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Mourouzis C, Schoinohoriti O, Mastagkas D, Rallis G. Fine-Needle Aspiration Cytology in the Diagnosis of Salivary Gland Tumors Before the Milan System: A Ten-Year Experience From a Tertiary Care Center in Greece. Cureus 2023; 15:e42737. [PMID: 37654959 PMCID: PMC10467328 DOI: 10.7759/cureus.42737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
Objective The objective of this study was to determine the diagnostic value of fine-needle aspiration cytology (FNAC) for salivary gland tumors. Methodology A retrospective file analysis of patients with salivary gland pathology, attending the Department of Oral and Maxillofacial Surgery of a tertiary care center in Athens, Greece, over a 10-year-long period, was conducted. Sensitivity, specificity, accuracy, positive prognostic value (PPV), and negative prognostic value (NPV) of FNAC for benign and malignant tumors separately were assessed and compared with histology. Results A total of 82 patients (46 male and 36 female) with salivary gland tumors, submitted to both FNAC and histology, were included. The mean age was 55 years. A total of 73 tumors were histologically diagnosed as benign and nine as malignant. FNAC identified 62 benign and seven malignant tumors but was inconclusive in 13 cases. The most common diagnosis of both histology and FNAC was pleomorphic adenoma. FNAC sensitivity, specificity, accuracy, PPV, and NPV were 98.3% and 100%, 87.5% and 100%, 97.1% and 100%, 98.3% and 100%, and 87.5% and 100% for benign and malignant tumors, respectively. Conclusions FNAC is highly sensitive but moderately specific for the preoperative identification of benign salivary gland tumors. Its use as an initial diagnostic modality is warranted, thanks to its safeness, rapidity, and lack of pain.
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Affiliation(s)
| | - Ourania Schoinohoriti
- Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, Athens, GRC
| | - Dimitris Mastagkas
- Department of Oral and Maxillofacial Surgery, 401 Military Hospital of Athens, Athens, GRC
| | - George Rallis
- Department of Oral and Maxillofacial Surgery, KAT Attica General Hospital, Athens, GRC
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Kazemi MA, Amini F, Kargar B, Lotfi M, Aghazadeh K, Sharifian H, Moradi B, Azadbakht J. The Value of Ultrasound-guided Core Needle Biopsy in Differentiating Benign from Malignant Salivary Gland Lesions. Indian J Otolaryngol Head Neck Surg 2023; 75:266-270. [PMID: 37275055 PMCID: PMC10235295 DOI: 10.1007/s12070-022-03148-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 08/19/2022] [Indexed: 06/07/2023] Open
Abstract
Purpose In recent years, core needle biopsy (CNB) technique has received much attention, being used as alternative method of tissue sampling for surgical biopsy of salivary gland tumors (SGTs). The present study aimed to evaluate the value of CNB in differentiating benign from malignant SGTs. Materials and methods Patients with suspected benign or malignant SGTs in imaging were enrolled in this study. All core needle biopsies were performed under ultrasound guidance, i.e. ultrasound-guided Core Needle Biopsy (USCNB). Histological examination of the specimen after surgical excision was regarded as gold standard test and set as reference standard to assess USCNB accuracy for discriminating between ultrasound-visible benign and malignant SGTs. Results Based on USCNB results, from 36 participants (14 women and 22 men) with SGTs, 44.4% of detected tumors were benign and 55.5% were malignant. Twenty-two patients underwent surgery and postoperative specimen histological examination showed that 59% of excised lesions were benign and 41% were malignant. USCNB and surgical biopsy (SB) findings were completely compatible for 21 patients. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of USCNB were 100% in differentiating malignant from benign lesions. Conclusion USCNB is a valuable and accurate method of diagnosis with high sensitivity and specificity in distinguishing benign from malignant ultrasound-visible SGTs.
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Affiliation(s)
- Mohammad Ali Kazemi
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Amini
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Kargar
- Faculty of medicine, Islamic Azad University Tehran Medical Sciences, Tehran, Iran
| | - Maryam Lotfi
- Department of Pathology, Amiralam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran
| | - Keyvan Aghazadeh
- Otorhinolaryngology research center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hashem Sharifian
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnaz Moradi
- Department of radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Women’ Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Javid Azadbakht
- Department of Radiology, Faculty of Medicine, Kashan University of Medical Sciences, Shahid Beheshti Hospital, Qotb Ravandi Blvd, 8715981151 Kashan, Iran
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Sučić M, Ljubić N, Perković L, Ivanović D, Pažanin L, Sučić Radovanović T, Župnić-Krmek D, Knežević F. Cytopathology and diagnostics of Warthin's tumour. Cytopathology 2021; 31:193-207. [PMID: 32259367 DOI: 10.1111/cyt.12830] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/25/2020] [Accepted: 03/29/2020] [Indexed: 12/17/2022]
Abstract
Warthin's tumour (WT) is a benign epithelial salivary tumour, one type of salivary adenoma. Histologically, WT is structured of two components, epithelial tissue that often lines cystic formations and lymphoid tissue in the tumour stroma. FNA is a reliable diagnostic approach in the diagnosis of salivary gland lesions allowing a highly accurate categorization of benign tumour-like lesions, benign tumours and malignant tumours. In the proposed Milan reporting system of salivary gland lesions, WT is categorized in the IVA group of benign neoplasms. Accurate cytological diagnosis is straightforward when three characteristic components are present: oncocytes, either isolated or associated in clusters, lymphocytes and lymphoid cells and often an inflammatory/necrotic-like substance. Also, specific features of scintigraphy and radiological imaging contribute to the diagnosis of WT. WT is categorized according to Seifert G. et al in 4 types, depending on the proportions of the epithelial component and lymphoid stroma. Differential cytopathological and pathohistological diagnosis include other salivary gland lesions with lymphoid, oncocytic epithelial and cystic components. In some cases, such as the metaplastic WT variant, there are additional cytopathological and histological diagnostic difficulties. Moreover, bilateral, multicentric or multiple and infrequently seen extra-salivary localizations of WT are associated with further cytopathological diagnostic difficulties. Also, a rare possibility of malignant transformation of the epithelial or lymphoid component of WT as well as possible association with other primary tumours remains a challenge in accurate cytopathological and histological diagnosis of WT.
