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Korean Journal of Otorhinolaryngology-Head and Neck Surgery 1995;38(12): 2041-9. |
Fine Needle Aspiration Cytology of Salivary Gland Lesions ? The Guideline for its Clinical Application - |
Yong-Gun Cho, MD1, Sang Yoon Kim, MD1, Hyo Jun Kim, MD1, Kwangchol Chu, MD1, and Gyungyub Gong, MD2 |
1;Department of Otolaryngology, 2;Diagnostic Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea |
타액서 병변에 대한 세침흡인 세포검사 - 임상적 이용원칙의 모색 - |
조용건1 · 김상윤1 · 김효준1 · 추광철1 · 공경엽2 |
울산대학교 의과대학 서울중앙병원 이비인후과학교실1;진단병리학교실2; |
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ABSTRACT |
Aspirates of eighty cases of salivary gland lesions with histologic correlation were reviewed along with the preoperative assessment in each case. Thirty-seven cases(46%) had frozen sections made. The eighty cases included 63 cases of benign lesions(45 cases of pleomorphic adenoma, 6 of Warthin’s tumor, 2 of other benign neoplasms and 10 of nonneoplastic lesions) and 17 of primary salivary gland malignancy. The accuracies in distinguishing malignancy from other benign lesions were 87.5% for fine needle aspiration cytology(FNAC) and 92.5% for preoperative assessment. The accuracy of FNAC in diagnosing the specific type of lesions was 60%. The diagnostic sensitivity and specificity of FNAC for malignant lesions were 82.3% and 91.8% respectively, and improved to 88.2% and 93.6% at the stage of preoperative assessment. Several previously published studies of more than 100 cases were listed. A comparison of the cytodiagnosis and frozen section diagnosis(FS) was made. The accuracy of FS in distinguishing malignant lesions was 83.7% and 78.3% was that of FNAC in the same cases. The accuracies in diagnosing the specific type of disease were 72.9% for FS and 45.9% for FNAC. The diagnostic sensitivity of FS for malignant disease was 45.4% and specificity of FS, 100%(for FNAC, 72.7% and 80.7% respectively). It would b advisable to work out more refined way to get better out of FNAC in that FS is not so accurate as we might expect to be and we can take a lot of advantage if we get the picture of histologic nature of the lesion preoperatively, though FNAC still has some problems and pitfalls and should be interpreted in the clinical context and reenforced by properly selected diagnostic imaging modalities and, if indicated, their FNAC adjuncts.
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Keywords:
Fine needle aspiration cytologyㆍFrozen section biopsyㆍSalivary gland. |
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