Role of fine-needle aspiration cytology and cell morphology in determining the histogenesis of salivary gland lesions.

Fine-needle aspiration (FNA) of suspicious salivary and neck swellings is a simple and cost-effective diagnostic method for the evaluation of inflammatory and neoplastic conditions. The aim of the present study was to evaluate the diagnostic accuracy of FNA cytology (FNAC) in determining the histogenesis of salivary gland lesions based on cytomorphological features and associated histopathological outcomes to refine diagnostic criteria and contribute to improved diagnostic accuracy in salivary gland cytopathology. FNA was performed in 544 patients at the Institute of Pathology, Hannover Medical School (Hannover, Germany). The cytological smears were stained with May-Grunwald Giemsa, Papanicolaou and periodic acid-Schiff and compared with histological specimens from the same patients using immunohistochemical and molecular methods. The samples were anonymized and analyzed retrospectively. Of the total cases, 422 (77.57%) were benign lesions, 59 (10.85%) were malignant lesions and 26 (4.78%) were normal cases. Insufficient material was obtained in 37/544 cases (6.80%). No complications were observed. The concordance with histological findings for neoplastic lesions was >97.5%, with a false negative rate of 1.7%. The sensitivity of the diagnostic methods was 94% and the specificity was 98%. Of the 544 cases, 283 were female (52%) and 261 were male (48%). The diagnostic value of FNAC in representative material was relatively high in distinguishing between benign and malignant lesions. Sensitivity and specificity were variable (60.0-97.5%). Correct diagnosis in the head and neck region requires interdisciplinary integration of findings and pathological-clinical cooperation.