Fine needle aspiration of salivary glands: 5-year experience from a single academic center

Abstract

Objective: To investigate 5 years' experience with fine needle aspiration (FNA) of salivary glands at a single academic center.

Study design: A total of 191 salivary gland FNAs were performed at Louisiana State University Health Science Center from 2003 to 2007, and all were done on major salivary glands except for 1 case.

Results: The cytologic diagnoses included 17 malignancies, 6 atypia, 73 neoplasms, 87 negative and 18 nondiagnostic. Eighty-six cases had histologic follow-up (45.0%). There were 5 false negatives: 2 adenoid cystic carcinomas, 1 acinic cell carcinoma, 1 polymorphous low grade adenocarcinoma and 1 metastatic basaloid squamous cell carcinoma. The only false positive was a pleomorphic adenoma misdiagnosed as adenoid cystic carcinoma. Four reactive processes were diagnosed as benign neoplasms, including 2 granulomatous inflammation and 2 chronic sialadenitis. Five benign neoplasms were interpreted as reactive processes, including 2 Warthin's tumors, 2 sebaceous lymphoadenomas and 1 pleomorphic adenoma. The overall accuracy in distinguishing benign from malignant lesions was 79.1%, and the sensitivity for salivary neoplasia was 89.4%.

Conclusion: Our results are consistent with the literature that salivary gland FNA has good sensitivity, specificity and accuracy in the diagnosis of salivary neoplasms. FNA can play a significant role in triaging patients with onsite cytologic interpretation and can reduce many unnecessary surgeries.