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Affiliation(s)
- Mirna Sučić
- Division of Cytology, Department of Pathology and Cytology, Clinical Hospital "Sveti Duh", Zagreb, Croatia.,Department of Medical Biochemistry and Hematology, Faculty of Pharmacy and Biochemistry, Zagreb University, Zagreb, Croatia.,Zagreb Medical School, Zagreb University, Zagreb, Croatia
| | - Nives Ljubić
- Division of Cytology, Department of Pathology and Cytology, Clinical Hospital "Sveti Duh", Zagreb, Croatia
| | - Leila Perković
- Division of Cytology, Department of Pathology and Cytology, Clinical Hospital "Sveti Duh", Zagreb, Croatia
| | - Dunja Ivanović
- Division of Cytology, Department of Pathology and Cytology, Clinical Hospital "Sveti Duh", Zagreb, Croatia
| | - Leo Pažanin
- Ljudevit Jurak Department of Pathology and Cytology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | | | - Dubravka Župnić-Krmek
- Division of Haematology, Clinical Department of Internal Medicine, Clinical Hospital "Sveti Duh", Zagreb, Croatia
| | - Fabijan Knežević
- Division of Pathology, Department of Pathology and Cytology, Clinical Hospital "Sveti Duh", Zagreb, Croatia
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Chirmade J, Kothari K, Naik L, Agnihotri M. Utility of the Milan system for reporting salivary gland cytopathology: A retrospective 5 years study. Diagn Cytopathol 2021; 49:500-508. [PMID: 33444484 DOI: 10.1002/dc.24697] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/20/2020] [Accepted: 01/04/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Fine-needle aspiration cytology (FNAC) is an established technique for preoperative diagnosis of salivary gland lesions; however, lack of a uniform reporting system has been a handicap. The main aims of this study were to evaluate the utility of the - "The Milan System for Reporting Salivary Gland Cytopathology" (MSRSGC) and ascertain the risk of malignancy (ROM) for each category. METHODS All salivary gland FNACs over 5 years (January 2014-December 2018) were reviewed and assigned a diagnostic category from the MSRSGC. Clinical data were taken from Cytology records. Cytodiagnosis was correlated with histopathology wherever available and ROM was calculated. RESULTS A total of 120 salivary gland FNACs were studied. Age ranged between 5 and 85 years, male:female ratio was 2:1 and parotid was the commonest gland aspirated. Cases were reclassified as I non-diagnostic (2.5%), II non-neoplastic (15%), III atypia of uncertain significance-AUS (1.7%), IV A neoplasm benign (50%), IV B neoplasm of uncertain malignant potential (12.5%), V suspicious for malignancy (5%), and VI malignant (13.3%). Follow-up was available in 70 (58.3%) cases. The sensitivity, specificity, negative predictive value, and positive predictive value were 92.3%, 100%, 100%, and 98.27% respectively. ROM was non-neoplastic (0%), AUS (50%), neoplasm benign (0%), neoplasm of uncertain malignant potential (28.6%), suspicious for malignancy (100%), and malignant (100%). CONCLUSION Salivary gland FNAC is a reliable diagnostic tool and the "Milan system" will further increase FNA reliability, help risk stratification, and improve patient care.
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Affiliation(s)
- Jyoti Chirmade
- Department of Pathology, Seth Gordhandas Sunderdas Medical College and KEM Hospital, Mumbai, India
| | - Kanchan Kothari
- Department of Pathology, Seth Gordhandas Sunderdas Medical College and KEM Hospital, Mumbai, India
| | - Leena Naik
- Department of Pathology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
| | - Mona Agnihotri
- Department of Pathology, Seth Gordhandas Sunderdas Medical College and KEM Hospital, Mumbai, India
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Mukundapai M, Sharma N, Patil A, Gopal C. Fine-Needle Aspiration Cytology of Salivary Gland Lesions: A Revised Classification Based on "Milan System"-4years Experience of Tertiary Care Cancer Center of South India. J Cytol 2019; 37:12-17. [PMID: 31942092 PMCID: PMC6947727 DOI: 10.4103/joc.joc_68_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 10/02/2019] [Accepted: 11/05/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Fine-needle aspiration cytology plays role in preoperative diagnosis of any salivary gland mass lesions. Because of heterogeneity of salivary gland lesions and cytomorphology overlap, a uniform 6-tier Milan classification proposed which could be helpful in better communication of reports for patient's management. Methods: Study included 4 years (2011–2015) retrospective data retrieval from cytology department of our Institute, which is a tertiary care cancer center of South India. Histopathology correlation was done wherever possible. Result: Total 253 cases were studied. Histopathological follow-up was available in 115 cases. Cases were categorized as nondiagnostic (1.58%), nonneoplastic (13.43%), benign (30%), atypia (0.8%), and suspicious for malignancy and malignant cytology (51.8%). The risk for malignancy was high for suspicious for malignancy and malignant cytological categories ranged from 96–100%. The sensitivity, specificity, and accuracy for diagnosing malignancy varied from 86.76%, 93.75%, and 89%, respectively. Conclusion: Risk stratification approach in classifying salivary gland cytology aspirate as per Milan system provides a standardized reporting and better communication to clinician.
