Fine Needle Aspiration Cytology of Salivary Gland Lesions with Categorization Based on Milan System – a 5-YEAR Retrospective Study (original) (raw)
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Fine needle aspiration cytology (FNAC) is a simple ,accurate ,inexpensive and minimally invasive technique used to diagnose different types of masses 1. Salivary gland tumours are rare and they account for 2-6.5% of all head and neck neoplasms in adults 1. Their superficial location ,easy accessibility and high diagnostic accuracy makes FNAC a valuable method for evaluation ,thus appropriate therapeutic management could be planned earlier 2. The aim of this study was to analyze the sensitivity and specificity of FNAC in the diagnosis of various salivary gland lesions and its correlation with histopathology wherever available and to evaluate the age ,sex and site distribution of salivary gland lesions. 60 patients with salivary gland swelling were studied prospectively over a period of 1 yr. FNAC was done using 10cc syringe and 20-22G needle after taking informed consent of the patient,. Smears were stained with papanicoloau stain and Giemsa stain. Histopathology was assessed on routine H &E stains Out of 60 cases ,43.3% were non neoplastic lesions ,the maximum no. of cases were of chronic sialadenitis. 56.7%cases were neoplastic(58.8% benign and 41.2%were malignant).Pleomorphic adenoma was the most frequent benign neoplasm while acinic cell carcinoma was the most frequent malignant lesion. Maximum cases were seen in parotid (73.3%) followed by submandibular gland (23.3%).Out of 60 cases, histopathology of 32 cases was available. A cytohistologic concordance was achieved in 93.75% of the lesions. There were 2 false negative cases diagnosed on FNAC. The sensitivity and specificity of the method was 93.75% and 100%respectively. FNAC is a safe and reliable technique in the primary diagnosis of salivary gland lesions. FNAC has a high diagnostic accuracy ,though rate of characterization of specific type of tumour is lower ,due to variable cytomorphology. In such cases , histopathology examination may prove to be accurate for diagnosis 2 .
2015
Objective: To elucidate the cytomorphological features of various salivary gland lesions and explore the diagnostic accuracy and pitfalls of FNAC. Materials and methods: 130 patients with various salivary gland lesions referred to the cytology lab of our institute over a period of two years were taken up for the study. FNAC was done with prior consent after recording the relevant clinical details. Only 61 patients who underwent surgery ultimately were included in the study. Results: In the present study, we obtained 130 cases of salivary gland lesions on which FNAC was done in the cytology department of our institute. The age range of the group varied from 1year to 88 years with a mean age of 45 years. Biopsy confirmation of diagnosis was available in 61 cases. Benign tumors constituted the largest category followed by malignant tumors and inflammatory lesions. Pleomorphic adenoma was the most common benign tumor and mucoepidermoid carcinoma was the most common malignant tumor in ou...
Journal of Pharmaceutical Research International
Aim: Fine needle aspiration cytology is an essential diagnostic tool for preoperative diagnosis of salivary gland lesions. Due to overlapping cytological features and heterogenecity of the lesions, a universal classification system was proposed, known as the “Milan System of Reporting Salivary Gland Cytopathology (MSRSGC). This system helps clinicians to plan further diagnosis and management according to the risk of malignancy (ROM) in different categories. Therefore, the aim was to stratify the lesions according to the system and calculate the risk of malignancy. Study Design: Retrospective and prospective study. Place and Duration of Study: Department of Pathology, Dr.D.Y.Patil Medical College, Hospital and Research Centre, Pune, between August 2016 and July 2021. Methodology: A five year study was conducted on 100 cases. FNAC was performed and correlation to histopathological aspects of resected and/or biopsied lesions were carried out in which tissue specimens were available. T...
