Tükürük bezi lezyonlarının tanısında ince iğne aspirasyon biyopsinin yeri: Histopatolojik karşılaştırmalı çalışma
Öz
Amaç: Tükürük bezi non-neoplastik ve neoplastik lezyonlarının tedavileri farklılık gösterdiği için, preoperatif dönemde ayrımlarının yapılması önemlidir. İnce iğne aspirasyon biyopsisi (İİAB) bu amaçla en yaygın kullanılan tanı yöntemlerinden biridir. Burada tükürük bezi lezyonlarının sitolojik-histopatolojik tanılarının karşılaştırılması, İİAB sonuçlarının sensitivite, spesifite, prediktif değer (PV) ve tanısal doğruluğunun değerlendirilmesi amaçlandı.
Materyal ve metod: Bölümümüzde incelenen İİAB ve eksizyon materyali olan 156 olgu sitolojik-histopatolojik tanıları ile karşılaştırıldı.
Bulgular: Lezyonlar 132 (%84.6) olguda parotis bezinde, 22 (%14.1) olguda submandibuler bezde ve 2 (%1.3) olguda minör tükürük bezinde lokalizeydi. İİAB’lerin sitomorfolojik sonuçlarına göre % 7.05’i (n=11) nondiagnostik, %78.21’i (n=122) benign, % 7.05’i (n=11) kuşkulu ve % 7.69’u (n=12) malign olarak sınıflandırıldı. Olguların sitolojik-histopatolojik tanıları karşılaştırıldığında; malign lezyonlar içinde 12 olgunun (12/12; %100) ve benign lezyonlar içinde 121 olgunun (121/122; %99.2) tanıları uyumluydu. False negatif bir olgu (%0.8) (warthin tümör→mukoepidermoid karsinom) saptandı. False pozitif olgu saptanmadı (%0). Kuşkulu lezyonlar içinde üç olgunun histopatolojik incelemeleri ektopik tiroid dokusu, sialadenit ve pleomorfik adenom tanıları ile sonuçlandı. Sensitivite, spesifite, pozitif PV, negatif PV ve doğruluk analizi değerlendirmesinde sırasıyla % 92.3, % 100.0, % 100.0, % 99.2 ve % 99.3 sonuçları elde edildi.
Sonuç: İİAB’lerinde yeterli örnekleme ile birlikte değerlendirmelerindeki deneyim, çalışmamızda olduğu gibi false pozitif/negatif sonuçları en aza indirgeyecek ve preoperatif dönemde doğru tanıya ulaştıracaktır. Bununla birlikte tükürük bezi lezyonlarının geniş yelpazesi ve örtüşebilecek sitomorfolojik bulguların varlığı da akılda tutulmalıdır.
Anahtar Kelimeler
Tükürük bezi ince iğne aspirasyon biyopsisi pleomorfik adenom mukoepidermoid karsinom
Kaynakça
- Eveson JW, Auclair P, Gnepp DR, El-Naggar AK. Tumours of the salivary glands: Introduction. Barnes L, Eveson JW, Reichart P, Sidransky D (editors): Pathology and genetics of head and neck tumours. IARC Press: Lyon; 2005, p. 210-212.
- Speight PM, Barrett AW. Salivary gland tumours: Diagnostic challenges and an update on the latest WHO classification, Diagn Histopathol. 2020;26(4):147-158.
- Uğuz AH. Tükürük bezleri. Sarıoğlu S (editor). Baş boyun patolojisi. O’tıp kitabevi: İzmir; 2014, s. 235-314.
- Naz S, Hashmi AA, Khurshid A, Faridi N, Edhi MM, Kamal A, Khan M. Diagnostic role of fine needle aspiration cytology (FNAC) in the evaluation of salivary gland swelling: an institutional experience, BMC Research Notes. 2015;8:101.
- Lekshmi V, Mini B. Diagnostic accuracy of FNAC in malignant salivary gland lesions-A study with histopathological correlation, J Evid Based Med Health. 2020;7:1587-1590.
