Context: Mucoepidermoid carcinoma (MEC) is the most common malignancy of salivary glands accounting for 5–10% being more common in the parotid gland, followed by minor salivary glands, especially palate. It is one of the most problematic tumours due to elusive features. FNAC is a valuable tool to preoperatively assess surgical management. However due to its morphological heterogeneity, overlapping architectural patterns and nuclear features a high false negative rate is seen. Aims: To elucidate the cytomorphological features of MEC. To explore the accuracy and pitfalls of FNAC in MEC by comparing it with final histopathological diagnosis. Methods and Material: This retrospective study was conducted on 15 cases of salivary gland lesions which were diagnosed as MEC on FNAC or later from biopsy/excision specimens by histopathology. The case details and slides were retrieved from the archives for a 10 year period (2006–2015). The cytological features were compared with the final histopathological diagnosis. Results: Out of 15 cases, 7 cases were concordant while 8 cases were found to be discordant with the final histopathological diagnosis. Underdiagnosis and overdiagnosis were noted and the overall diagnostic accuracy was 46.6%. Conclusions: This study of salivary gland tumours emphasizes the inherent problems in cytologic diagnosis of MEC as low & intermediate grade lesions are commonly underdiagnosed as benign.

Keywords: Fine Needle Aspiration Cytology (FNAC); salivary gland; Mucoepidermoid Carcinoma (MEC).