Indian journal of applied basic medical sciences, 2020
BACKGROUND: Salivary gland swellings can result from tumors, an inflammatory process or cyst. Fine needle aspiration cytology(FNAC) is a diagnostic tool for evaluating neoplastic and non neoplastic swelling of salivary gland. The objective of this study was to evaluate the diagnostic accuracy and sensitivity and specificity of fine needle aspiration cytology in numerous salivary gland lesions and with its histopathological correlation. METHOD: The study was conducted in department of pathology; Amc met medical college, Ahmedabad, Gujarat, India, for duration of 1 year from January 2019 to January 2020. During the study period 44 cases of fine needle aspiration cytology of salivary gland lesions were performed. Formalin fixed (10%), surgically resected specimens were received and prepared for histopathological salivary gland lesion diagnosis. RESULT: During the study period 998 FNAC were undertaken of which 44 FNAC were of salivary gland swelling. Correlation of cytology from FNAC with histopathology tissue was possible in 9 cases, for which FNAC data was available. 62 % were from male and 38 % were from female patients. The age of patient ranged from 8 to 85 Years. 15 cases were benign swellings. 8 cases were malignant, 7 cases were cysts and 14 cases had an inflammatory etiology. CONCLUSION: Fine needle aspiration cytology (FNAC) is highly sensitive and specific procedure for diagnosis of salivary gland lesions.
https://www.ijrrjournal.com/IJRR\_Vol.7\_Issue.2\_Feb2020/Abstract\_IJRR0032.html, 2020
Introduction: Fine needle aspiration cytology (FNAC) is a well established technique for categorization of salivary gland lesions preoperatively. It has apt sensitivity and specificity to diagnose various salivary gland pathologies. However, there is lack of uniformity in reporting of various pathologists. This results in lack of appropriate communication and management of the patients. To overcome this problem 'Milan system for reporting of salivary gland cytopathology' (MSRSGC) was introduced. Aims and Objectives: This is a retrospective study to reclassify the previously diagnosed salivary gland lesions and to evaluate the risk of malignancy in different categories. Material and methods: The clinical details, FNAC smears, histological reports were retrieved from the hospital records and the cases were reclassified according to Milan system. False positive, false negative, true positive and true negative cases were calculated by comparing with the final histopathological diagnosis and then the accuracy and risk of malignancy of each diagnostic category were calculated. Results: A total of 288 cases were included in the study of which histological follow up was present in 118 cases. The sensitivity, specificity, negative predictive value and positive predictive value were 78.57 %, 98.83 %, 90.43 % and 97.06 % respectively. The overall diagnostic accuracy to differentiate the benign and malignant cases was 92.19%. Also, the risk of malignancy in each category was 20%, 14.3%,
Fine-Needle Aspiration Cytology of Salivary Gland Lesions: A Systematic Review
Journal of Oral and Maxillofacial Surgery, 2010
Objective: Fine needle aspiration (FNA) cytology aims to assist the clinician in the management of patients with salivary gland (SG) masses. We aimed to present our twelve -year experience concerning FNA in SG lesions to address the importance of this procedure. Study Design: Aspirates of 221 cases from SG lesions were reviewed retrospectively. In 151 cases, the FNA diagnosis was consistent with histologic findings. Results: FNA diagnoses were benign in 72.8 %, and malignant in 19.2% of the cases. Eleven cases were reported as suspicious for malignancy. The diagnostic sensitivity was 94% and specificity was 100%. Eight of 43 malignant cases were clinically referred with no evidence for a malignant tumor initially, but FNA was reported as malignant or suspicious for malignancy. Conclusions: Our study documents that FNA is a highly sensitive and specific procedure. It provides preoperative recognition of benign and malignant tumors. Besides that, it helps to prevent unnecessary surgery in SG swellings. To our knowledge, this article is the largest series in Turkish literature concerning FNA of SG. We think that our results are suggestive for FNA to be a primary diagnostic tool in SG lesions.
