Salivary Gland Tumours- A Histo-Cytological study

Abstract

Introduction: Fine-needle aspiration cytology (FNAC) is used as the main initial diagnostic investigation for lumps in the head and neck region. It is relatively inexpensive, quick to do, well accept by patients, associated with low morbidity, and has a relatively high diagnostic accuracy. However, its role in the diagnosis of salivary gland neoplasms is controversial. The mainstay of FNAC in salivary gland disease is distinguishing benign from malignant disease. These tumours form a heterogeneous group with many different subtypes, and as a result they can be difficult to interpret even after excision so histopathology reveal confirm diagnosis. Objective: Evaluate the usefulness and accuracy of fine needle aspiration cytology in the diagnosis of salivary gland tumors and to see the histo-cytological correlation in salivary gland lesions. Materials and Method: We reviewed files of all those patients undergoing surgery for various salivary gland pathologies between Januaruy 2013 – June 2013 at BJMC, CHA. A total of 50 salivary gland resections were performed during this time period in which preoperative FNAC and final histology slides were available for review. FNAC was done by our pathology department using a 22 gauge needle attached to a 10-ml syringe holder. A minimum of two needle passes were made in each case. The specimens were expelled onto slides, and thin smears were prepared between two slides and immediately fixed. The slides were generally stained with Papanicolaou, Hematoxylin and Eosin and May-Grunwald Giemsa (MGG) methods. Results: Among 50 patients reviewed in this study 39 were males and 11 female. Youngest patient in the series was 18 years of age and while the oldest one was 75 years with a mean age of 42.8 years. The results of FNAC showed 7 malignant cases, 39 benign and 4 non-conclusive results. On histological examination 8 malignant cases and 42 cases were benign[table 5].Among 39 benign reported on FNAC, 38 cases proved to be benign and 1 was malignant on final histology. Among 4 non-conclusive, 3 were benign and 1 was proven malignant.
Conclusion: Our study shows that preoperative FNAC plays an important role in the accurate diagnosis of salivary gland tumors. It is a safe and effective modality for the treatment of patients with salivary gland lesion. This office based procedure is reliable, well tolerated, easy to perform and cost effective. Moreover preoperative differentiation of tumors may help prepare both the surgeon and patient for an appropriate surgical procedure.