Cytology or Histopathology for Salivary Gland Swellings?

Arjun Singh, Amit Haritwal, BM Murali

Abstract

Background
Salivary gland swellings can result from tumours, an inflammatory process, or cysts. It can sometimes be difficult to establish whether pathology arises from the salivary gland itself or adjacent structures. Fine needle aspiration cytology (FNAC) is a simple, rapid and safe method to diagnose salivary gland swelling. FNAC has high sensitivity, specificity and accuracy. The aims of this study are to correlate FNAC diagnoses with histopathology and to establish the sensitivity and specificity of FNAC in diagnosis of salivary gland swellings in our institution.

Method 
The study was conducted in the department of pathology, Sri Venkateshwara Medical college Hospital and research Centre, Pondicherry, India. Data was collected retrospectively for the time period 2007-2008 and prospectively for that obtained between January 2009 and June 2010. Results of cytologicial assessment were compared with histopathological data where possible to establish sensitivity and specificity of FNAC.

Results
During the study period, 1309 FNAC were undertaken of which 96 FNAC were of salivary gland swellings. Correlation of cytology from FNAC with histopathology tissue was possible in 56 cases. Of the 96 cases for which FNAC data was available, 38.56% were from male and 61.45% were from female patients. The age of the patients ranged from 8 to 69 years. 48.95% cases were benign swellings, 13.54% were malignant, 6.25% were cysts and 31.25% had an inflammatory aetiology.  Comparison of FNAC findings with histopathology specimens was available for 56 (58.33%) cases, following which the sensitivity and specificity of cytology were found to be 76.9% and 97.1% respectively.

Conclusion
FNAC is highly sensitive and specific technique for diagnosis of most of the salivary gland swelling. FNAC can be used preoperatively to avoid unnecessary surgery and discomfort associated with open biopsy.

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