Parotid Gland Tumors: diagnostic accuracy of fine needle aspira-tion cytology, imaging studies and histopathological findings
Abstract Introduction and objective: Our aim is to establish the profitability of cytological diagnosis by fine needle aspiration (FNA) and the usefulness of preoperative imaging in the management of parotid masses. Method: A retrospective study of a sample of 142 patients with parotid tumors operated on by the HUPR Otorhinolaryngology Service in the last 10 years, with preoperative radiological (ultrasound, CT, MRI) and cytological diagnosis, by FNA, was carried out. The results of both tests have been classified as positive or negative for malignancy and were compared with the pathological diagnosis. Results: The average age was 56, 61.3% were men. FNA had a sensitivity to detect malignancy of 75% and a specificity of 100%; with positive and negative predictive values (NPV) of 100 and 97%, respectively. The sensitivity of the radiological study was 25%, and the specificity 99%. The positive predictive value for malignancy was 80%, and the negative predictive value was 89%. Conclusions: FNA is a simple test, but of limited utility for diagnostic orientation due to its low sensitivity and high false negatives; however, its high specificity and high NPV make it a more accurate test against a benign or negative result. The previous radiological study is useful in the diagnosis of tumor extension and characteristics, although it is limited by itself in the differential diagnosis of malignancy. MRI has become the imaging modality of choice.
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Gete García P, Almodóvar Álvarez C, García Álvarez G, Rodríguez Francos MI, Cerván Rubiales F, Sangó Lamban P. Tumores parotídeos: correlación entre la punción aspiración con aguja fina y los hallazgos histopatológicos. Acta Otorrinolaringol Esp. 2006;57(6):279–82.
Inohara H, Akahani S, Yamamoto Y, Hattori K, Tomiyama Y, Tomita Y, et al. The role of fine-needle aspiration cytology and magnetic resonance imaging in the management of parotid mass lesions. Acta Otolaryngol. 2008;128(10):1152–8.
Zbären P, Schär C, Hotz MA, Loosli H. Value of fine-needle aspiration cytology of parotid gland masses. Laryngoscope. 2001;111(11 Pt 1):1989–92.
Zbären P, Nuyens M, Loosli H, Stauffer E. Diagnostic accuracy of fine-needle aspiration cytology and frozen section in primary parotid carcinoma: Diagnoses of Parotid Carcinomas. Cancer. 2004;100(9):1876–83.
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(8):781–6.
Takashima S, Sone S, Takayama F, Maruyama Y, Hasegawa M, Horii A, et al. Assessment of parotid masses: which MR pulse sequences are optimal? Eur J Radiol. 1997;24(3):206–15.
Takashima S, Takayama F, Wang Q, Kurozumi M, Sekiyama Y, Sone S. Parotid gland lesions: diagnosis of malignancy with MRI and flow cytometric DNA analysis and cytology in fine-needle aspiration biopsy. Head Neck. 1999;21(1):43–51.
Contucci AM, Corina L, Sergi B, Fadda G, Paludetti G. Correlation between fine needle aspiration biopsy and histologic findings in parotid masses. Personal experience. Acta Otorhinolaryngol Ital. 2003;23(4):314–8.
Christensen RK, Bjørndal K, Godballe C, Krogdahl A. Value of fine-needle aspiration biopsy of salivary gland lesions. Head Neck. 2010;32(1):104–8.
Bajaj Y, Singh S, Cozens N, Sharp J. Critical clinical appraisal of the role of ultrasound guided fine needle aspiration cytology in the management of parotid tumours. J Laryngol Otol. 2005;119(4):289–92.
Liu CC, Jethwa AR, Khariwala SS, Johnson J, Shin JJ. Sensitivity, specificity, and posttest probability of parotid fine-needle aspiration: A systematic review and meta-analysis: A systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2016;154(1):9–23.
Cohen EG, Patel SG, Lin O, Boyle JO, Kraus DH, Singh B, et al. Fine-needle aspiration biopsy of salivary gland lesions in a selected patient population. Arch Otolaryngol Head Neck Surg. 2004;130(6):773–8.
Al-Khafaji BM, Nestok BR, Katz RL. Fine-needle aspiration of 154 parotid masses with histologic correlation: ten-year experience at the University of Texas M. D. Anderson Cancer Center. Cancer. 1998;84(3):153–9.
Atula T, Grenman R, Laippala P, Klemi PJ. Fine needle aspiration biopsy in the diagnosis of parotid gland lesions. Diagn Cytopathol 1995;15:185-190.
Zerpa Zerpa V, Cuesta Gonzáles MT, Agostini Porras G, Marcano Acuña M, Estellés Ferriol E, Dalmau Galofre J. Diagnostic accuracy of fine needle aspiration cytology in parotid tumours. Acta Otorrinolaringol (Engl Ed). 2014;65(3):157–61.
Muñoz Palza C, Cordero Jiménez A, Tenor Serrano R, García Mata R, Contreras Molina P, García Muñoz I. Correlación citohistológica en tumores de la glándula parótida. Acta Otorrinolaringol Esp. 2010;61(3):184–8.
