Enhancing Diagnostic Precision and Clinical Outcomes With FNAC in Parotid Gland Masses

Area of Science:

• Oncology
• Pathology
• Surgical Diagnosis

Background:

• Parotid gland masses present diagnostic challenges, requiring differentiation between neoplastic and non-neoplastic conditions.
• Fine-needle aspiration cytology (FNAC) is a primary tool, but faces limitations in sensitivity and potential sampling errors.
• Evaluating FNAC accuracy and the Milan Salivary Gland Cytopathology Reporting System (MSRSGC) is crucial for improving parotid mass diagnosis.

Purpose of the Study:

• To assess the diagnostic accuracy of FNAC for parotid gland lesions.
• To evaluate the utility of the Milan Salivary Gland Cytopathology Reporting System (MSRSGC).
• To compare FNAC results with definitive histopathological findings.

Main Methods:

• Retrospective analysis of 352 patients undergoing parotid gland FNAC and subsequent surgical resection over 20 years.
• Application of the MSRSGC for cytological sample classification.
• Statistical comparison of FNAC results against histopathology to determine accuracy, sensitivity, and specificity.

Main Results:

• FNAC demonstrated an overall accuracy of 93.9%, with 78.3% sensitivity and 91.5% specificity.
• Malignancy risk varied significantly across Milan categories, from 0% (Category III) to 95% (Category VI).
• False negative and positive rates were 2.4% and 3.4%, respectively; malignancy risk correlated with age, mass size, and facial nerve involvement.

Conclusions:

• FNAC is a valuable diagnostic method for parotid gland masses, offering high accuracy and specificity.
• The MSRSGC provides a reliable framework for estimating malignancy risk in parotid lesions.
• Careful assessment is advised for patients with atypical presentations, and FNAC's limitations necessitate correlation with clinical and pathological data.