Abstract

Salivary gland lesions are relatively less common but challenging because of their marked variability in cytomorphology, clinical features and biologic behavior. Fine needle aspiration cytology (FNAC) is helpful in evaluating suspicious salivary glands lesions due to its their superficial location, easy accessibility, low cost, minimum morbidity, rapid turnaround time, high specificity and sensitivity. Fine needle aspiration cytology in salivary gland lesions is intriguing for the cytopathologists due to their diverse morphology and overlapping cytological features which lead to the dilemma in diagnosis. Materials and Methods: Present study was a retrospective analytical study in a tertiary care centre over a duration of 3 years. All the salivary gland FNAC cases were retrieved and divided into various categories as per Milan system for reporting salivary gland cytopathology. Histopathological correlation was done wherever possible. Results: A total of 152 were included in the study. The percentage of cases in each category was: nondiagnostic 4.5%, nonneoplastic 51.9%, atypical lesions 0.76%, neoplastic category benign neoplasm 21.37%, salivary lesion of uncertain malignant potential 1.52%, suspicious category 2.29%, and malignant category 17.5%. The risk of malignancy for indivdual category was 6.25% (nonneoplastic), 100% (atypical), 3.3% (neoplastic), 0% (benign), 25% (salivary neoplasm of uncertain neoplastic potential), 100% (suspicious for malignancy), and 100% (malignant) categories. Sensitivity, specificity, positive predictive value, and negative predictive value of FNAC with application of Milan system was 89.4%, 100%, 100%, and 95.74%, respectively. Conclusion: Salivary gland FNAC when classified toa particular category by Milan system helps to overcome the pitfalls due to congruent features of various diagnostic categories yet provide risk stratification and stochastic information for the doubtful cases.

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