The Role of Fine Needle Aspiration Biopsy in The Diagnosis of Parotis Masses

Yıl 2022, Cilt: 11 Sayı: 2, 194 - 199, 31.08.2022

Ercan Kurt Mahmut Çoraplı Safiye Kafadar Bilge Aydın Türk Koray Tümüklü

https://doi.org/10.47493/abantmedj.1061042

Öz

Objective: The aim of this study is to determine the accuracy and usefulness of fine needle aspiration biopsy(FNAB) in the diagnosis of parotid masses.

Materials and Methods: FNAB findings of 123 patients who were operated over a last ten years period were retrospectively analyzed and compared with histopathological findings. We examined the sensitivity, the specificity, the positive predictive value (PPV), the negative predictive value (NPV) of FNAB.

Results: FNAB results of the patients who participated in the study are as follow; non-diagnostic for 7 patient (%5.7), atypia of undetermined significance for 7 patients (%5.7), bening neoplasm for 98 patients (79.7%) and malign cytology for 11 patients (%8.9). Histopathological results were maligned found in 1 out of 98 patients with benign neoplasm in cytology results in FNAB. The histopathological result was benign in 2 of 11 patients with malignant neoplasm in the cytology findings with FNAB. The specificity of FNAB in the diagnosis of parotid masses was found as 98% and the sensitivity was 90%. The positive predictive value (PPD) was detected as 86% and the negative predictive value was detected 98%.

Conclusion: Since malignant masses of the parotid are rare and diverse, diagnosis with FNAB can be difficult. Another complicating factor is the similarity of low-grade malignant tumor and benign tumor. As a result, FNAB has high accuracy for benign parotid tumors, but low for malignant parotid tumors.

Anahtar Kelimeler

Parotid Masses, Fine Needle Aspiration Biopsy, Parotidectomy, Salivatory Gland

Parotis Kitlelerinin Teşhisinde İnce İğne Aspirasyon Biyopsisinin Rolü

Öz

Amaç: Bu çalışmanın amacı; parotis kitlelerinin teşhisinde ince iğne aspirasyon biyopsisinin doğruluğu ve yararlılığını belirlemektir.

Gereç ve Yöntemler: 10 yıllık süre içinde parotis bezinde kitle nedeniyle opere edilen 123 hastanın ince iğne aspirasyon biyopsisi bulguları retrospektif olarak incelendi ve histopatolojik bulgularla karşılaştırıldı. İnce iğne aspirasyon biyopsisinin(İİAB) duyarlılık, özgüllük, pozitif prediktif değer (PPV), negatif prediktif değerlerine (NPV) bakıldı.

Bulgular: Çalışmaya katılan 123 hastanın 67’si erkek (%54.4), 56’sı bayandır(%45.6). Hastaların yaş ortalaması 52’dir (yaş aralığı: 38-84). Çalışmaya katılan hastaların İİAB sonuçları 7 hastanın non-diagnostik (%5.7), 7 hastanın atypia of undetermined significance (%5.7), 98 hastanın bening sitoloji (79.7), 11 hastanın ise malign sitoloji (%8.9) gelmiştir. İİAB’de sitoloji sonucu bening neoplazm gelen 98 hastanın, 1 tanesinde histopatojik sonuç malign olarak gelmiştir. İİAB ‘de sitoloji sonucu malign neoplazm gelen 11 hastanın, 2 tanesinde histopatoji sonucu bening olarak gelmiştir. Parotis kitlelerinin tanısında İİAB'nin özgüllüğü %98, duyarlılığı %90 olarak bulundu. Pozitif prediktif değer %86, negatif prediktif değer %98 olarak tespit edildi.

Sonuç: Malign karakterli parotis kitlelerinin nadir olması, malign tümör çeşitliliğinin çok olması nedeniyle malign parotis kitlelerinin ince iğne aspirasyon biyopsisi ile tanısı zordur. Diğer zorlaştırıcı faktör bening tümörler ile düşük dereceli malign tümörlerin benzer yapıda olmasıdır. Preoperatif İİAB’nin tanısal doğruluğu, iyi huylu tümörler için yüksek ve kötü huylu tümörler için düşüktür.

