Abstract:

In this study, our aim was to find out the role of fine needle aspiration cytology in the diagnosis and treatment of salivary gland lesions in our institution. We also searced for the cyto-histopathological correlation of our cases. A total number of 120 salivary gland fine needle aspiration cytology cases which had been examined in the Pathology Department of Kocaeli University Medical Faculty for the last five years were retrospectively reviewed. Thirty nine of these were correlated with their histopathology. A cytopathologic diagnosis were not given in 42 out of the total 120. Twenty seven were interpreted as non-neoplastic benign lesions (like sialadenitis, sialadenosis...) Twenty-seven were diagnosed as pleomorphic adenomas while 9 Warthin tumors, 2 acinic cell carcinomas and 1 mucoepidermoid carcinoma were diagnosed. Five cases were reported to be malignant while 3 were suspicious for malignancy. Four cases were interpreted as “tumoral lesion of salivary gland origin” without benign or malignant discrimination. Cyto-histopathologic correlation of the cases which have tissue specimens were resulted in concordance in 94.44 % of pleomorfic adenomas (17/18) and 85.71 % of Warthin tumors (6/7). Of the four cases that were diagnosed as “malignant” cytologically, two were carcinoma ex pleomorfic adenoma while two were acinic cell carcinomas. One of the 3 cases that were suspicious cytologically was found out to be a Warthin tumor with cystic degeneration. Another suspicious case was diagnosed as carcinoma ex pleomorfic adenoma. Histopathological examination revealed lymphoma in the cytopathologically “suspicious lymphoproliferative lesion.” In two cases that benign-malignant differentiation could not be made, 1 adenoid cystic carcinoma and one pleomorfic adenoma was detected. Two cases which were “normal” cytopathologically were also reported to be “normal” histopathologically. Of the 2 unsatisfactory cases, one resulted in the diagnosis of basal cell adenocarcinoma while the other was adenoid cystic carcinoma. In the differentiation of benign from malignant lesions of salivary glands in our institution, sensitivity rate is 87.5%, specificity is 92.86 % and the accuracy is 91.67 %. FNAC has successfully been used in the diagnosis and treatment of salivary gland lesions. If high inadequacy rate can be minimized by considering fine needle aspiration cytology as a team work, reperating in case of insufficient material and providing close clinicopathological relations; the success rate will increase.

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