The accuracy of fine-needle aspiration cytology for diagnosis of parotid gland masses: a clinicopathological study of 114 patients

ABSTRACT Objective Fine-needle aspiration cytology is a valuable method for preoperative assessment of head and neck tumors. However, its accuracy in detection of salivary gland masses is controversial compared with other methods. The aim of this work was to evaluate the effectiveness and accuracy of fine-needle aspiration cytology (FNAC) in the diagnosis of parotid gland masses. Material and Methods Over a 10-year period, 126 parotid gland masses were resected. Retrospective chart reviews of 114 patients were performed. The results of FNAC and final histological diagnosis were compared and the accuracy of FNAC was determined. Results Final histological evaluation revealed 11 malignant tumors and 103 benign lesions. Pleomorphic adenoma was the most common neoplasm (63%), followed by Warthin’s tumor (17.5%). The sensitivity of FNAC in detecting malignant tumors was 73% and the specificity was 97%. Positive predictive value (PPV) was 73% and negative predictive value (NPV) was 97%. The overall accuracy of FNAC in detecting parotid masses was 95%. False-negative diagnosis was found in mucoepidermoid carcinoma, acinic cell carcinoma, and epithelial-myoepithelial carcinoma whereas there was false-positive diagnosis in cases of pleomorphic adenoma and normal parotid gland tissue. Conclusion FNAC is a reliable minimally invasive diagnostic method with a high sensitivity in diagnosis of lesions in parotid glands. The sensitivity of detection of malignant tumors in parotid glands was low due to the biopsy technique used, and depended on tumor location. Postoperative complications decreased after superficial parotidectomy.

CT findings of tuberculous lymphadenitis in parotid gland / 中华放射学杂志

Objective To analyze the CT findings of tuberculous lymphadenitis in parotid gland, so as to improve the diagnostic accuracy of tuberculosis of parotid gland. Methods Nine cases with tuberculous lymphadenitis in parotid gland confirmed by surgical pathology and acid-fast bacilli after preoperative spiral CT plain scan and two phases dynamic enhancement scan were retrospectively analyzed.Imaging findings of CT were reviewed and compared with surgical pathology. Results Seven of the 9 cases of tuberculosis of the parotid gland occurred in the left side, and 2 in the right side, and superficial lobe involvement occurred in 8 cases and deep lobe in 1 ease. The lesion was classified as tumour type (8 cases)and infiltration type (1 case). In tumour type, the number of lesion was from 1 to 4, and the size was from 2.7 to 5.3 cm in diameter. One case of infiltration type measured 3.4 cm in diameter. On CT plain scan,the lesions showed homogeneous slight high-density with regular edge in 5 cases and irregular low-density in 4 cases, and 2 of them with partly blurred edge. On CT enhanced scan, uniform moderate enhancement was seen in 3 cases, circular enhancement in 4 cases, inhomogeneous enhancement in 1 case, and lace-like enhancement in 1 case. Local infiltration occurred in 6 cases. Lymphadenovarix in the same side of lesion occurred in 2 cases. Conclusion CT findings of tuberculous lymphadenitis in parotid gland present diversification, which correlate well with pathological changes. Understanding of characteristic CT findings of tuberculous lymphadenitis in parotid gland is helpful for differential diagnosis, but final diagnosis still depends on pathology and acid-fast baeilli.