Diagnostic challenges in fine needle aspiration cytology of salivary gland lesions.

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.