.
Mistry D, Sood S. Benign salivary gland tumours. CME bulletin otolaryngology. Head Neck Surg. 2004;8:49-52.
Boccato P, Altavilla G, Blandamura S. Fine needle aspiration biopsy of salivary gland lesions: a reappraisal of pitfalls and problems. Acta Cytologica. 1998;42(4):888-98.
Das DK, Petkar MA, Al-Mane NM, Sheikh ZA, 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 Principles Pract. 2004;13(2):95-106.
Mavec P, Eneroth CM, Franzen S, Moberger G, Zajicek J. Aspiration biopsy of salivary gland tumors I: correlation of cytologic reports from 652 aspiration biopsies with clinical and histologic findings. Acta Otolaryngol Stockh. 1964;58:471-84.
Schoeman BJ, Clifford SD. The incidence of malignancy in neoplasms of the submandibular salivary gland. S Afr J Surg. 2007;45:134-5.
Eglis K, Juris T, Gunars L. Treatment of parotid gland tumours in latvian oncological center. Stomatologija Baltic Dent Maxillofac J. 2005;7:110-4.
Holger N, Hermann HJ, Rainer L, Reinhard C, Manfred D. Cytologic diagnosis of adenoid cystic carcinoma of the salivary glands. Diagn Cytopathol. 1999;20:358-66.
Fakhry N, Antonini F, Michel J, Penicaud M, Mancini J, Lagier A, et al. Fine-needle aspiration cytology in the management of parotid masses: evaluation of 249 patients. Eur Ann Otorhinolaryngol Head Neck Dis. 2012;129:131-5.
Dasa DK, Petkarc MA, Al-Maneb NA, Sheikhb ZA, Mallikb MK, Anima 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;13:95-106.