Diagnostic Accuracy of Benign Salivary Gland Aspiration Cytology - A Study with Histopathological Correlation

BACKGROUND Fine needle aspiration cytology (FNAC) is commonly used as a safe and minimally invasive diagnostic test in benign salivary gland lesions. Nevertheless, the capacity of aspiration cytology in diagnosing benign lesions in the salivary gland is still disputed because accurate tumour typing is dependent on the quality and yield of the aspirate, as well as the competence of the cytopathologist. We aim to assess the precision of fine needle aspirate in the pre-operative diagnosis of benign salivary gland lesions and compare it with the histopathological findings. METHODS This is a longitudinal study conducted among 45 patients with preoperative cytological diagnosis of benign salivary gland lesions, who were followed-up till surgery with subsequent histopathological examination in Government Medical College, Thrissur, from 1 st January 2013 to 30th June 2015. RESULTS Among the benign neoplasms, 29 out of 30 cases of pleomorphic adenoma were confirmed on histopathology and one was basal cell adenoma. Out of nine cases of Warthin’s tumour, only seven were confirmed by histopathology. Of the remaining two, one was found to be salivary duct carcinoma showing the typical comedo necrosis and the other was found to be low grade mucoepidermoid carcinoma. So, these two cases were found to be false negative. The statistical analysis showed an overall diagnostic accuracy of 95.5 % for benign salivary gland lesions. CONCLUSIONS FNAC is a minimally invasive technique useful in salivary gland lesions. In nonneoplastic lesions surgery can be avoided and in neoplasms appropriate surgery can be planned. An accurate cytological diagnosis is often possible but may sometimes require the expertise of the cytopathology and use of ancillary techniques KEYWORDS Salivary Gland, Fine Needle Aspiration Cytology, Benign Tumours, Pleomorphic Adenoma, Warthin’s Tumour, Mucoepidermoid Carcinoma, Salivary Duct Carcinoma

Atypical localisation of pleomorphic adenoma issue from heterotopic salivary tissue in the supraclavicular region: diagnosis and management

Heterotopic salivary tissue (HST) is a normal salivary tissue located outsides the major and minor salivary glands. Multiple sites of localisation of heterotopias have been described, the occurrence of HST in the neck is rare and it may have several clinical manifestation. We report the case of 72-year-old Caucasian man presenting a suspect mass on the left-sided supraclavicular region. He is known for melanoma of the right elbow, surgically treated 11 years ago. The final diagnosis of pleomorphic adenoma of HST was retained. Methods of diagnosis and management are documented. Neoplasms arising from HST are uncommon with approximately 80% of benign tumours. Warthin’s tumour is the most frequent. The localisation of these neoplasms in the lower neck is very rare and often causes a diagnostic pitfall. Histological analysis provides certainty of diagnosis, defines management and follow-up.

A Rare Presentation of Warthin’s Tumour in the Submandibular Gland of a 7- Year-Old Boy

A seven-year-old boy presented with a painless swelling of the right submandibular salivary gland for 1 year. The submandibular swelling was not associated with any calculus. Right submandibular sialo adenectomy done. Surprisingly the histopathology came as Warthin’s tumour. Warthin’s tumour mostly occurs in parotid gland in older age group. Because of the rare occurrence of this tumour in a young boy in extra parotid location, the case is reported.

An Intraparotid Schwannoma Mimicking A Warthin’s Tumour

In this report, we describe the rare presentation of a cystic intraparotid facial nerve schwannoma (IPFNS) in a young female who initially presented with a painful unifocal parotid mass gradually enlarging over 5 years. Preliminary imaging and cytology offered this to be a Warthin’s tumour. Here we describe the limitations of current diagnostic tools in the workup of intraparotid cystic lesions and highlight the importance of keeping rare tumours in mind to optimize pre-­surgical management.