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Affiliation(s)
- Malathi Mukundapai
- Cytology and Histopathology Division, Kidwai Cancer Center, Bangalore, Karnataka, India
| | - Neelam Sharma
- Cytology and Histopathology Division, Kidwai Cancer Center, Bangalore, Karnataka, India
| | - Akkamahadevi Patil
- Cytology and Histopathology Division, Kidwai Cancer Center, Bangalore, Karnataka, India
| | - Champaka Gopal
- Cytology and Histopathology Division, Kidwai Cancer Center, Bangalore, Karnataka, India
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Ronchi A, Montella M, Zito Marino F, Panarese I, Pagliuca F, Colella G, Franco R, Cozzolino I. Diagnostic accuracy of FNA cytology for diagnosis of salivary gland tumors in pediatric patients. Cancer Cytopathol 2019; 127:529-538. [DOI: 10.1002/cncy.22162] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 05/21/2019] [Accepted: 06/18/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine University of Campania “L. Vanvitelli” Naples Italy
| | - Marco Montella
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine University of Campania “L. Vanvitelli” Naples Italy
| | - Federica Zito Marino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine University of Campania “L. Vanvitelli” Naples Italy
| | - Iacopo Panarese
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine University of Campania “L. Vanvitelli” Naples Italy
| | - Francesca Pagliuca
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine University of Campania “L. Vanvitelli” Naples Italy
| | - Giuseppe Colella
- Maxillofacial Surgery Unit, Department of Medical, Surgical and Dental Specialty University of Campania “Luigi Vanvitelli” Naples Italy
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine University of Campania “L. Vanvitelli” Naples Italy
| | - Immacolata Cozzolino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine University of Campania “L. Vanvitelli” Naples Italy
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Chowsilpa S, An D, Lose H, Huang X, Nayar R, Maleki Z. Risk of malignancy associated with cytomorphology subtypes in the salivary gland neoplasm of uncertain malignant potential (SUMP) category in the Milan System: A bi-institutional study. Cancer Cytopathol 2019; 127:377-389. [PMID: 31116514 DOI: 10.1002/cncy.22150] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 04/19/2019] [Accepted: 04/30/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Salivary gland neoplasm of uncertain malignant potential (SUMP) is a diagnostic category in the Milan System for Reporting Salivary Gland Cytopathology. The objective of this study was to assess the risk of neoplasm (RON) and the risk of malignancy (ROM) in SUMP cases by evaluating them based on their prominent cytomorphology. METHODS The pathology databases were searched for cases of fine-needle aspiration-diagnosed SUMP at The Johns Hopkins Hospital and Northwestern University from 2013 to 2018. Only cytopathology cases diagnosed as SUMP that had available surgical follow-up were included. RESULTS Sixty-five patients with SUMP were identified, including 31 men and 34 women who ranged in age from 15 to 87 years (mean age, 55.2 years). Sixty-five cases had histologic follow-up, including 13 (20%) with basaloid features, 13 (20%) with oncocytic features, and 39 (60%) with unspecified features. No cases with clear cell features were found. Overall, the RON in the SUMP category was 95.4% (62 of 65 cases), and the ROM was 33.8% (22 of 65 cases). The RON in SUMPs with basaloid, oncocytic, and unspecified subtypes was 92.3%, 100%, and 94.9%, respectively, whereas the ROM was 38.5%, 7.7%, and 41%, respectively. The most common benign neoplasm was pleomorphic adenoma (23.1%), whereas mucoepidermoid carcinoma (9.2%) was the most common malignant neoplasm. CONCLUSIONS This study shows that the ROM differs significantly based on cytomorphology subtypes, whereas the overall ROM is approximately the same as the target rate in the Milan System for Reporting Salivary Gland Cytopathology. Moreover, the RON remains high in the SUMP category among different cytomorphology subtypes. Adequate sampling, immunohistochemical staining, and familiarity with metaplastic and reactive changes may improve the diagnosis.
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Affiliation(s)
- Sayanan Chowsilpa
- Division of Cytopathology, Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland.,Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Daniel An
- National Institutes of Health, Bethesda, Maryland
| | - Holly Lose
- Division of Cytopathology, Department of Pathology, Northwestern University, Chicago, Illinois
| | - Xiao Huang
- Division of Cytopathology, Department of Pathology, Northwestern University, Chicago, Illinois
| | - Ritu Nayar
- Division of Cytopathology, Department of Pathology, Northwestern University, Chicago, Illinois
| | - Zahra Maleki
- Division of Cytopathology, Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland
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8
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Farahani SJ, Baloch Z. Retrospective assessment of the effectiveness of the Milan system for reporting salivary gland cytology: A systematic review and meta-analysis of published literature. Diagn Cytopathol 2018; 47:67-87. [DOI: 10.1002/dc.24097] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 09/28/2018] [Indexed: 01/20/2023]
Affiliation(s)
- Sahar J Farahani
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania; University of Pennsylvania; Philadelphia Pennsylvania
| | - Zubair Baloch
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania; University of Pennsylvania; Philadelphia Pennsylvania
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Marzouki HZ, Altabsh MA, Albakrei MO, Al-Khatib TA, Merdad MA, Farsi NJ. Accuracy of preoperative fine needle aspiration in diagnosis of malignant parotid tumors. Saudi Med J 2018; 38:1000-1006. [PMID: 28917063 PMCID: PMC5694632 DOI: 10.15537/smj.2017.10.20988] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: To determine the diagnostic accuracy of fine needle aspiration (FNA) for detecting malignant parotid tumors. Methods: We conducted a retrospective study of all patients diagnosed with benign or malignant parotid gland tumors in King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between January 2004 and May 2015. The records of 65 subjects were obtained. Histopathological findings and data from FNA examinations were obtained from medical records. Twenty-three subjects were excluded due to missing FNA, histopathology results or both. The sensitivity, specificity, negative predictive value, and positive predictive value of FNA for detecting malignant lesions were estimated and compared with the gold standard, histopathology. Results: The specimens of 5 cases were insufficient for diagnosis; therefore, 38 cases were diagnosed by FNA and had histopathological reports. Three cases were diagnosed positive for cancer using histopathology and missed by FNA, 3 were diagnosed as malignant lesions using both FNA and histopathology, and 32 cases were determined benign based on histopathology and FNA analysis. The total prevalence of parotid malignancies was 15.8%. The sensitivity of FNA for detecting malignancy was 50%, and the specificity was 100%; with a positive predictive value of 100% and negative predictive value of 91.4%. Conclusion: Fine needle aspiration is a highly specific, but only moderately sensitive test. We support the use of this method as an initial tool for diagnosing parotid gland malignancies, as it is a safe, rapid, and painless procedure, compared to histopathology.
