Fine-Needle Aspiration Cytology of Tumors of Major Salivary Glands

Abstract

Between 1986 and 1997, 124 patients with tumors of major salivary glands (93 parotid tumors, 31 submandibular gland tumors) were assessed by fine-needle aspiration cytology (FNAC). The 124 cases included 28 cases of primary malignant tumors and 96 cases of benign lesions. The preoperative fine-needle diagnoses were compared with postoperative pathologic findings. Sensitivity for malignancy was 64%, and specificity was 99%. Overall accuracy was 91%, and the predictive value for malignancy was 95%. FNAC allowed determination of histogenesis in 13 (68%) of the 19 cases cytologically diagnosed as malignant, and in 72 (71%) of the 105 cases cytologically diagnosed as benign. The diagnostic accuracy for histologic diagnosis of malignant neoplasms, pleomorphic adenoma, and Warthin's tumor was 46%, 73%, and 82%, respectively. The predictive value for specific histologic diagnosis of malignancy, pleomorphic adenoma, and Warthin's tumor was 100%, 91%, and 100%, respectively. The diagnostic accuracy and the predictive value for histologic diagnoses were relatively high (>70%) for squamous cell carcinoma, adenocarcinoma, malignant lymphoma, pleomorphic adenoma, and Warthin's tumor. Adenoid cystic carcinoma and low-grade malignancies such as mucoepidermiod carcinoma and acinic cell carcinoma were the lesions most frequently misdiagnosed.