Diagnostic Accuracy of Fine Needle Aspiration Cytology (FNAC) in Salivary Gland Tumors.

Professor Oral Pathology, Islamabad Dental Hospital, Islamabad 6Demonstrator Oral Pathology Margalla Institute of Health Sciences, Islamabad   Author`s Contribution 1Conception and idea acquisition of data, 2Data Analysis, 3Results interpretation, 4Editing and drafting, 5Critical Revision, 6Final approval of the study to be published Funding Source: None Conflict of Interest: None Received: February 02, 2024 Accepted: May 27, 2024 Address of Correspondent Dr. Zainab Niazi Associate Professor Oral Pathology, Islamabad Dental Hospital, Islamabad dr.zainabniazi@gmail.com                       ABSTRACT Objectives: To evaluate the diagnostic accuracy of fine needle aspiration cytology (FNAC) by comparing its findings with the gold standard histological features of salivary gland lesions. Methodology: This retrospective study was conducted at the Department of Histopathology, Islamabad Medical and Dental Hospital (IMDC), from January 2023 to December 2023, patients presenting with salivary gland swellings. Fifty-seven patients having salivary gland swelling were included on which both histological and cytological evaluation had been done. Twenty cases were excluded because either they had lack of correlation between FNAC and histology or on view of inadequate material. All the patients were clinically evaluated clinically and FNAC was done using 10ml disposable syringe and 23/24-gauge needle without using local anesthesia. The histopathology of the surgical specimens and cytology of the FNAC specimens were compared, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were evaluated. Results: On FNAC, 37 cases were diagnosed cytologically, as 9 cases identified malignant and 28 as benign. Histopathological examination confirmed 9 malignant cases and 25 benign cases, whereas 3 cases were classified as false positive. The specificity and sensitivity of FNAC were 75% and 94%, respectively. Overlapping cytological features, heterogeneity, and unsampled areas were the primary factors contributing to false-positive. Conclusion: This study showed that salivary gland FNA cytology is a valuable diagnostic technique for salivary gland lesions, however due to great variation in pleomorphic adenoma, the samples must be confirmed by histopathological features.