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Affiliation(s)
- Hani Z Marzouki
- Department of Otolaryngology-Head and Neck Surgery, Jeddah, King Abdulaziz University, Kingdom of Saudi Arabia. E-mail.
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Gavín-Clavero MA, Usón-Bouthelier T, Jariod-Ferrer ÚM, Fernández-Larrañaga A, Pantilie B, Lobera-Molina F, Simón-Sanz MV, Cristóbal BN. Accuracy of FNAC and CT in the Differentiation of Benign and Malignant Parotid Tumours in a Case Series. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2018. [DOI: 10.1016/j.otoeng.2017.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Accuracy of FNAC and CT in the differentiation of benign and malignant parotid tumours in a case series. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017; 69:25-29. [PMID: 28844507 DOI: 10.1016/j.otorri.2017.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 04/13/2017] [Accepted: 05/10/2017] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Parotid tumours, in addition to the wide variety of types, are histologically complex. Differentiating between benign and malignant tumours in preoperative diagnosis is important in deciding the type of surgery required. Fine needle aspiration cytology (FNAC) is a simple, quick, low-cost, low-invasive and well-tolerated tool used in the preoperative diagnosis of these tumours. MATERIAL AND METHODS we calculated the sensitivity, specificity, predictive positive value (PPV) and negative predictive value (NPV) of FNAC and computed tomography (CT) in the differentiation of benign and malignant parotid tumours operated between 2010 to 2014 in the oral and maxillofacial surgery department of the University Hospital Miguel Servet. RESULTS The sensitivity of FNAC is 50%, while the specificity is high, at 98.7%. FNAC offers high reliability in the diagnosis of malignant tumours, despite its low sensitivity. However, when the diagnosis is indeterminate or benign, other than pleomorphic adenoma or Whartin tumour, the reliability to exclude malignancy decreases. CONCLUSION The low sensitivity of FNAC to differentiate malignant from benign parotid tumours, means that we cannot rule out other diagnostic tests, clinical symptoms and especially the intraoperative vision of each surgeon. Especially when the diagnosis is indeterminate. Nevertheless, it is a technique used in a systematised way and helps in pre-surgical decision-making.
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Wei S, Layfield LJ, LiVolsi VA, Montone KT, Baloch ZW. Reporting of fine needle aspiration (FNA) specimens of salivary gland lesions: A comprehensive review. Diagn Cytopathol 2017; 45:820-827. [DOI: 10.1002/dc.23716] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 03/03/2017] [Accepted: 03/15/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Shuanzeng Wei
- Department of Pathology; Fox Chase Cancer Center; Philadelphia Pennsylvania 19111
| | - Lester J. Layfield
- Department of Pathology & Anatomical Sciences; M263 Medical Science Building, One Hospital Drive, University of Missouri; Columbia Missouri 65212
| | - Virginia A. LiVolsi
- Department of Pathology and Laboratory Medicine; University of Pennsylvania, Perelman School of Medicine; 3400 Spruce Street, 6th Floor Founders Building Philadelphia Pennsylvania 19104
| | - Kathleen T. Montone
- Department of Pathology and Laboratory Medicine; University of Pennsylvania, Perelman School of Medicine; 3400 Spruce Street, 6th Floor Founders Building Philadelphia Pennsylvania 19104
| | - Zubair W. Baloch
- Department of Pathology and Laboratory Medicine; University of Pennsylvania, Perelman School of Medicine; 3400 Spruce Street, 6th Floor Founders Building Philadelphia Pennsylvania 19104
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Sandhu VK, Sharma U, Singh N, Puri A. Cytological spectrum of salivary gland lesions and their correlation with epidemiological parameters. J Oral Maxillofac Pathol 2017; 21:203-210. [PMID: 28932028 PMCID: PMC5596669 DOI: 10.4103/jomfp.jomfp_61_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The role fine-needle aspiration (FNA) in the diagnosis of salivary gland lesions has evolved over the years. Although clinical and radiological parameters help to narrow the differential diagnosis the tissue diagnosis still remains the gold standard. MATERIALS AND METHODS This study is from January 2013 to December 2015 in our Department of Pathology where 170 salivary gland lesions were aspirated. The aim of the present study was to analyze adequacy rate in relation to the size of lesion and to evaluate varied cytological spectrum of salivary gland lesions with emphasis on differential diagnosis and to correlate cytological diagnosis with age, gender and anatomical site. RESULTS The 170 cytological smears were categorized into two groups: Group 1 adequate aspirations (88.2%), Group 2 inadequate aspirations (11.7%). The adequate aspirations were subdivided as neoplastic (53.33%) and nonneoplastic (46.66%). The distribution of the various neoplastic lesions (80; 53.33%) were 66 (82.5%) benign, 12 (15%) were malignant and 2 (2.5%) were suspicious of malignancy. Among benign neoplasms, the pleomorphic adenoma (62; 93.3%) was the most frequent followed by Warthins tumor (4; 6%). The most common malignant neoplasms were adenoid cystic carcinoma (6; 50%), followed by mucoepidermoid carcinoma (4; 33.3%), malignant lymphoma (1; 8.3%) and metastatic carcinomatous deposits (1; 8.3%). In two cases, cytological picture indicated suspicion for malignancy however specific tumor typing could not be done. The neoplasms occurred more frequently in the parotid gland (65%), followed by submandibular gland (21.3%) and minor salivary glands (13.8%). The nonneoplastic lesions (70) included 68.6% cases of chronic sialadenitis, 17.1% cases were reported as mucocele, 11.4% cases of acute sialadenitis 2.9% cases as tubercular granulomas. CONCLUSION FNA cytology provides useful information on the management of salivary gland lesions and prevents unnecessary surgery in cases of nonneoplastic lesions and identification of malignancy helps the surgeon in deciding type and extent of surgery.
