Fine Needle Aspiration Cytology (FNAC) of Salivary Gland Swellings with Histopathological Correlation

Background: Salivary gland swelling is a common clinical presentation in Head Neck region. The parotid gland is the most commonly affected site. Accurate diagnosis is imperative considering wide-ranging differential diagnoses comprising infectious, inflammatory conditions, cysts, benign and malignant tumors. Fine needle aspiration cytology (FNAC) has emerged as a useful, quick, nontraumatic diagnostic modality in this field by providing relevant information about the nature of such swellings. The study aims: to assess the diagnostic validity of FNAC in patients presenting with salivary gland swellings comparing the findings obtained from FNAC with histopathological findings. Methods: A cross-sectional study was carried out from November 2018 to November 2019 among the patients who presented to the Department of Otolaryngology & Head-Neck Surgery of Sir Salimullah Medical College Mitford Hospital, Dhaka. The sample size consists of a total of 50 patients presenting with salivary gland swellings. FNAC was done for all the patients, and the results were compared with the surgical biopsy and histopathological examination. Results: Of the 50 cases, 78% were neoplastic. The benign tumor most encountered was pleomorphic adenoma, constituting 59.26%, while the most common malignant tumor was mucoepidermoid carcinoma, which accounted for 38.46%. The sensitivity of the FNAC came to 76.9%, specificity was 94.6%, PPV constituted 83.3%, NPV was 92.1%, and overall diagnostic accuracy came to 90.0%. Conclusion: FNAC is a very useful and effective diagnostic modality in the work-up of salivary gland swellings, with high diagnostic accuracy with respect to distinguishing benign from malignant lesions. The findings indicate that FNAC diagnosis should be integrated with clinical correlation and histopathological confirmation to achieve maximum benefit in patient care with minimal diagnostic discrepancy.