Syed Qaiser Hussain Naqvi, Syed Qarib Abbas Shah, Shamsuddin Shaikh, Jan Muhammad Memon, Anwar Ali Akhund, Tabinda Taqi.
Diagnosis of salivary gland masses: FNAC vs ultrasound guided core needle biopsy.
Pak J Surg Jan ;24(2):105-9.

Objective: To assess the efficacy of fine needle aspiration cytology (FNAC) in comparison to ultrasound-guided core needle biopsy (US-CNB) in the histopathological diagnosis of salivary glands lesions. Design & Duration: A prospective cross-sectional study carried out from Jan. 2005 to Dec. 2007. Setting: Departments of Pathology, Surgery and Medicine, Nawabshah Medical College Nawabshah. Patients: A total of 108 patients, 63(58.3%) males and 45(41.7%) females, with ages between 13-72 years and having salivary gland swellings ranging between 1.5 to 8.5 cms in size were included in the study. Methodology: FNAC and US-CNB was performed in all cases followed by excision biopsy. The diagnosis of FNAC was compared with the histological findings of US-CNB and excisional biopsy specimen in all cases. The diagnosis was divided into three groups including non-neoplastic, benign neoplastic and malignant neoplastic lesions. Cystic lesions were excluded from the study. Results: Out of 108 patients, 70(64.8%) lesions were diagnosed in the parotid gland and 38(35.2%) in the submandi- bular gland. Non-neoplastic lesions were detected in 27(25%) cases by FNAC and 29(26.8%) cases by US-CNB. Benign neoplastic lesions were discovered in 45(41.7%) cases by FNAC and 54(50%) cases by US-CNB. Malignant neoplastic lesions were reported in 36(33.3%) cases by FNAC and 25(23.1%) cases by US-CNB. Comparison with excisional biopsy revealed 14 false +ve and eight false -ve cases by FNAC; US-CNB on the other hand showed no false +ve and only one false -ve case. The sensitivity of FNAC was 74.2% and specificity 81.8%, while the sensitivity of US-CNB was 96.2%, and specificity 100%. Conclusion: US-CNB has potential benefits over FNAC, having an accuracy almost equal to that of excision biopsy. It can be performed in an outpatient clinic and may help to reduce the need and cost for surgical biopsy.

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