Diagnostic Accuracy of Fine Needle Aspiration Cytology (FNAC) in Salivary Gland Tumors.


  • Farah Farhan Associate Professor Oral Pathology Rawal Institute of Health Sciences
  • Maria Ilyas Assistant Professor Oral Pathology, CMH Lahore
  • Sadia Muneer Assistant Professor, NUMS
  • Zainab Niazi Associate Professor Islamabad Dental Hospital
  • Abeer Zahra Demonstrator Oral Pathology Rawal Institute of Health Sciences
  • Maria Farooq Demonstrator Oral Pathology Margalla Institute of Health Sciences


Abstract :


Fine-needle aspiration cytology (FNAC) is well recognized as a safe diagnostic method for evaluating salivary gland abnormalities prior to operation. This diagnostic technique is affordable, simple to use, and generally painless. It also gives helpful information that assists with surgery planning and care by distinguishing between benign and malignant salivary gland tumors. The goal of this study was to evaluate the diagnostic accuracy of FNAC by comparing its findings with gold standard histological features of salivary gland cancers.

Methods and materials

37 salivary gland samples of FNAC from various different patients were collected and compared them with their histological findings. These patients presented with salivary gland swelling to the department of pathology at Islamabad Medical and Dental Hospital (IMDC) from January 2022 to January 2023. The procedure was performed by employing a 22–24G needle, and smears were stained with hematoxylin and eosin, as well as Papanicolaou and Giemsa stain. Histopathological diagnosis was done on hematoxylin- and eosin-stained sections. Diagnostic accuracy is measured by positive, negative predictive values and specificity and sensitivity.


On FNAC, 37 cases were diagnosed cytologically , of which 9 were malignant and 28 were bening. Histopathological 9 of which were diagnosed as malignant and the remaining 25 were benign. The sepecificity and sensitivity are 75 %and 94% respectively. Overlapping cytological features, heterogeneity and unsampled areas were the primary factors contributing to false positive and false negative diagnosis.  Conclusion: FNAC of salivary lesions is a precise, sensitive, and specific initial diagnostic procedure. However, the characterization of specific tumor types is limited due to variations in cytomorphology. False-negative diagnoses are mainly due to issues with the specimens obtained, while false-positive diagnoses are primarily caused by errors in interpretation. Cytopathologists should improve their skills and standards to avoid making false-positive diagnoses. In challenging cases, histologic examination may be used for accurate diagnosis. Keyword: FNAC, salivary gland, misdiagnoses, false negative, false positive, efficacy





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