Fine-needle aspiration biopsy in the diagnostic of the tumors and non-neoplastic lesions of salivary glands.

Objective: Fine-needle aspiration biopsy (FNAB) has not been part of the basic algorithm of preoperative evaluation of tumors of the major salivary glands in the Czech Republic. Most opponents of salivary gland FNAB consider it unnecessary. This paper documents the utility of the punction aspiration biopsy in the diagnosis of these lesions.

Methods: Between January 1998, and December 2003, 136 patients with clinically significant masses of the salivary glands were evaluated using FNAB. The parotid gland was involved in 68 patients, the submandibular gland in 58 patients and the region of the sublingual gland in 10 cases. In the retrospective analysis, the preoperative cytological findings were correlated with the postoperative histopathological evaluation.

Results: Histopathological evaluation revealed 107 benign lesions (79%), of which 68 were non-neoplastic, and 39 were benign neoplasms, and 19 malignant tumors (21%). The cytological specimens were found to be non-diagnostic in 15 (11%) cases, true-positive in 68 (50%), true-negative in 40 (29.4%), false-positive in 1 (0.73%) and false-negative in 12 (8.8%) cases in detecting tumors. The sensitivity, specificity and diagnostic accurary aspiration cytology were 85.0%, 97.5% and 89.2%, respectively. We recorded complications in only one case (0.7%), a subcutaneous haematoma.

Conclusions: Our results document the utility of the FNAB in the diagnosis of salivary gland masses. FNAB does not substitute other diagnostic methods or as an adjunct to sound clinical judgement. Together with the clinical and ultrasonographical evaluations it should belong to the basic algorithm of diagnosis in salivary gland lesions (Tab. 3, Ref. 18).