- Gudmundsson JK, Ajan A, Abtahi J. The accuracy of fine-needle aspiration cytology for diagnosis of parotid gland masses: A clinicopathological study of 114 patients, J App Oral Sci. 2016;24(6):561-567.
- Salehi S, Maleki Z. Diagnostic challenges and problem cases in salivary gland cytology: A 20-year experience, Cancer Cytopathol. 2018;126(2):101-111.
- Faquin WC, Rossi ED: The Milan system for reporting salivary gland cytopathology (Eds. Faquin WC, Rossi ED). Springer: Switzerland; 2108.
- Singh R, Pawane PS. Cytological diagnosis of salivary gland lesions with histopathological correlation, Ann App Bio-Sci. 2017;4(1):A41-A45.
- Kakoty S, Baruah TD, Babu G. FNAC and histopathological correlation of salivary gland lesions: An observational study, Int Surg J. 2017;4(7):2148-2152.
- Jain B, Gupta R, Kudesia M, Singh S. Fine needle aspiration cytology in diagnosis of salivary gland lesions: A study with histologic comparison, Cytojournal. 2013;10:5.
- Ali NS, Akhtar S, Junaid M, Awan S, Aftab K. Diagnostic accuracy of fine needle aspiration cytology in parotid lesions, ISRN Surg. 2011;2011:721525.
- Supreetha MS, Hemalatha A, Bhaskaran A. Salivary gland tumors: Features not to be missed on cytology. A study of five cases, J Diagn Pathol Oncol. 2019;4(1):50-53.
- Elagoz S, Gulluoglu M, Yılmazbayhan D, Ozer H, Arslan I. The value of fine needle aspiration cytology in salivary gland lesions, 1994-2004, ORL J Otorhinolaryngol Relat Spec. 2007;69:51-56.
- Tahoun N, Ezzat N. Diagnostic accuracy and pitfalls of preoperative fine needle aspiration cytology in salivary gland lesions, J Egypt Natl Canc Inst, 2008;20(4):358-368.
- Piccioni LO, Fabiano B, Gemma M, Sarandria D, Bussi M. Fine-needle aspiration cytology in the diagnosis of parotid lesions, Acta Otorhinolaryngol Ital. 2011;31:1-4.
- Fernandes H, D’souza CRS, Khosla C, George L, Katte NH. Role of FNAC in the preoperative diagnosis of salivary gland lesions, J Clin Diagn Res. 2014;8(9):FC01-FCO3.
- Koirala S, Sayami G, Pant AD. Correlation of FNAC and histopathology in diagnosis of salivary gland lesions, J Pathol Nepal. 2014;4:654-657.
- Mengi, Kara CO, Tumkaya F, Ardic FN, Topuz B, Bir F. Salivary gland tumors: A 15-year experience of a university hospital in Turkey, North Clin Istanb. 2020;7(4):366-371.
- Edizer DT, Server EA, Yiğit Ö, Yıldız M. Role of fine needle aspiration biopsy in the management of salivary gland masses, Turk Arch Otorhinolaryngol. 2016;54:105-111.
- Nanda KDS, Mehta A, Nanda J. Fine-needle aspiration cytology: A reliable tool in the diagnosis of salivary gland lesions, Oral Pathol Med. 2012;41(1):106-112.
- Özkara SK, Yıldız K. Tükürük bezi ince iğne aspirasyon sitolojisi (39 olguda sito-histopatolojik korelasyon), Turk J Pathol. 2002;18(3-4):35-38.
- Fundakowski C, Castano J, Abouyared M, Lo K, Rivera A, Ojo R, Gomez-Fernandez C, Messinger S, Sargi Zoukaa. The role of indeterminate fine-needle biopsy in the diagnosis of parotid malignancy, Laryngoscope. 2014;124:678-681.
- Babazade F, Mortazavi H, Jalalian H, Shahvali E. Thyroid tissue as a submandibular mass: a case report, J Oral Sci. 2009;51(4):655-657.
- Omhare A, Singh SK, Nigam JS, Sharma A. Cytohistopathological study of salivary gland lesions in Bundelkhand Region, Uttar Pradesh, India, Pathol Res Intern. 2014;2014:804265.
