Adequacy and accuracy of salivary gland fine needle aspiration cytology

Fine needle aspiration cytology (FNAC) is a widely utilized procedure in the preoperative assessment of salivary gland mass lesions. The aim of this study was to determine the adequacy of salivary gland FNA specimens and the accuracy of the cytological diagnoses made at a single institution over a 13-year period. All salivary gland FNAs performed at University Hospital Waterford between 2000 and 2013 were reviewed. Specimens were categorized into those performed by pathologists, radiologists or surgeons and adequacy determined for each. Cases with subsequent surgery had their histology reviewed and compared with cytology for concordance. Of 262 salivary gland FNAs 93.1 % were from parotids and 6.9 % from submandibular glands. Thirty-four FNAs (13 %) were inadequate. The inadequacy rates for pathologists, radiologists and surgeons were 11, 9.1 and 20 %, respectively (p = 0.101). Pleomorphic adenoma was the most frequent cytological diagnosis (53.5 %) followed by primary and secondary malignancies (15.8 %), inflammatory conditions (11.4 %) and Warthin tumour (10.1 %). The histology and cytology were discordant in 13.3 % of 143 cases. The sensitivity and specificity for malignancies were 80.7 and 98.2 %, respectively. Salivary gland FNAC has good sensitivity and specificity. Radiologists and pathologists have the best adequacy rates and image guidance makes radiologists good aspirators.