Annals of Pathology and Laboratory Medicine
Background: Fine needle aspiration cytology (FNAC) of salivary glands is one of the most commonly done first line investigations in the head and neck region. A wide variety of benign and malignant tumors originate in the salivary glands and insufficient tumor cells make their diagnosis difficult in some patients. The aim of this study was to evaluate the efficacy of fine-needle aspiration cytology in the diagnosis of salivary gland lesions by correlating cytological findings with histopathology. Methods: All the FNAC slides of salivary gland lesions received at our tertiary hospital for a period of 6years from January 2013 to July 2017were reviewed retrospectively. Histopathological correlation was done for cases wherever available Result: FNAC categorized 50% of the salivary gland lesions as neoplastic and 50% as non-neoplastic lesions. Amongst the neoplastic lesions, 64.28% were benign and 35.72%were malignant cases. Histopathological examination revealed that 66.64% of the cases were benign and 33.36% were malignant. Fine needle aspiration cytology had a sensitivity, specificity and diagnostic accuracy of 75%, 100% and 94.05%, respectively. The positive predictive value and negative predictive value were 100% and 92.75%, respectively. Conclusion: Fine needle aspiration of the salivary gland is a safe and reliable technique in the primary diagnosis of salivary gland lesions. This study has shown that fine needle aspiration cytology has a high sensitivity, specificity and diagnostic accuracy in diagnosing salivary gland lesions. Being an rninimally invasive procedure, FNA of salivary glands continues to be an important diagnostic tool in the preoperative diagnosis of salivary gland lesions despite few pitfalls in diagnosing due to cytomorphological overlapping
Cytomorphological Spectrum of Salivary Gland Lesions by Fine Needle Aspiration Cytology
https://www.ijrrjournal.com/IJRR\_Vol.8\_Issue.7\_July2021/IJRR-Abstract057.html, 2021
Introduction: Salivary gland lesions encompass a baffling subset of lesions with overlapping morphologies on cytomorphology, due to their heterogenous histologies and rare enough to sometimes bewilder even the most knowledgeable cytopathologists. The technique of fine needle aspiration (FNA) cytology in the evaluation of salivary gland lesion is simple to perform, saves time, reliable, safe and inexpensive. FNA is highly accurate when used in proper clinical setting and supported by appropriate clinical and relevant diagnostic data. Rapidity of obtaining a pathological diagnosis allows more intelligent therapeutic approach. Materials and Methods: It was a prospective study carried out in the cytology section of pathology department for a period of two years using fine needle aspiration as a diagnostic tool as per standard protocol. The clinical and radiological data were obtained from the patient’s case papers and collaboration with the operating surgeon, the lesions were analysed on cytology. Haematoxylin & Eosin, Papanicolaou stain and Giemsa were used as standard stains. Results: A total of 66 cases of salivary gland lesions were aspirated for a period of two years. Majority of cases were in the age group of 21-30 years with 36 male patients (55%) and 30 female patients (45%). About 44(66.7%), 19(28.8%), 1(1.5%) and 2(3.0%) cases occurred in parotid gland, submandibular gland, sublingual gland and minor salivary gland respectively. There were 21(32%) cases of non-neoplastic lesions and 45(68%) cases of neoplastic lesions. Histopathological specimens were available in 11 out of 66 cases and showed correlation with cytological findings. Conclusion: Fine needle aspiration cytology of salivary gland lesions has high diagnostic accuracy, helps in appropriate therapeutic management and is useful as a diagnostic procedure because of the availability of earlier diagnosis in comparison with the histopathology.
Oral surgery, oral medicine, oral pathology and oral radiology, 2014
The purpose of this study was to assess the efficacy and reproducibility of the cytologic diagnosis of salivary gland tumors (SGTs) using fine-needle aspiration cytology (FNAC). The study aimed to determine diagnostic accuracy, sensitivity, and specificity and to evaluate the extent of interobserver agreement. We retrospectively evaluated SGTs from the files of the Division of Pathology at the Clinics Hospital of São Paulo and Piracicaba Dental School between 2000 and 2006. We performed cytohistologic correlation in 182 SGTs. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 94%, 100%, 100%, 100%, and 99%, respectively. The interobserver cytologic reproducibility showed significant statistical concordance (P < .0001). FNAC is an effective tool for performing a reliable preoperative diagnosis in SGTs and shows high diagnostic accuracy and consistent interobserver reproducibility. Further FNAC studies analyzing large sa...
A study of fine needle aspiration cytology in salivary gland lesions in a rural population
International Journal of Advances in Medicine
Background: Fine needle aspiration cytology (FNAC) of suspected salivary gland lesions has an established role in preoperative diagnosis and management of patients. However diverse morphological patterns and overlapping features make it a challenging job, to give a precise diagnosis at times.Methods: This was a prospective study done from October 2011 to October 2013. Fine needle aspiration cytology was performed in 64 patients with clinically significant salivary gland lesions.Results: Fine needle aspiration cytology categorized 38 (59.4%) of the salivary gland lesions as neoplastic and 26 (40.6 %) as non- neoplastic lesions. Amongst the neoplastic lesions, 86.9% were benign and 13.2% were malignant cases.Conclusions: FNAC of the salivary gland is simple, cheap, safe and reliable technique in the primary diagnosis of salivary gland lesions.