Anahtar Kelimeler

Parotis Kitlesi, İnce İğne Aspirasyon Biyopsisi, Parotidektomi, Tükrük Bezi

Kaynakça

• Reference1-Pinkston JA, Cole P. Incidence rates of salivary gland tumors: results from a population-based study. Otolaryngol Head Neck Surg. 1999;120(6):834–40.
• Reference2- Eveson JW, Cawson RA. Salivary gland tumors. A review of 2410 cases with particular reference to histological types, site age and sex distribution. J Pathology 1985;146:51-8.
• Reference3- Stewart CJ, MacKenzie K, McGarry GW, Bir M. Fine-needle aspiration cytology of salivary gland: a review of 341 cases. Diagn Cytopathol. 2000;22:139–46.
• Reference4- Zbaren P, Schar C, Hotz MA, Loosli H. Value of fine needle aspiration cytology of parotid gland masses. Laringoskop. 2001; 111 (11 Pt 1): 1989–92.
• Reference5- Henrys C.E, Grigg. Use of fine‐needle aspiration cytology in the diagnosis of parotid neoplasms, OTOLARYNGOLOGY HEAD AND NECK SURGERY, First published: 26 November 2014 https://doi.org/10.1111/ans.12939
• Reference6- 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 Appl Oral Sci. Nov-Dec 2016;24(6):561-67. doi: 10.1590/1678-775720160214.
• Reference7- Galli A , Tulli M, Giordano L , Biafora M , Santo DD , Bondi S, Piccioni LO, Bussi M, Fine needle aspiration cytology for parotid neoplasms: risk of malignancy through inconclusive results and lower grade tumors, Eur Arch Otorhinolaryngol. 2020 Mar;277(3):841-51. doi: 10.1007/s00405-019-05733-w. Epub 2019 Nov 19.
• Reference8-S Dalları , Gusella B , P Campanella , M Ciommi , P Pantanetti , E Tortato , Castriotta B, Current usefulness of aspiration cytology (FNAC) in the head and neck diagnosis, Pathologica. 2017 Dec;109(4):355-62.
• Reference9-Hanege FM, Tüysüz O, Sakallıoğlu Ö, Solmaz ÖA, Diagnostic value of preoperative fine needle aspiration cytology in parotid gland tumors, Diagn Cytopathol. 2020 Jun 20. doi: 10.1002/dc.24514.
• Reference10. Jeong WJ, Park SJ, Cha W, Sung MW, Kim KH, Ahn SH. Fine needle aspiration of parotid tumors: utility from a clinical perspective. J Oral Maxillofac Surg. 2013;71:1278---82.
• Reference11. Bartels S, Talbot JM, diTomasso J, Everts EC, Andersen PE, Wax MK, et al. The relative value of fine-needle aspiration and imaging in the preoperative evaluation of parotid masses. Head Neck. 2000;22:781---6.
• Reference12. Feinstein AJ, Alonso J, Yang SE, St John M. Diagnostic accuracy of fine-needle aspiration for parotid and submandibular gland lesions. Otolaryngol Head Neck Surg. 2016;155:431---6.
• Reference13. Ghantous Y, Naddaf R, Barak M, Abd-Elraziq M, Abu Eln- Naaj I. The role of fine needle aspiration in the diagnosis of parotid gland tumors: correlation with preoperative computer- ized tomography tumor size. J Craniofac Surg. 2016;27:e192---6.
• Reference14. Weerasinghe A, Lai FY, Foong MM. Re: Use of fine-needle aspira- tion cytology in the diagnosis of parotid neoplasms. ANZ J Surg. 2015;85:892.
• Reference15. Hartimath B, Kudva A, Rathore AS. Role of fine-needle aspiration cytol- ogy in swellings of the parotid region. Indian J Surg. 2011;73:19-23.
• Reference16. Marzouki HZ, Altabsh MA, Albakrei MO, Al-Khatib TA, Merdad MA, Farsi NJ. Accuracy of preoperative fine needle aspiration in diagnosis of malignant parotid tumors. Saudi Med J. 2017;38(10):1000-6.