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Affiliation(s)
- Vaneet Kaur Sandhu
- Department of Pathology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Upender Sharma
- Department of Pathology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Navtej Singh
- Department of Pathology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Arun Puri
- Department of Pathology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
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Silva WPP, Stramandinoli-Zanicotti RT, Schussel JL, Ramos GHA, Ioshi SO, Sassi LM. Accuracy, Sensitivity and Specificity of Fine Needle Aspiration Biopsy for Salivary Gland Tumors: A Retrospective Study from 2006 to 2011. Asian Pac J Cancer Prev 2016; 17:4973-4976. [PMID: 28032725 PMCID: PMC5454705 DOI: 10.22034/apjcp.2016.17.11.4973] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objective: This article concerns evaluation of the sensitivity, specificity and accuracy of FNAB for pre-surgical diagnosis of benign and malignant lesions of major and minor salivary glands of patients treated in the Department of Head and Neck Surgery of Erasto Gartner Hospital. Methods: This retrospective study analyzed medical records from January 2006 to December 2011 from patients with salivary gland lesions who underwent preoperative FNAB and, after surgical excision of the lesion, histopathological examination. Results: The study had a cohort of 130 cases, but 34 cases (26.2%) were considered unsatisfactory regarding cytology analyses. Based on the data, sensitivity was 66.7% (6/9), specificity was 81.6% (71/87), accuracy was 80.2% (77/96), the positive predictive value was 66,7% (6/9) and the negative predictive value was 81.6% (71/87). Conclusion: Despite the high rate of inadequate samples obtained in the FNAB in this study the technique offers high specificity, accuracy and acceptable sensitivity.
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Kim MW, Kim DW, Jung HS, Choo HJ, Park YM, Jung SJ, Baek HJ. Factors Influencing the Outcome of Ultrasound-Guided Fine-Needle Aspiration for Salivary Gland Lesion Diagnosis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:877-883. [PMID: 27022169 DOI: 10.7863/ultra.15.06062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/01/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES This study aimed to assess multiple factors influencing the outcomes of ultrasound (US)-guided fine-needle aspiration (FNA) of salivary gland lesions. METHODS From 2008 to 2013, a single radiologist performed US-guided FNA of salivary gland lesions in 243 patients. With the exclusion of pure cysts, poor image quality, and insufficient static image cases, 218 salivary gland lesions in 218 patients were included. The composition, size, location, and vascularity of the lesions were retrospectively investigated on the basis of sonographic findings by the same radiologist. The relationship between sampling adequacy and multiple factors was compared, and the diagnostic accuracy of US-guided FNA of salivary gland lesions was calculated by using the final diagnosis as a reference standard. RESULTS The sampling adequacy rate for US-guided FNA of the 218 salivary gland lesions was 96.8% (211 of 218). A significant difference was observed in the composition and vascularity of the lesions (P < .0001), whereas there was no significant difference in the patient age and sex, lesion size, lesion location, and needle size. The rate of inadequate sampling increased in predominantly cystic lesions compared with solid lesions as well as in low-vascularity lesions compared with high-vascularity lesions. Of the 218 lesions, 178 (81.7%) were ultimately diagnosed, and most were benign (162 of 178 [91.0%]). When 3 cases with indeterminate cytologic results were excluded, the sensitivity, specificity, positive and negative predictive values, and accuracy of US-guided FNA of salivary gland lesions were 64.3%, 98.8%, 81.8%, 97.0%, and 96.0%, respectively. CONCLUSIONS When using US-guided FNA to diagnose salivary gland lesions, sampling adequacy depends on the composition or vascularity of the lesions.
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Affiliation(s)
- Min Woo Kim
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Dong Wook Kim
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hyun Seok Jung
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hye Jung Choo
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Young Mi Park
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Soo Jin Jung
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hye Jin Baek
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
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Ge N, Peng X, Zhang L, Cai ZG, Guo CB, Yu GY. Partial sialoadenectomy for the treatment of benign tumours in the submandibular gland. Int J Oral Maxillofac Surg 2016; 45:750-5. [PMID: 26970852 DOI: 10.1016/j.ijom.2015.12.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 11/09/2015] [Accepted: 12/18/2015] [Indexed: 10/22/2022]
Abstract
The conventional treatment for benign tumours arising in the submandibular gland (SMG) has always involved whole gland excision with the tumour. In light of developments in parotid gland functional surgery, this prospective study was performed to evaluate the effectiveness and safety of partial sialoadenectomy (PS) for benign tumours in comparison with conventional total sialoadenectomy (TS). Thirty-one consecutive patients with a preoperative diagnosis of benign tumour in the SMG were included in the study from December 2008 to December 2010. Eleven patients were treated with PS and 20 patients underwent conventional TS. Salivary gland function and surgery-related complications were assessed. No difference in resting saliva flow was found between the two groups before the operation, while this was significantly higher in the PS group than in the TS group at 1 year after surgery (P=0.009). With regard to complications, there was less deformity in facial appearance in the PS group. There was no recurrence in any of the 31 patients during the follow-up period (range 41-82 months). It is believed that this modification to SMG surgery is consistent with the idea of functional and minimal invasive salivary gland surgery. This technique represents a good choice for the management of benign tumours of the SMG for appropriately selected cases.
