Fine needle aspiration biopsy of the salivary glands

A five-year experience with emphasis on diagnostic pitfalls

Ricardo S. Cajulis, Sefik T. Gokaslan, Gordon H. Yu, Denise Frias-Hidvegi

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

OBJECTIVE: To review the fine needle aspiration (FNA) findings in 151 patients who presented with salivary gland (both major and minor) enlargement from January 1991 to December 1995 in order to determine its sensitivity and specificity and to study the various pit falls. STUDY DESIGN: The study group consisted of 77 males and 74 females, 16-98 years old (average 55). One hundred twenty-five aspirates (83%) were from the parotid gland, 23 (15%) from the submandibular gland and 3 (2%) from the soft palate. One hundred thirty-seven cases (91%) were adequate for diagnosis. There were 89 (59%) aspirations done by cytopathologists, 100% of which were diagnostic, and 62 (41%) done by clinicians, 48 (77%) of which were diagnostic. Sixty-eight (45%) cases had histologic confirmation. There were 104 (75.9%) benign, 20 (14.6%) malignant and 13 (9.5%) atypical cytologic diagnoses. RESULTS: Using histology as the 'gold standard,' the sensitivity of FNA cytology was 91%, with a specificity of 96%. A number of problems were encountered interpreting some cases, not only in differentiating benign from malignant ones but also in the specific classification of these neoplasms. Problems encountered involved differentiating hematopoietic from non-hematopoietic lesions and interpretation of spindle cell neoplasms, acinic cell carcinoma, mucoepidermoid carcinoma, adenoid cystic carcinoma, lymphoproliferative disorders, postirradiation changes, sialoadenitis and atypia in pleomorphic adenoma. CONCLUSION: FNA biopsy of the salivary gland is a sensitive and specific diagnostic tool at our institution. Particular attention to subtle morphologic changes may aid in avoiding pitfalls and arriving at the right diagnosis.

Original languageEnglish (US)
Pages (from-to)1412-1420
Number of pages9
JournalActa Cytologica
Volume41
Issue number5
StatePublished - 1997

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Fine Needle Biopsy
Salivary Glands
Acinar Cell Carcinoma
Sialadenitis
Mucoepidermoid Carcinoma
Pleomorphic Adenoma
Soft Palate
Adenoid Cystic Carcinoma
Lymphoproliferative Disorders
Submandibular Gland
Parotid Gland
Cell Biology
Neoplasms
Histology
Sensitivity and Specificity

Keywords

  • Aspiration biopsy
  • Salivary gland diseases
  • Salivary gland neoplasms

ASJC Scopus subject areas

  • Anatomy
  • Cell Biology
  • Histology

Cite this

Fine needle aspiration biopsy of the salivary glands : A five-year experience with emphasis on diagnostic pitfalls. / Cajulis, Ricardo S.; Gokaslan, Sefik T.; Yu, Gordon H.; Frias-Hidvegi, Denise.

In: Acta Cytologica, Vol. 41, No. 5, 1997, p. 1412-1420.

Research output: Contribution to journalArticle

Cajulis, Ricardo S. ; Gokaslan, Sefik T. ; Yu, Gordon H. ; Frias-Hidvegi, Denise. / Fine needle aspiration biopsy of the salivary glands : A five-year experience with emphasis on diagnostic pitfalls. In: Acta Cytologica. 1997 ; Vol. 41, No. 5. pp. 1412-1420.
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abstract = "OBJECTIVE: To review the fine needle aspiration (FNA) findings in 151 patients who presented with salivary gland (both major and minor) enlargement from January 1991 to December 1995 in order to determine its sensitivity and specificity and to study the various pit falls. STUDY DESIGN: The study group consisted of 77 males and 74 females, 16-98 years old (average 55). One hundred twenty-five aspirates (83{\%}) were from the parotid gland, 23 (15{\%}) from the submandibular gland and 3 (2{\%}) from the soft palate. One hundred thirty-seven cases (91{\%}) were adequate for diagnosis. There were 89 (59{\%}) aspirations done by cytopathologists, 100{\%} of which were diagnostic, and 62 (41{\%}) done by clinicians, 48 (77{\%}) of which were diagnostic. Sixty-eight (45{\%}) cases had histologic confirmation. There were 104 (75.9{\%}) benign, 20 (14.6{\%}) malignant and 13 (9.5{\%}) atypical cytologic diagnoses. RESULTS: Using histology as the 'gold standard,' the sensitivity of FNA cytology was 91{\%}, with a specificity of 96{\%}. A number of problems were encountered interpreting some cases, not only in differentiating benign from malignant ones but also in the specific classification of these neoplasms. Problems encountered involved differentiating hematopoietic from non-hematopoietic lesions and interpretation of spindle cell neoplasms, acinic cell carcinoma, mucoepidermoid carcinoma, adenoid cystic carcinoma, lymphoproliferative disorders, postirradiation changes, sialoadenitis and atypia in pleomorphic adenoma. CONCLUSION: FNA biopsy of the salivary gland is a sensitive and specific diagnostic tool at our institution. Particular attention to subtle morphologic changes may aid in avoiding pitfalls and arriving at the right diagnosis.",
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