Fine needle aspiration cytology in the diagnosis of mass lesions of the salivary gland.

Fine needle aspiration was performed on 101 patients with mass lesions of the salivary gland. In 98 patients satisfactory material was obtained. This could be correlated with the histology done in 54 cases. There were 12 inflammatory lesions; 52 benign and 34 malignant tumors. Of the malignant tumors 32 were primary salivary tumors and one case each of lymphoma and leukemia. The overall accuracy was 97 per cent. There were no false positives but one false negative diagnosis. In two cases there was a discrepancy of tumor type between the cytology and histopathology; these were due mainly to sampling errors. This study documents that cytomorphology can characterise a wide range of histologically described lesions including the rare epithelial myoepithelial tumor. The application of stringent criteria in the diagnoses of salivary lesions, even inflammatory conditions like chronic sialadenitis, avoids over-diagnosis. Both inflammatory and neoplastic lesions may be cystic. These cystic lesions may prove to be a pitfall in cytology. Reaspiration of cystic lesions especially from residual solid areas greatly improves accuracy. We suggest that a fore-knowledge of tumor type preoperatively greatly reduces surgery in clinically questionable salivary lesions.