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Affiliation(s)
- N Ge
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - X Peng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - L Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Z-G Cai
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - C-B Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
| | - G-Y Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
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Negahban S, Shirian S, Khademi B, Oryan A, Sadoughifar R, Mohammad MP, Aledavood A, Daneshbod K, Daneshbod Y. The Value of Ultrasound-Guided Fine-Needle Aspiration Cytology by Cytopathologists in the Diagnosis of Major Salivary Gland Tumors. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2016. [DOI: 10.1177/8756479316634320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Because of the typical sonographic appearances of many salivary gland masses, as well as the normal appearance and anatomy of the glands, differentiation of salivary glands tumors based only on clinical and imaging criteria is difficult. We compared the utility, safety, specificity, and accuracy of ultrasound-guided fine needle aspiration cytology (UG-FNAC) in the detection of nonpalpable tumors in the major salivary glands. A retrospective review was done of a 5-year experience of 102 consecutive patients undergoing UG-FNAC. Clinical opinion, FNA results, and final pathologic findings were examined. Histological evaluation showed 29 malignant tumors and 54 benign lesions (neoplasms and nonneoplastic lesions). The cytologic findings were nondiagnostic in 19 cases (18.6%), true negative in 50 (49%), true positive in 20 (19.6%), false negative in 9 (8.8%), and false-positive in 4 (3.9%) cases for detecting malignant tumors. Six of 20 (30%) malignant tumors (true positive) and 41 of 50 (82%) benign lesions (true negative) were classified accurately. The accuracy, sensitivity, and specificity were 84.3%, 68.9%, and 92.6%, respectively. Ultrasound guided FNAC was found to be highly specific for malignancy and its sensitivity for malignancy was good. It is a reliable and accurate diagnostic technique with minimal complications and easy to perform with high specificity 92.5% (95% CI: 82.09%-97.90%). It should be the preferred primary approach for initial investigation in diagnosing salivary gland tumors.
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Affiliation(s)
- Shahrzad Negahban
- Shiraz Molecular Pathology Research Center, Daneshbod Pathology Laboratory, Shiraz, Iran
| | - Sadegh Shirian
- Department of Pathology, School of Veterinary Medicine, Shahrekord University, Shahrekord, Iran
- Shefa Neuroscience Research Center, Khatam-Al-Anbia Hospital, Tehran, Iran
- Brain and Spinal Cord Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bijan Khademi
- Head and Neck Cancer, Endoscopic Sinus Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Oryan
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz Iran
| | - Roshanak Sadoughifar
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz Iran
| | | | - Azita Aledavood
- Shiraz Molecular Pathology Research Center, Daneshbod Pathology Laboratory, Shiraz, Iran
| | - Khosrow Daneshbod
- Shiraz Molecular Pathology Research Center, Daneshbod Pathology Laboratory, Shiraz, Iran
| | - Yayha Daneshbod
- Shiraz Molecular Pathology Research Center, Daneshbod Pathology Laboratory, Shiraz, Iran
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Altinay S, Taskın U, Sar M, Aydın S, Oktay MF. Histopathological diversity in parotidectomy materials in Turkish population: clinicopathologic analysis and demographic features of 136 cases in a tertiary care hospital. Asian Pac J Cancer Prev 2015; 15:5701-7. [PMID: 25081689 DOI: 10.7314/apjcp.2014.15.14.5701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Salivary gland tumours, which account for approximately 3% of head-neck cancers, are a heterogeneous group and thus it is difficult to identify their epidemiological characteristics. The aim of this study is to determine demographic features and histopathologic distribution of parotid neoplasms in a large sample from Turkey. MATERIALS AND METHODS This study was conducted retrospectively on 136 parotidectomy materials from operations between May 2009-May 2013. Age, gender, tumor diameter, histopathological diagnosis and surgical margin status were recorded. RESULTS The benign cases were 112 (82.4%), while the malignancies were 24 (17.6%). The accuracy rate of FNAC was 91%. There were 46 (33.8%) male and 90 (66.2%) female patients. Female/ male ratio (M/F=0.5) was two, the Warthin (WT) tumor being more apparent in males (p<0.05). Pleomorphic adenoma (PA) was detected most frequently among benign pathologies at 61.6% (69/112), while the Warthin Tumor (WT) was detected as the second most frequent tumor at 20.5% (23/112). Mucoepidermoid carcinoma (MEC) and carcinoma ex pleomorphic adenoma (Ca ex PA) were detected at equal frequency at 20.8% (5/24) among malign tumors. These were followed by acinic cell carcinoma at 16.7% (4/24). While the surgical margin was positive in ten patients with malignant tumors (41.7%), all of the benign tumors were negative (p<0.01). No significant difference was detected in the age-gender of patients, tumor size and distribution of sites among benign and malignant groups (p>0.05). CONCLUSIONS Pleomorphic adenoma is the most frequently reported benign tumor almost in all global literature. Yet, the distribution of malignant tumors displays geographical differences. Based on these data, we believe that our findings will provide a significant contribution to future epidemiological studies. We think that it will be beneficial to generate awareness on parotid tumors and ensure a fight against smoking as with all head-neck cancers.