Picazo MDM, Monfort LR, Ripollés ÁM, Ojeda MDR, Guarín JMP, Mallagaray FB. Algoritmos diagnósticos en la patología glandular de cabeza y cuello. Cómo realizar el manejo clínico-radiológico de las patologías más frecuentes. Seram. 2018
Assili S, Fathi Kazerooni A, Aghaghazvini L, Saligheh Rad HR, Pirayesh Islamian J. Dynamic contrast magnetic resonance imaging (DCE-MRI) and diffusion weighted MR imaging (DWI) for differentiation between benign and malignant salivary gland tumors. J Biomed Phys Eng. 2015;5(4):157–68.
Inohara H, Akahani S, Yamamoto Y, Hattori K, Tomiyama Y, Tomita Y, et al. The role of fine-needle aspiration cytology and magnetic resonance imaging in the management of parotid mass lesions. Acta Otolaryngol. 2008;128(10):1152–8.
Zbären P, Schär C, Hotz MA, Loosli H. Value of fine-needle aspiration cytology of parotid gland masses. Laryngoscope. 2001;111(11 Pt 1):1989–92.
Zbären P, Nuyens M, Loosli H, Stauffer E. Diagnostic accuracy of fine-needle aspiration cytology and frozen section in primary parotid carcinoma: Diagnoses of Parotid Carcinomas. Cancer. 2004;100(9):1876–83.
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(8):781–6.
Takashima S, Sone S, Takayama F, Maruyama Y, Hasegawa M, Horii A, et al. Assessment of parotid masses: which MR pulse sequences are optimal? Eur J Radiol. 1997;24(3):206–15.
Takashima S, Takayama F, Wang Q, Kurozumi M, Sekiyama Y, Sone S. Parotid gland lesions: diagnosis of malignancy with MRI and flow cytometric DNA analysis and cytology in fine-needle aspiration biopsy. Head Neck. 1999;21(1):43–51.
Contucci AM, Corina L, Sergi B, Fadda G, Paludetti G. Correlation between fine needle aspiration biopsy and histologic findings in parotid masses. Personal experience. Acta Otorhinolaryngol Ital. 2003;23(4):314–8.
Christensen RK, Bjørndal K, Godballe C, Krogdahl A. Value of fine-needle aspiration biopsy of salivary gland lesions. Head Neck. 2010;32(1):104–8.
Bajaj Y, Singh S, Cozens N, Sharp J. Critical clinical appraisal of the role of ultrasound guided fine needle aspiration cytology in the management of parotid tumours. J Laryngol Otol. 2005;119(4):289–92.
Liu CC, Jethwa AR, Khariwala SS, Johnson J, Shin JJ. Sensitivity, specificity, and posttest probability of parotid fine-needle aspiration: A systematic review and meta-analysis: A systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2016;154(1):9–23.
Cohen EG, Patel SG, Lin O, Boyle JO, Kraus DH, Singh B, et al. Fine-needle aspiration biopsy of salivary gland lesions in a selected patient population. Arch Otolaryngol Head Neck Surg. 2004;130(6):773–8.
Al-Khafaji BM, Nestok BR, Katz RL. Fine-needle aspiration of 154 parotid masses with histologic correlation: ten-year experience at the University of Texas M. D. Anderson Cancer Center. Cancer. 1998;84(3):153–9.
Atula T, Grenman R, Laippala P, Klemi PJ. Fine needle aspiration biopsy in the diagnosis of parotid gland lesions. Diagn Cytopathol 1995;15:185-190.
Zerpa Zerpa V, Cuesta Gonzáles MT, Agostini Porras G, Marcano Acuña M, Estellés Ferriol E, Dalmau Galofre J. Diagnostic accuracy of fine needle aspiration cytology in parotid tumours. Acta Otorrinolaringol (Engl Ed). 2014;65(3):157–61.
Muñoz Palza C, Cordero Jiménez A, Tenor Serrano R, García Mata R, Contreras Molina P, García Muñoz I. Correlación citohistológica en tumores de la glándula parótida. Acta Otorrinolaringol Esp. 2010;61(3):184–8.
Picazo MDM, Monfort LR, Ripollés ÁM, Ojeda MDR, Guarín JMP, Mallagaray FB. Algoritmos diagnósticos en la patología glandular de cabeza y cuello. Cómo realizar el manejo clínico-radiológico de las patologías más frecuentes. Seram. 2018
Assili S, Fathi Kazerooni A, Aghaghazvini L, Saligheh Rad HR, Pirayesh Islamian J. Dynamic contrast magnetic resonance imaging (DCE-MRI) and diffusion weighted MR imaging (DWI) for differentiation between benign and malignant salivary gland tumors. J Biomed Phys Eng. 2015;5(4):157–68.
Caceres-Puerto, M., Porras-Alonso, E., & Salom-Coveñas, C. (2022). Parotid Gland Tumors: diagnostic accuracy of fine needle aspira-tion cytology, imaging studies and histopathological findings. Revista ORL, 14(2), e29977. https://doi.org/10.14201/orl.29977
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