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Background: Fine Needle Aspiration Cytology (FNAC) of the salivary gland is one of the most challenging in the field of cytopathology due to the wide spectrum of lesions. There is significant cytomorphologic diversity and overlap between many benign and malignant salivary gland tumours. Though FNAC is quite an effective tool for the diagnosis of salivary gland lesions, it has always been under scrutiny and histopathology continues to be the final method to establish a diagnosis.Methods: A total of 80 patients who presented with clinical diagnosis of salivary gland mass at the Department of Pathology, SMCH, Assam from August 2017 to August 2019 were included in the study. FNAC was performed in all the cases and the cytological findings were correlated with that of the histopathological findings (wherever possible).Results: The median age group of patients was in the range of 30-40 years (30%). 60 patients underwent surgical procedure and hence histopathological correlation could be done in these patients. Among the various diagnosis in FNAC, benign tumours constitute the majority with 36 cases (60%). The most commonly involved benign tumour was pleomorphic adenoma (27 cases). The overall sensitivity, specificity & diagnostic accuracy of FNAC were found to be 87.3%, 93.9% and 93.33% respectively.Conclusions: FNAC is a safe, reliable, time saving, cost-effective, convenient and accurate method and should be considered as one of the pivotal investigations in the evaluation of salivary gland lesions.
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Background: Fine needle aspiration cytology is an inexpensive, minimally invasive, outpatient diagnostic procedure. FNA of salivary gland is easier to perform as the site is superficial and repeat FNAC can be perform. As compared to biopsy methods, FNA is a very smooth, cheaper, outpatient procedure helping clinician to save his time for earlier diagnosis and treatment. Though anatomical structure of the gland is very simple, it is subjected to a diverse and heterogenous range of tumors.Methods: The present study on “Cytomorphological features of salivary gland lesion by FNAC” was carried out on department of pathology from June 2015 to June 2017. 65 patients with salivary gland lesions who were sent to pathology department for FNAC were aspirated and correlated histopathologically.Results: Benign salivary gland lesions contribute to majority of cases (54%). Pleomorphic Adenoma was the most common benign salivary gland lesions and Mucoepidermoid Carcinoma was most common malignant lesion. Parotid gland was the most commonly involved in benign tumors and submandibular gland was commonly involved by malignant tumors. Commonly affected age group by benign salivary gland lesion was 31-40 years and those with malignant salivary gland lesion was 41-50 years.Conclusions: FNA cytology provides useful information for the management of salivary gland lesions and prevents unnecessary surgery in cases of nonneoplastic lesions and identification of malignancy helps the surgeon in deciding type and extent of surgery.
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Background: There is a wide spectrum of salivary gland lesions with morphological and clinical diversity which makes it a difficult task for histopathological interpretation. Tumours of salivary glands are uncommon accounting for 3-10% of the total tumors of head and neck region and less than one percent of all tumours. The aim of this study was to recognize various histomorphological patterns of salivary gland lesions, their frequency, age, gender and site wise distribution.Methods: This study was carried out from June 2015 to May 2018 in the department of Pathology, JLN Medical College and associated Group of Hospitals, Ajmer. Total 121 cases of salivary gland lesions were included. Specimens were processed and stained by Hematoxylin and Eosin stain followed by histopathological examination.Results: Out of total 121 cases, 43.8% were non-neoplastic and 56.2% were neoplastic. In non-neoplastic lesions predominant was chronic sialadenitis (50.9%) followed by mucocele (28.3%) which commonly seen in submandibular gland (47.17%). Among neoplastic cases, 79.4% were benign and 20.6% were malignant lesions. Neoplastic lesions commonly were seen in parotid (75%). Pleomorphic adenoma was the commonest benign tumour (81.4%). Mucoepidermoid carcinoma was the most common malignant salivary tumour. Benign tumours were common in third and fourth decades, whereas malignant tumours were more common in fifth and sixth decades. Male predominance was seen in overall salivary gland lesions.Conclusions: Histopathological examination is mandatory in the diagnosis of salivary gland lesions because of their wide spectrum of histomorphology.
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Diagnosis of sialolithiasis usually needs the combination of clinical and imaging-based examination. The use of cone-beam computed tomography (CBCT) in patients with sialolithiasis has been increasing in dental practice in recent years. CBCT has some advantages in the diagnosis and treatment of sialolithiasis. However, CBCT should not be considered as the first choice for the diagnosis and treatment of sialolithiasis, and it is suitable to be used in the case of complex sialolithiasis which can not be diagnosed by traditional imaging methods. The research progress of the use of CBCT in the diagnosis of sialolithiasis is reviewed.
