Fine needle aspiration in the diagnosis of salivary gland lesions.

Fine needle aspiration biopsy (FNAB) of salivary glands was performed in 187 patients. In 106 patients with satisfactory FNAB smears who proceeded to surgery, the original cytologic diagnosis was compared with subsequent histopathology. There were 74 benign tumours and 25 malignant tumours. Nineteen of the latter were primary malignant neoplasms of the salivary glands, and 6 were metastatic. The cytologic diagnosis by FNAB correlated exactly with the histologic diagnosis in 95% of benign neoplasms and in 68% of malignant neoplasms, with an overall accuracy of 88%. A false negative diagnosis for malignancy was made in five cases and a false positive diagnosis in one case. Hence the sensitivity for malignancy was 80% and the specificity was 99%. The most frequently misdiagnosed lesions were pleomorphic adenoma and muco-epidermoid carcinoma. FNAB of salivary gland lesions is easy to perform and free of complications, but the cytologic patterns may be difficult to interpret, and considerable experience is necessary in order to achieve a high diagnostic accuracy.