Pitfalls in Salivary Gland Fine-Needle Aspiration Cytology
Pitfalls in Salivary Gland Fine-Needle Aspiration Cytology
复制标题
唾液腺细针抽吸细胞学检查的陷阱
DOI：
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发表时间：
2009
期刊：
影响因子：
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通讯作者：
A. Tanwani
中科院分区：
文献类型：
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作者：
A. Tanwani
前言：细针吸取细胞学（FNAC）在涎腺病变中的应用越来越多。大唾液腺和一些小唾液腺是细针穿刺（FNA）的最佳目标。在某些情况下，这些病变的最终组织学结果与FNA结果不同。目的：确定细针吸取细胞学检查对涎腺病变诊断的准确性，并识别组织学诊断不一致的涎腺细针吸取细胞学检查病例，以避免最常见的诊断陷阱。材料和方法：回顾性分析2008年1月至2009年9月在PIMS病理科进行的61例涎腺FNAC病例，以确定可能导致这种差异的细胞学特征。结果：31例患者为男性，年龄04-76岁，平均38.84 ± 14岁。非肿瘤性25例（43.1%），良性31例（55.1%），恶性02例（3.44%）。FNAC阳性预测值为100%，阴性预测值为91.4%。08例FNAC对病变分型诊断不一致。6/8例误诊为多形性腺瘤。最常见的漏诊是粘液表皮样癌。结论：多形性腺瘤和粘液表皮样癌是临床常见病，诊断困难。经验丰富的细胞病理学家应审查所有的细胞学切片
Introduction: Fine needle aspiration cytology (FNAC) of salivary gland lesion is being increasingly used. Major salivary glands and some minor salivary glands are optimal targets for fine-needle aspiration (FNA). In some instances the final histology of these lesions differs from the FNA result. Objective: To determine the diagnostic accuracy of FNAC in salivary gland lesions and identify the salivary gland FNA cases having discordant histological diagnosis so that most common diagnostic pitfalls can be avoided. Material and Methods: In Pathology department, PIMS, 61 salivary gland FNAC cases from Jan 2008 to Sep 2009 were retrospectively reviewed to identify the cytological characteristics that may have contributed to this discrepancy. Results: 31 were males and age ranges from 04-76 years (mean 38.84 ± 14). 25(43.1%) were diagnosed non-neoplastic, 31(55.1%) were rendered benign while 02 (3.44%) were malignant on cytology. Positive predictive value of FNAC was 100% and negative predictive value was 91.4%. 08 FNAC cases show discordant diagnosis in specific typing of the lesion. 6/8 cases were misdiagnosed as pleomorphic adenoma. The most common missed diagnosis was mucoepidermoid carcinoma. Conclusion: Pleomorphic adenoma and mucoepidermoid carcinoma are common in occurrence and create problems in diagnosis. Experience cytopathologist should review all the cytology slides