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Background: Fine needle aspiration cytology (FNAC) has been widely accepted as a safe method for diagnosis of salivary gland lesions and its accuracy is increased with increasing the experience of the physician. This study was conducted to examine the sensitivity, specificity and accuracy of FNAC of salivary gland lesions by cyto-histological correlation and to identify the discrepancies that contribute to false diagnoses. Method: A retrospective study was carried out over a 7-year period from 2003 to 2009 to review the cases of patients with salivary gland lesions who underwent FNAC with histopathological confirmation. Results: A total of 101 cases had cytological correlation of whom 76 (75.3%) were neoplastic (58.4% benign, 16.8% malignant) and 25 (24.7%) were nonneoplastic. Pleomorphic adenoma (PA) was the most frequent benign neoplasm while adenoid cystic carcinoma (ACC) was the most frequent malignant neoplasm. FNAC had a sensitivity of 80% and a specificity of 98.8% for overall benign and malignant diagnoses and positive predictive and negative predictive values of 92.3% and 96.4% respectively. The most common false negative cases were pleomorphic adenoma. Conclusions: This study demonstrated that FNAC of the salivary gland is a useful technique for diagnosis of salivary gland lesions. Combined with clinical and radiological findings, it can provide a preliminary assessment on which management decision can be based.
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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.
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Introduction: The salivary gland lesions are relatively common clinical problems and range from non neoplastic lesions like sialadenitis and cysts to benign and malignant tumors of different malignant potential. FNAC is generally first diagnostic test in such patients. The objective of current study was to study the age, sex and site distribution of salivary gland lesions, and to analyze sensitivity and specificity of FNA diagnosis of salivary gland tumors by correlating with histopathological examination whenever available. Method: FNAC of all 90 patients was done using 22-gauge needle and 10 ml syringe applying negative pressure. Smears were either wet fixed or air dried and stained by H & E and Giemsa stain respectively. The histopathological specimens when available were fixed overnight in 10% formalin, processed using automatic tissue processor, stained with routine H & E stain and special stain if required and reported by a pathologist without prior knowledge of FNA diagnosis. Sensitivity & specificity of FNA diagnosis of salivary gland tumors were then analyzed. Results and conclusion: A total of 90 cases of salivary gland lesions were diagnosed on FNA, showing an overall male predominance with male to female ratio being 1.43:1. The maximum incidence of salivary gland lesions was observed in IV decade of life in both male and female patients. There were 36 (40%) non neoplastic and 54 (60%) neoplastic lesions which included 42 (46.7%) benign and 12 (13.3%) malignant neoplasm. Parotid gland was the commonest affected site, followed by submandibular and minor salivary glands but malignant lesions were commoner in minor salivary glands followed by Parotid gland. 49 cases in which histopathological correlation was available, there were 9 non neoplastic and 40 neoplastic lesions. There was no false positive diagnosis but one false negative diagnosis. Overall sensitivity and specificity of FNAC of salivary gland tumors were 97.5 and 100% respectively, thus FNAC is quite useful in diagnosing salivary gland lesions.
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Background: Fine-needle aspiration (FNA) is an effective and safe procedure for analyzing salivary gland lesions. Various morphological and overlapping cytomorphology features can bring difficulty in diagnosis of the salivary gland lesions. This study aimed to evaluate the diagnostic accuracy of fine needle aspiration cytology of salivary glands lesions. Methods: There were 107 cases of cytology and 39 cases of histopathology of salivary gland lesions collected and reviewed from the archives of Anatomical Pathology Department, Faculty of Medicine, Universitas Indonesia / Cipto Mangunkusumo Hospital from 2005-2009. Seven cases of cytology were excluded, due to unsatisfactory specimens. Diagnostic test was applied to analyze the 39 pairs of cytology-histopathology cases. Results: There were 100 cases of salivary gland lesions cytology obtained, consisted of 27 negatives, eight cases inconclusive and 65 cases of neoplastic lesions. Of the 39 pair cases, fourteen cases showed result discrepancies between cytology and histopathology, with 3 false-negative cases and 1 false-positive case. The sensitivity and specificity of cytology analysis in differentiating malignant from non-malignant lesions were 82.35%, and 95.45% respectively, NPV 87.5% and PPV 93.34%. Conclusion: This study showed diagnostic accuracy of FNA cytology salivary gland lesions was varied, with 82.35% sensitivity and 95.45% specificity in differentiating malignant from non-malignant hence this information can still be used for case management.
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Salivary Glands , Biopsy, Fine-NeedleABSTRACT
Background: Mast cells with a battery of crucial chemical mediators in their typical metachromatic granules are known to play a role in health and various disease states in man. This study was undertaken to evaluate the mast cell profile in some commonly encountered benign and malignant salivary gland neoplasms. Materials & Methods: The present study was carried out in the Department of Pathology, M.R. Medical College, Gulbarga over a period of 5 years (3 years retrospective i.e., from August 2003 to August 2006 and 2 years prospective study i.e., from September 2006 to August 2008) which included a total of 50 cases each of control and study groups. Sections were stained with H&E and 1% aqueous toluidine blue (pH=4) for mast cells. The mast cell count was performed per 10 HPF, tabulated, analyzed and statistically evaluated. Results: A significant (p<0.001) increase of mast cell was observed in commonly encountered salivary gland neoplasm’s when compared with that of control group. Mast cell count was significantly increased in Pleomorphic adenoma as compared to basal cell adenoma and oncocytoma. Mast cell count was significantly more (p<0.05) in malignant tumor as compared to benign tumors of salivary gland. Conclusion: The present study documents striking mast cell alteration in some common salivary gland lesions. Mast cell profile may be used as an additional diagnostic or supportive parameter to differentiate between malignant versus benign lesions of salivary gland in addition to other diagnostic parameters.