ROLE OF FINE NEEDLE ASPIRATION CYTOLOGY IN DIAGNOSIS OF SALIVARY GLAND LESIONS

BACKGROUND Salivary glands are affected by a variety lesions which may be non-neoplastic such as inflammation (Sialadenitis), cysts or neoplastic which includes both benign and malignant tumours. Except for acute infections which are usually painful, salivary gland diseases rarely present with any symptoms during the early stages1 MATERIALS AND METHODS A cross sectional study to evaluate the role of fine needle aspiration cytology in the diagnosis of salivary gland lesions in Department of Pathology, Government Medical College Jammu, Jammu & Kashmir was done. All cases diagnosed in Department of Pathology as salivary gland lesions in cytopathology and histopathology sections from March 2015 to March 2016 were included in the study. Papanicolaou and May-Grunwald Giemsa stained slides of all these cases were reviewed and categorized/diagnosed. Of 156 FNAC cases, 102 had their corresponding histopathology reports. All these cases were retrieved from the histopathology section. H & E slides of all cases were reviewed, where required new H & E slides from paraffin blocks were also made. All these were categorized and diagnosed as per latest guidelines. Clinical features and follow up data was obtained from the consult files of referring surgeon. RESULTS The age of patients ranged from 11 years to 80 years with the mean age being 42.7 years. Majority of the patients i.e. 94 out of 156 (60.25 %) were in the age group of 21-50 years. Male to female ratio was 1.3:1. Most of the patients presented with swelling in parotid region i.e. 104 (66.66 %) followed by submandibular region 40 (25.64%) and oral cavity 12 (7.69%). Of the 156 cases, 38 (24.35%) were diagnosed as inflammatory lesions and 114 (73.07%) as neoplastic. Of the 38 inflammatory salivary gland lesions, sialadenitis was the most common lesion 18 cases (47.36%), followed by sialadenosis, 8 cases (21.05%). A total of 114 neoplastic lesions were diagnosed on fine needle aspiration cytology. Out of 114 cases, 92 (80.70%) cases were benign tumours and 22 (19.30%) cases were malignant tumours. 102 of 156 patients had their corresponding histopathological report. Histopathology of biopsy/surgical specimen revealed that 68 (66.6 %) patients had benign lesions, 20 (19.60%) had malignant lesions while 14 (13.72%) patients had non-neoplastic lesions. FNA cytology findings were correlated with histopathology in cases where histopathology reports were available. In our study, sensitivity and specificity of FNAC is 99.02% and 99.20%. Positive and negative predictive values are 96.6% and 98.14%. Percentage of false negative is 1.01% and accuracy of FNAC is 98.68%. CONCLUSION FNAC is a rapid, convenient and accurate method of tissue diagnosis that can be performed on outpatient basis. It is highly sensitive and specific technique for diagnosis of most salivary gland swellings.