"Cystic" parotid swelling on FNA: significance on clinical management.

The clinical significance of a cystic aspirate, defined as an aspirate yielding fluid of any nature, on fine needle aspiration cytology (FNA) of parotid masses was studied. A total of 464 FNA from 236 patients over a 4-year period in a university head and neck department was analyzed. The incidence of cystic aspirates was 17.4%. The gross appearance of the aspirated fluid was consistent between sessions. Aspirated fluids could be blood-related, serous, or purulent, and these were associated with the pathological nature of lesions. Volume and viscosity were not useful features in predicting pathology. Cysts that could be completely emptied may not recur, but the pathology should still be noted. There was no difference in pathology between cystic and noncystic swellings. The incidental finding of fluid on FNA carries very limited clinical implication and parotid masses should be fully worked up and treated as in the noncystic swelling.