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Affiliation(s)
- Serdar Altinay
- Department of Pathology, Bagcilar Training and Research Hospital, Istanbul, Turkey E-mail :
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P A, C A, Masilamani S, Jonathan S. Diagnosis of Salivary Gland Lesions By Fine Needle Aspiration Cytology and Its Histopathological Correlation in A Tertiary Care Center of Southern India. J Clin Diagn Res 2015; 9:EC07-10. [PMID: 26266126 DOI: 10.7860/jcdr/2015/14229.6076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 04/30/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Salivary glands may enlarge either due to inflammation or neoplastic conditions and the diagnosis is possible by fine needle aspiration cytology (FNAC). AIM The present study was undertaken to determine utility of FNAC in the diagnosis of salivary gland lesions. MATERIALS AND METHODS In this retrospective study, a total of 186 FNACs of salivary gland lesions were retrieved and evaluated. Of these, 146 cases had follow-up histopathological diagnosis. FNAC diagnoses were compared to histopathological diagnoses. RESULTS The parotid glands were more commonly involved than others. Among the various diagnostic categories used in FNAC reports, Non neoplastic category was seen in 24 (16.4%), benign category in 86 (58.9%) and malignant category in 30 (20.6%) and unsatisfactory category in 6 (4.1%) of 146 cases. The overall sensitivity, specificity, accuracy, positive predictive value and negative predictive value of FNAC in the diagnosis of salivary gland lesions were 86.6%, 94.6%, 93.6%, 88.3%, and 94.6% respectively. CONCLUSION The present study concluded that FNAC in the diagnosis of salivary gland lesions is highly sensitive, specific and accurate method. Hence, FNAC is a useful, quick and reliable diagnostic tool. It also appears to be a safe, cost effective and minimally invasive procedure, which provides information for management of salivary gland lesions.
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Affiliation(s)
- Arul P
- Assistant Professor, Department of Pathology, Dhanalakshmi Srinivasan Medical College and Hospital , Siruvachur, Perambalur, Tamilnadu, India
| | - Akshatha C
- Assistant Professor, Department of Pathology, Dhanalakshmi Srinivasan Medical College and Hospital , Siruvachur, Perambalur, Tamilnadu, India
| | - Suresh Masilamani
- Associate Professor, Department of Pathology, Dhanalakshmi Srinivasan Medical College and Hospital , Siruvachur, Perambalur, Tamilnadu, India
| | - Srivani Jonathan
- Assistant Professor, Department of Pathology, Dhanalakshmi Srinivasan Medical College and Hospital , Siruvachur, Perambalur, Tamilnadu, India
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Consamus EN, Smith D, Pina Oviedo S, Mody DR, Takei H. Diagnostic accuracy of fine-needle aspiration cytology of salivary gland lesions: A 6-year retrospective review. J Am Soc Cytopathol 2015; 4:63-73. [PMID: 31051711 DOI: 10.1016/j.jasc.2014.11.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 11/06/2014] [Accepted: 11/06/2014] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the diagnostic accuracy of salivary gland fine-needle aspiration (FNA) in comparison to histologic examination and to recognize possible pitfalls in diagnosis. MATERIALS AND METHODS The diagnoses and demographics of all cases of salivary gland FNAs with concurrent or subsequent histologic correlation at our institution over a 6-year period (2006-2011) were retrospectively reviewed and compared for discrepancies. Discrepancies were categorized as either major or minor and due to sampling or interpretive variance. RESULTS Overall, the following values were calculated: sensitivity 80.6%, specificity 97.5%, positive predictive value 92.6%, negative predictive value 92.8%, accuracy 92.7%, and concordance rate 90.9%. In addition, concordance rates were calculated for the 2 most common diagnoses: pleomorphic adenoma (97.1%, n = 35) and Warthin tumor (88.9%, n = 9). Five major and 5 minor discrepancies were found. Most of the major discrepancies and all of the minor discrepancies were due to sampling and interpretive variances, respectively. Sampling issues occurred in FNAs with and without ultrasound guidance. The interpretive variance included interpretative discrepancies in monomorphic cellular lesions, abundant inflammation and reactive atypia, cystic changes, abundant matrix deposition or fibrosis, and difficulty in diagnosing mucoepidermoid carcinoma or lymphoma on cytology. CONCLUSIONS FNA of salivary gland lesions is a procedure with high specificity, positive predictive value, negative predictive value, accuracy, and concordance with histologic examination; however, discrepancies do exist. Recognizing potential pitfalls is key to avoiding discrepancies.
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Affiliation(s)
- Erin N Consamus
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin Street, Houston, Texas
| | - Deborah Smith
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin Street, Houston, Texas
| | - Sergio Pina Oviedo
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin Street, Houston, Texas
| | - Dina R Mody
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin Street, Houston, Texas
| | - Hidehiro Takei
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin Street, Houston, Texas.
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Song IH, Song JS, Sung CO, Roh JL, Choi SH, Nam SY, Kim SY, Lee JH, Baek JH, Cho KJ. Accuracy of Core Needle Biopsy Versus Fine Needle Aspiration Cytology for Diagnosing Salivary Gland Tumors. J Pathol Transl Med 2015; 49:136-43. [PMID: 26148740 PMCID: PMC4367109 DOI: 10.4132/jptm.2015.01.03] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 12/16/2014] [Accepted: 01/03/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Core needle biopsy is a relatively new technique used to diagnose salivary gland lesions, and its role in comparison with fine needle aspiration cytology needs to be refined. METHODS We compared the results of 228 ultrasound-guided core needle biopsy and 371 fine needle aspiration procedures performed on major salivary gland tumors with their postoperative histological diagnoses. RESULTS Core needle biopsy resulted in significantly higher sensitivity and more accurate tumor subtyping, especially for malignant tumors, than fine needle aspiration. No patient developed major complications after core needle biopsy. CONCLUSIONS We recommend ultrasoundguided core needle biopsy as the primary diagnostic tool for the preoperative evaluation of patients with salivary gland lesions, especially when malignancy is suspected.
