Fine-Needle Aspiration Biopsy of Salivary Gland Lesions in a Selected Patient Population | Head and Neck Cancer | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 34.236.187.155. Please contact the publisher to request reinstatement.
1.
Al-Khafaji  BMNestok  BRKatz  RL Fine-needle aspiration of 154 parotid masses with histologic correlation: ten-year experience at the University of Texas M. D. Anderson Cancer Center.  Cancer.1998;84:153-159.PubMedGoogle Scholar
2.
Wong  DSYLi  GKH The role of fine-needle aspiration cytology in the management of parotid tumors: a critical clinical appraisal.  Head Neck.2000;22:469-473.PubMedGoogle Scholar
3.
Jayaram  GVerma  AKSood  NKhurana  N Fine needle aspiration cytology of salivary gland lesions.  J Oral Pathol Med.1994;23:256-261.PubMedGoogle Scholar
4.
Atula  TGrenman  RLaippala  P Fine-needle aspiration cytology of submandibular lesions.  J Laryngol Otol.1995;109:853-858.PubMedGoogle Scholar
5.
Atula  TGrenman  RLaippala  P  et al Fine-needle aspiration biopsy in the diagnosis of parotid gland lesions: evaluation of 438 biopsies.  Diagn Cytopathol.1996;15:185-190.PubMedGoogle Scholar
6.
Boccato  PAltaville  GBlandamura  S Fine needle aspiration biopsy of salivary gland lesions: a reappraisal of pitfalls and problems.  Acta Cytol.1998;42:888-898.PubMedGoogle Scholar
7.
Cajulis  RSGokaslan  STYu  GHFrias-Hidvegi  D Fine needle aspiration biopsy of salivary glands.  Acta Cytol.1997;41:1412-1420.PubMedGoogle Scholar
8.
Zurrida  SAlasio  LTradati  N  et al Fine-needle aspiration of parotid masses.  Cancer.1993;72:2306-2311.PubMedGoogle Scholar
9.
Hee  CGQPerry  CF Fine-needle aspiration cytology of parotid tumors: is it useful?  ANZ J Surg.2001;71:345-348.PubMedGoogle Scholar
10.
Chan  MKMMcGuire  LJKing  W Cytodiagnosis of 112 salivary gland lesions.  Acta Cytol.1992;36:353-363.PubMedGoogle Scholar
11.
Pilotti  SDi Palma  SAlasio  LBartoli  CRilke  F Diagnostic assessment of enlarged superficial lymph nodes by fine needle aspiration.  Acta Cytol.1993;37:853-866.PubMedGoogle Scholar
12.
Chai  CDodd  LGGlasgow  BJLayfield  LJ Salivary gland lesions with a prominent lymphoid component: cytologic findings and differential diagnosis by fine-needle aspiration biopsy.  Diagn Cytopathol.1997;17:183-190.PubMedGoogle Scholar
13.
Young  NAAl-Saleem  TIEhya  HSmith  MR Utilization of fine-needle aspiration cytology and flow cytometry in the diagnosis and subclassification of primary and recurrent lymphoma.  Cancer.1998;84:252-261.PubMedGoogle Scholar
Original Article
June 2004

Fine-Needle Aspiration Biopsy of Salivary Gland Lesions in a Selected Patient Population

Author Affiliations

From the Head and Neck Service, Department of Surgery (Drs Cohen, Patel, Boyle, Kraus, Singh, Wong, Shah, and Shaha), and the Department of Pathology (Dr Lin), Memorial Sloan-Kettering Cancer Center, New York, NY. The authors have no relevant financial interest in this article.

Arch Otolaryngol Head Neck Surg. 2004;130(6):773-778. doi:10.1001/archotol.130.6.773
Abstract

Objective  To report the role of selective use of preoperative fine-needle aspiration biopsy (FNAB) in patients with major salivary gland lesions at a tertiary care cancer center.

Design  Retrospective review of FNAB results compared with final histologic diagnosis as the criterion standard.

Setting  An academic tertiary care cancer center.

Patients  A consecutive series of 258 patients who underwent FNAB of major salivary gland lesions between 1996 and 2000, of whom 169 had surgical resection.

Main Outcome Measures  Predictive value, sensitivity, specificity, and accuracy.

Results  FNAB was performed in 169 (37%) of 463 salivary gland lesions undergoing surgical procedures. A total of 126 lesions were in the parotid gland and 44 in the submandibular gland. Seventy-nine lesions (46%) were malignant. There were 150 FNAB specimens (89%) that were satisfactory for evaluation. The FNAB diagnosis of malignant or suspicious lesion had positive and negative predictive values of 84% and 77%, respectively. Ten of 20 false-negative FNAB results were low-grade lymphoma on final histologic assessment. Fine-needle aspiration biopsy diagnosis of a benign neoplasm had positive and negative predictive values of 83% and 88%, respectively. A cytopathologic diagnosis of a nonneoplastic lesion was predictive in only 47% of cases. Fifteen (47%) of 32 lymphocyte-predominant FNAB specimens were lymphoma on final histologic assessment. Ten (20%) of 49 patients with history of a solid, non–head and neck malignancy had evidence of distant metastasis to the salivary gland by histologic and/or cytopathologic assessment.

Conclusions  An FNAB diagnosis of malignant or neoplastic major salivary gland disease is generally predictive of final histologic diagnosis. The predictive value of a negative FNAB finding is low, and should not supersede clinical suspicion. Cytologic findings of a lymphocyte-predominant lesion should prompt further workup to rule out lymphoma.

×