FINE-NEEDLE ASPIRATION CYTOLOGY IN THE MA NAGEMENT OF SALIVARY-GLAND LESIONS SUGGESTIVE OF MALIGNANCY

imaging offers little support in the management of salivary gland mass es suggestive of a neoplastic lesion. There are also contraindications for a surgical biopsy in many cases. Fine-needle aspiration cytology (FNAC) is not yet widely recognized as a diagnostic tool. To date, 206 FNAC were carried out from 1986 through 1993 on 181 consecutive patie nts and were reviewed in the present study. Histological confirmation was possible in 174 tests, while 32 were confirmed on clinical follow- up. In sum, 192 samples were sufficient for interpretation, 10 were qu estionable by our standards and 4 were non-diagnostic. One hundred-sev enty-one samples were true-negative, 27 true-positive, 4 false-negativ e and 4 false-positive. Sensitivity was 87.1% and specificity 97.7%. O ut of 141 primary diagnostic procedures in which a final histologic di agnosis was available, FNAC was able to determine histogenesis in 113/ 124 benign lesions and 9/17 malignant masses. These included 65/67 ple omorphic adenomas and 21/22 adenolymphomas. In 8 cases a diagnosis of ''adenoma'' was made. Difficulties in interpretation were found in les ions that were mucoepidermoid carcinomas and, in part, adenoid cystic carcinomas. No complications occurred. Provided that there was suffici ent experience in performing the aspiration technique and in cytologic interpretation, FNAC was found to be a quick, reliable, low-cost, eas y-to-perform method with low risk in the management of nearly all beni gn and most malignant salivary gland lesions.