- Lombardi D, Accorona R, Lambert A, Mercante G, Coropciuc R, Paderno A, Lancini D, Spriano G,Nicolai P, Poorten VV. Long-term outcomes and prognosis in submandibular gland malignant tumors: A multicenter study, Laryngoscope. 2018;128(12):2745-2750.
The role of fine-needle aspiration biopsy in the diagnosis of salivary gland lesions: a comparative histopathological study
Öz
Objective: As the treatment of neoplastic and non-neoplastic lesions of salivary gland differs, their differentiation in preoperative period is crucial. Fine-needle aspiration biopsy (FNAB) is among the common diagnostic methods for this purpose. We intended to compare the cytological-histopathological diagnosis of salivary gland lesions, and evaluate sensitivity, specificity, predictive value (PV) and diagnostic accuracy of the FNAB results.
Methods: 156 cases examined in our department, having FNAB and excision material, were compared with their cytological-histopathological diagnosis.
Results: Lesions were localized in parotid gland in 132 cases, in submandibular gland in 22 cases, and in minor salivary gland in 2 cases. FNABs were categorized based on their cytomorphological results into nondiagnostic (7.05%), benign (78.21%), suspicious (7.05%) and malignant (7.69%) groups. When the cytological-histopathological diagnosis of cases was compared, the diagnosis of 12 cases among malignant lesions (100%, 12/12) and 121 among benign lesions (99.2%, 121/122) were found to be compatible. One false negative case (0.8%) (warthin tumor→mucoepidermoid carcinoma) was detected, but no false positive (0%) was the case. Histopathological examinations of three cases among suspicious lesions resulted in diagnosis of ectopic thyroid tissue, sialadenitis and pleomorphic adenoma. Results of sensitivity, specificity, positive PV, negative PV and accuracy analysis examinations were respectively 92.3%, 100%, 100%, 99.2% and 99.3%.
Conclusion: Evaluating FNABs with sufficient sampling minimizes false positive/negative results, leading to accurate diagnosis in preoperative period. Wide range of salivary gland lesions and overlapping cytomorphological findings should also be minded.
Anahtar Kelimeler
Salivary gland fine-needle aspiration biopsy pleomorphic adenoma mucoepidermoid carcinoma
Kaynakça
- Eveson JW, Auclair P, Gnepp DR, El-Naggar AK. Tumours of the salivary glands: Introduction. Barnes L, Eveson JW, Reichart P, Sidransky D (editors): Pathology and genetics of head and neck tumours. IARC Press: Lyon; 2005, p. 210-212.
- Speight PM, Barrett AW. Salivary gland tumours: Diagnostic challenges and an update on the latest WHO classification, Diagn Histopathol. 2020;26(4):147-158.
- Uğuz AH. Tükürük bezleri. Sarıoğlu S (editor). Baş boyun patolojisi. O’tıp kitabevi: İzmir; 2014, s. 235-314.
- Naz S, Hashmi AA, Khurshid A, Faridi N, Edhi MM, Kamal A, Khan M. Diagnostic role of fine needle aspiration cytology (FNAC) in the evaluation of salivary gland swelling: an institutional experience, BMC Research Notes. 2015;8:101.
- Lekshmi V, Mini B. Diagnostic accuracy of FNAC in malignant salivary gland lesions-A study with histopathological correlation, J Evid Based Med Health. 2020;7:1587-1590.
- Gudmundsson JK, Ajan A, Abtahi J. The accuracy of fine-needle aspiration cytology for diagnosis of parotid gland masses: A clinicopathological study of 114 patients, J App Oral Sci. 2016;24(6):561-567.
- Salehi S, Maleki Z. Diagnostic challenges and problem cases in salivary gland cytology: A 20-year experience, Cancer Cytopathol. 2018;126(2):101-111.
- Faquin WC, Rossi ED: The Milan system for reporting salivary gland cytopathology (Eds. Faquin WC, Rossi ED). Springer: Switzerland; 2108.