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Affiliation(s)
- In Hye Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Seon Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Ohk Sung
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong-Lyel Roh
- Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Ho Choi
- Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soon Yuhl Nam
- Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Yoon Kim
- Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong Hyun Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Hwan Baek
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung-Ja Cho
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Cytohistopathological study of salivary gland lesions in bundelkhand region, uttar pradesh, India. PATHOLOGY RESEARCH INTERNATIONAL 2014; 2014:804265. [PMID: 25202469 PMCID: PMC4151527 DOI: 10.1155/2014/804265] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 07/10/2014] [Accepted: 07/29/2014] [Indexed: 11/17/2022]
Abstract
Background. FNAC is a useful method for evaluating suspicious salivary glands lesions due to its low cost, minimum morbidity, rapid turnaround time, high specificity, and sensitivity. Aim. To know the frequency of the salivary gland lesions and cytohistological correlation in the Jhansi region, Uttar Pradesh, India. Material and Methods. In present study 124 cases were included and cytohistological correlation was made in 86 cases only. FNA was performed by using a 23/24-gauge needle without local anaesthesia. Air dried and 95% ethyl alcohol fixed wet smears were stained with Giemsa stain and Papanicolaou stain, respectively. Paraffin embedded tissue sections were stained with Haematoxylin and Eosin. Results. Parotid gland was the most commonly involved salivary gland. The commonest age group was 20 to 29 years, 30 to 39 years, and 60 to 69 years for nonneoplastic lesions, benign tumours, and malignant tumours, respectively. The overall male to female ratio was 1.17 : 1. The diagnostic accuracy of FNAC was 100%, 93.3%, and 88.2% for nonneoplastic lesions, benign tumours, and malignant tumours, respectively. Conclusion. The high accuracy, sensitivity, and specificity of FNAC confirm that preoperative cytology is a useful, quick, reliable diagnostic technique for rapid diagnosis and suitable for developing countries.
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Sharma JD, Kalit M, Nirmolia T, Saikia SP, Sharma A, Barman D. Cancer: Scenario and Relationship of Different Geographical Areas of the Globe with Special Reference to North East-India. Asian Pac J Cancer Prev 2014; 15:3721-9. [DOI: 10.7314/apjcp.2014.15.8.3721] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lee DH, Yoon TM, Lee JK, Lim SC. Clinical utility of fine needle aspiration cytology in pediatric parotid tumors. Int J Pediatr Otorhinolaryngol 2013; 77:1272-5. [PMID: 23726957 DOI: 10.1016/j.ijporl.2013.05.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 05/06/2013] [Accepted: 05/07/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the usefulness and accuracy of fine needle aspiration cytology (FNAC) in the diagnosis of pediatric parotid tumors. METHODS From June 2002 to June 2012, 22 patients ≤18-years-of-age with parotid mass were treated at Chonnam National University Hospital. Included in the study were 21 cases with preoperative FNAC. A retrospective chart review analyzed the results of FNAC and compared them with the corresponding histopathological diagnosis. RESULTS Twenty-one of the 22 patients had undergone preoperative FNAC, which diagnosed pleomorphic adenoma in 13 patients. The remaining eight patients were diagnosed with benign tumor (n = 6), malignant tumor (n = 1) or Kimura disease (n = 1). All 21 patients underwent parotid tumor removal. FNAC had a diagnostic sensitivity of 92.3%, positive-predictive value of 92.3% and accuracy of 90.5% for diagnosing pleomorphic adenoma of pediatric parotid tumor. FNAC had a diagnostic sensitivity of 100%, a positive-predictive value of 85% and accuracy of 85.7% for diagnosing benign parotid tumor. CONCLUSIONS Preoperative FNAC is a useful and accurate adjunct for preoperative evaluation of pediatric parotid tumors. We recommend that preoperative FNAC should be part of the initial evaluation of pediatric patients with parotid masses.
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Affiliation(s)
- Dong Hoon Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, Hwasun, South Korea.
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Liu DY, Tian XJ, Li C, Sun SS, Xiong YH, Zeng XT. The sternocleidomastoid muscle flap for the prevention of Frey syndrome and cosmetic deformity following parotidectomy: A systematic review and meta-analysis. Oncol Lett 2013; 5:1335-1342. [PMID: 23599790 PMCID: PMC3629134 DOI: 10.3892/ol.2013.1179] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 01/28/2013] [Indexed: 12/21/2022] Open
Abstract
Approximately 34-86% of neoplasms of the salivary glands are located in the parotid gland and parotidectomy is the first-line treatment for parotid gland tumors. Frey syndrome and cosmetic deformity are common complications experienced by patients following parotidectomy and the sternocleidomastoid muscle flap (SCMF) is used to prevent them. Numerous studies have been performed to examine the effectiveness of the SCMF for the prevention of cosmetic deformity and Frey syndrome, however, they provide contradictory results and possess small sample sizes with consequently low statistical power. In order to evaluate the effectiveness of the SCMF for the prevention of Frey syndrome and cosmetic deformity following parotidectomy, we performed a systematic review and meta-analysis based on published randomized controlled trials (RCTs), which were identified using PubMed and CNKI databases, and references of studies up to August 2012 were included. Using these criteria, we yielded 11 RCTs. Following an independent assessment of the methodological quality of these studies and the extraction of data, a systematic review and meta-analysis was conducted. The results of the meta-analysis demonstrated that there was a significant trend towards a lower risk of objective incidence [67%; risk ratio (RR), 0.33; 95% confidence interval (CI), 0.16-0.67; P<0.01] and subjective incidence (66%; RR, 0.34; 95% CI, 0.16-0.75; P= 0.01) of Frey syndrome in the SCMF group. The sensitivity analysis also indicated that this result was significant. Due to the considerable variation between the included studies, a meta-analysis was not applicable to assess cosmetic deformity. Two RCTs demonstrated that the difference between the SCMF and no SCMF group was not statistically significant, while the other seven RCTs detected a statistically significant difference between the two groups. Publication bias was detected. In conclusion, based on currently available evidence, the use of the SCMF is benefical for the prevention of Frey syndrome, however, whether it is also benefical for cosmetic deformity remains inconclusive.
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Affiliation(s)
- Dong Yan Liu
- Departments of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan 442000
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