ABSTRACT
Background: Management of salivary gland lesions is greatly influenced by preoperative or intraoperative diagnosis of malignancy. Fine needle aspiration cytology (FNAC) is used as a primary diagnostic tool since long. Objective: The objective of study was to evaluate usefulness and diagnostic accuracy of FNAC in primary diagnosis of salivary gland lesions. Methods: Study includes 75 cases suspected of salivary gland lesions evaluated by FNAC from January 2010 to August 2012. Whenever possible follow up histopathology also studied. Results: Out of total of 75 cases of salivary gland lesions 30 cases (40%) were nonneoplastic, 30 cases (40%) were benign and 15 cases (20 %) were malignant. FNAC showed satisfactory sensitivity and specificity with about 91% diagnostic accuracy for benign lesions and for malignant lesions. Conclusions: Study concludes that FNAC has proven to be simple, easy, minimally invasive method with satisfactory accuracy for initial diagnosis of Salivary gland lesions especially benign and malignant neoplasms. It almost accurately type benign tumors like pleomorphic adenoma and showed fair accuracy and reliability. FNAC is vital for management primarily to exclude need of surgery as nonneoplastic lesions are managed conservatively and planning preoperative chemoradiation like in cases of Mucoepidermoid carcinoma arising in odd locations like palate.
ABSTRACT
Background: Biopsy method of choice is a controversy issue for diagnosis of soft tissue sarcoma which are traditionally been managed by wide excision surgery and radiotherapy. Chemotherapy is reserved for advanced cases. Aims & Objective: The objective of study was to evaluate diagnostic accuracy of various modes of biopsy focusing on image guided core needle biopsy (CNB). Material and Methods: Current study includes 50 cases of soft tissue sarcoma from January 2010 to October 2012. The Mode of biopsies included image guided CNB, open and excision biopsy. Effective accuracy of each was determined by accuracy of biopsy to provide adequate tissue for histopathological and other special examinations like immunohistochemistry to reach final diagnosis. Results: Out of total 50 cases CNB was done in 13 cases, open biopsy in 2 cases and in 35 cases excision biopsy was done. CNB was adequate in 92.31 % cases and 7.69 % cases it was inadequate. Open and excision biopsy were 100 % adequate. Conclusion: Image guided CNB is very helpful in early diagnosis and shows high accuracy especially for high-grade sarcoma. It is less invasive compared to others and differentiate benign from malignant. It is handful when preoperative diagnosis is essential for planning pre-operative chemotherapy especially in patients with primarily inoperable, advanced tumour with compromised performance status or recurrent tumour. But it should be properly directed and representative of whole tumour and require full radiological correlation by experienced hands. Tumours with myxoid pattern, lipomatous tumours and low grade sarcomas encounters lower diagnostic accuracy on CNB.