What question did this study set out to answer?

This research aims to assess the diagnostic accuracy of fine-needle aspiration cytology (FNAC) for salivary gland lesions.

April 5, 2026

Role of fine-needle aspiration cytology in the diagnosis of salivary gland lesions

Key Points

This research aims to assess the diagnostic accuracy of fine-needle aspiration cytology (FNAC) for salivary gland lesions.
Conducted a retrospective analysis of 384 FNAC cases from the National Cancer Institute
Compared FNAC results to histopathology in 162 patients
Calculated the diagnostic accuracy, sensitivity, and specificity of FNAC
Overall FNAC accuracy was 94.4%
Sensitivity was 71.4%, indicating the ability to identify neoplastic cases
Specificity was 99.3%, showing its reliability in recognizing non-neoplastic cases
Majority of lesions were neoplastic (57.6%), especially in parotid glands (60%)
False negatives were noted in certain carcinomas, necessitating repeated aspiration for accurate diagnosis

Abstract

Background Morphological diagnosis of single and small groups of cells via fine-needle aspiration cytology (FNAC) is the safest and most valuable diagnostic tool. This study is designed to weigh up the spectrum of evaluation of salivary gland lesions in patients of National Cancer Institute, Cairo University, and to estimate FNAC diagnostic accuracy. Materials and methods A retrospective study involved 384 cases of salivary gland lesions in patients who underwent FNAC in National Cancer Institute. Histopathology was available for 162 patients. The results of FNAC and histopathology were compared, and accuracy of FNAC was calculated. Results The mean age of the patients was 48 years, with males more than females (1.3 : 1 ratio). Parotid gland was most commonly involved (68%) followed by submandibular gland (26%) and minor salivary glands (5%). Forty percent of cases were non-neoplastic, whereas 57.6% were neoplastic. Benign neoplasms represented 79%, and 39% were malignant. In the parotid glands, 60% of cases were neoplastic, whereas 44.6 and 85% were neoplastic in the submandibular and minor salivary gland, respectively. The overall accuracy of the procedure in the current study was found to be 94.4% with 71.4% sensitivity and 99.3% specificity. False-negative cases occurred mainly in mucoepidermoid carcinoma, adenoid cystic carcinoma, and myoepithelial carcinoma, whereas the only case of false positive was given in a case of pleomorphic adenoma. Conclusion Salivary gland FNAC continues to have a high diagnostic accuracy; consequently, it is helpful for designing appropriate management. Lesions with classic cytomorphology are easily diagnosed; however, pleomorphic adenoma, mucoepidermoid carcinoma, adenoid cystic carcinoma, and cysts may impart a diagnostic challenge when inadequately aspirated and therefore we advice repeat aspiration under image guidance.

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