Diagnostic Accuracy of Fine Needle Cytology in Salivary Gland Lesions – Experience At A Tertiary Care Hospital
Journal Title: Journal of Fatima Jinnah Medical University Lahore - Year 2017, Vol 11, Issue 4
Abstract
Background: Swellings of salivary gland origin comprise different types of benign and malignant lesions which can be diagnostic challenge to the surgeons and pathologists. Fine needle aspiration cytology (FNAC) is considered a valuable preoperative diagnostic tool used for evaluation of such swellings. The aim of this study is to evaluate diagnostic accuracy of fine needle aspiration cytology in various salivary gland lesions. Methods: This prospective observational study was done at Department of Surgery, Surgical Unit II of Sir Ganga Ram Hospital in collaboration with Department of Pathology, Fatima Jinnah Medical University (SGRH/FJMU) Lahore from January 2013 till December 2017. All patients with salivary gland lesions presented to surgical outdoor underwent FNAC after thorough history and detailed examination. All FNACs were done at Pathology department of this institute. Patients identified, to have lesions requiring surgery, clinically or based on FNAC report, were admitted for subsequent surgical procedures. Excised specimens were confirmed by histopathology (HP) and the results of FNAC and HP were compared. The diagnostic accuracy of the fine needle cytology in terms of sensitivity, specificity, and accuracy was evaluated. Results: Mean age was 35 years. Out of 65 patients operated for various reasons, 26 (40%) were males and 39 (60%) females; male to female ratio being 1:1.5. The FNAC findings of salivary lesions were: benign 62 (95.38%) and malignant 3 (4.6%). When compared with histopathology of the same lesions, 58 (89.2%) specimens were reported as benign (89.23 %) and 7 (10.76 %) as malignant. Mucoepidermoid cancer was missed in all 4 patients. Comparison of cytology and histopathology for neoplastic lesions as true negative, true positive, false negative, and false positive respectively was 58, 3, 4, and zero. The sensitivity, specificity, and accuracy for FNAC were calculated as 42.85%,100% and 93.84% respectively. Conclusion: The results of this study show that FNAC is a relatively reliable, quick and convenient method for preoperative diagnosis of salivary gland lesions having an accuracy of 93.8%. However, it is recommended that negative cytology report of a clinically suspicious lesion should be further evaluated by appropriate imaging and repeat image-guided cytology should be considered. False negative reports need to be communicated to the histopathologist for further improvement in technique and reporting.
Authors and Affiliations
HAYAT ULLAH KHAN, KAMRAN KHALID, IMRAN YOUSAF
Keywords
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