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. 2025 Jun 16;17(6):e86177.
doi: 10.7759/cureus.86177. eCollection 2025 Jun.

Diagnostic Accuracy of Fine-Needle Aspiration Cytology in the Diagnosis of Parotid Gland Swellings

Nandakumar B M  1   2 , Sandeep S  1 , Madhukumar H V  1 , Srikantaiah C Hiremath  1 , Padma Priya  3
Affiliations

Diagnostic Accuracy of Fine-Needle Aspiration Cytology in the Diagnosis of Parotid Gland Swellings

Nandakumar B M et al. Cureus. .

Abstract

Background Parotid gland swellings are the most common salivary gland lesions. Fine-Needle Aspiration Cytology (FNAC), apart from being the first-line diagnostic tool in the evaluation of parotid gland swellings, plays an integral role in planning both surgical and non-surgical therapy. Objectives To determine the diagnostic accuracy of FNAC in the evaluation of parotid gland swellings. Methodology Medical records of all patients who underwent surgery for parotid gland lesions at Ramaiah Medical College and Hospital, Bengaluru, Karnataka, since 2010 were retrospectively analyzed. Demographic data, FNAC reports, and final histopathology reports were extracted, assessed, and statistically analyzed. Results Out of the 193 patients who underwent surgery for parotid gland swelling during the study period, 112 cases were included in the study. The cohort consisted of 67 male and 45 female patients, with a mean age of 50 years. FNAC diagnosed 94 patients with benign disease and 18 patients with malignant disease. Final histopathological analysis of post-surgical specimens revealed that 86 cases had benign pathology, while 26 had malignant disease. Pleomorphic adenoma was the most common pathology observed in both FNAC and histopathological analysis. The diagnostic performance of FNAC in identifying parotid gland pathology was as follows: sensitivity, 65.38%; specificity, 98.83%; accuracy, 91.07%; positive predictive value (PPV), 94.4%; negative predictive value (NPV), 90.42%; positive likelihood ratio (LR+), 55.88; and negative likelihood ratio (LR-), 0.35. Conclusions Our findings demonstrate that FNAC has good accuracy in distinguishing benign lesions from malignant ones. FNAC is a readily available, repeatable, inexpensive, minimally invasive, and relatively painless outpatient procedure with no known serious complications. While a relatively low sensitivity may limit its standalone diagnostic value, its high specificity, PPV, NPV, and LR+ underscore its importance as a valuable diagnostic tool in the evaluation of parotid gland swellings.

Keywords: diagnostic test accuracy; fine needle aspiration cytology (fnac); fnac of parotid lesions; parotid swelling; pleomorphic adenomas.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Ethics Committee, RMC, registered under M.S. Ramaiah University of Applied Sciences issued approval MSRMC/EC/SP-03/11-2024. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Distribution of patients’ ages in the study.
See this image and copyright information in PMC

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