- Singh R, Pawane PS. Cytological diagnosis of salivary gland lesions with histopathological correlation, Ann App Bio-Sci. 2017;4(1):A41-A45.
- Kakoty S, Baruah TD, Babu G. FNAC and histopathological correlation of salivary gland lesions: An observational study, Int Surg J. 2017;4(7):2148-2152.
- Jain B, Gupta R, Kudesia M, Singh S. Fine needle aspiration cytology in diagnosis of salivary gland lesions: A study with histologic comparison, Cytojournal. 2013;10:5.
- Ali NS, Akhtar S, Junaid M, Awan S, Aftab K. Diagnostic accuracy of fine needle aspiration cytology in parotid lesions, ISRN Surg. 2011;2011:721525.
- Supreetha MS, Hemalatha A, Bhaskaran A. Salivary gland tumors: Features not to be missed on cytology. A study of five cases, J Diagn Pathol Oncol. 2019;4(1):50-53.
- Elagoz S, Gulluoglu M, Yılmazbayhan D, Ozer H, Arslan I. The value of fine needle aspiration cytology in salivary gland lesions, 1994-2004, ORL J Otorhinolaryngol Relat Spec. 2007;69:51-56.
- Tahoun N, Ezzat N. Diagnostic accuracy and pitfalls of preoperative fine needle aspiration cytology in salivary gland lesions, J Egypt Natl Canc Inst, 2008;20(4):358-368.
- Piccioni LO, Fabiano B, Gemma M, Sarandria D, Bussi M. Fine-needle aspiration cytology in the diagnosis of parotid lesions, Acta Otorhinolaryngol Ital. 2011;31:1-4.
- Fernandes H, D’souza CRS, Khosla C, George L, Katte NH. Role of FNAC in the preoperative diagnosis of salivary gland lesions, J Clin Diagn Res. 2014;8(9):FC01-FCO3.
- Koirala S, Sayami G, Pant AD. Correlation of FNAC and histopathology in diagnosis of salivary gland lesions, J Pathol Nepal. 2014;4:654-657.
- Mengi, Kara CO, Tumkaya F, Ardic FN, Topuz B, Bir F. Salivary gland tumors: A 15-year experience of a university hospital in Turkey, North Clin Istanb. 2020;7(4):366-371.
- Edizer DT, Server EA, Yiğit Ö, Yıldız M. Role of fine needle aspiration biopsy in the management of salivary gland masses, Turk Arch Otorhinolaryngol. 2016;54:105-111.
- Nanda KDS, Mehta A, Nanda J. Fine-needle aspiration cytology: A reliable tool in the diagnosis of salivary gland lesions, Oral Pathol Med. 2012;41(1):106-112.
- Özkara SK, Yıldız K. Tükürük bezi ince iğne aspirasyon sitolojisi (39 olguda sito-histopatolojik korelasyon), Turk J Pathol. 2002;18(3-4):35-38.
- Fundakowski C, Castano J, Abouyared M, Lo K, Rivera A, Ojo R, Gomez-Fernandez C, Messinger S, Sargi Zoukaa. The role of indeterminate fine-needle biopsy in the diagnosis of parotid malignancy, Laryngoscope. 2014;124:678-681.
- Babazade F, Mortazavi H, Jalalian H, Shahvali E. Thyroid tissue as a submandibular mass: a case report, J Oral Sci. 2009;51(4):655-657.
- Omhare A, Singh SK, Nigam JS, Sharma A. Cytohistopathological study of salivary gland lesions in Bundelkhand Region, Uttar Pradesh, India, Pathol Res Intern. 2014;2014:804265.
- Lombardi D, Accorona R, Lambert A, Mercante G, Coropciuc R, Paderno A, Lancini D, Spriano G,Nicolai P, Poorten VV. Long-term outcomes and prognosis in submandibular gland malignant tumors: A multicenter study, Laryngoscope. 2018;128(12):2745-2750.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Cerrahi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Ağustos 2023 |
| Gönderilme Tarihi | 26 Nisan 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 2 Sayı: 2 |
