D S Wong1, G K Li. 1. Division of Head & Neck Surgery, Department of Surgery, University of Hong Kong Medical Center, Queen Mary Hospital.
Abstract
BACKGROUND: Fine-needle aspiration cytology (FNA) is a well-established tool for investigating many head and neck conditions. It application in parotid tumors is, however, very controversial. This article is aimed at defining the exact role of FNA in the diagnostic workup of patients. METHODS: A retrospective review of a 12-years' experience in a university surgical unit of 186 consecutive patients. Clinical opinion, FNA results, and final pathologic findings were examined. RESULTS: FNA obtained the correct final pathologic condition in 54.3% of cases. It increased the identification of malignancy to 64.5% compared with 26% based solely on clinical signs. Malignant FNA diagnoses (85.7%) and repeatedly inconclusive reports (25.7%) were associated with a higher incidence of malignancy. CONCLUSIONS: Methodological interpretation of FNA results provides useful preoperative information and enables more reliable patient counseling and reduces pathologic surprises. Its enhancement of the preoperative recognition of malignant parotid tumors may alert more stringent attention to the operative margin and hence better tumor clearance.
BACKGROUND: Fine-needle aspiration cytology (FNA) is a well-established tool for investigating many head and neck conditions. It application in parotid tumors is, however, very controversial. This article is aimed at defining the exact role of FNA in the diagnostic workup of patients. METHODS: A retrospective review of a 12-years' experience in a university surgical unit of 186 consecutive patients. Clinical opinion, FNA results, and final pathologic findings were examined. RESULTS: FNA obtained the correct final pathologic condition in 54.3% of cases. It increased the identification of malignancy to 64.5% compared with 26% based solely on clinical signs. Malignant FNA diagnoses (85.7%) and repeatedly inconclusive reports (25.7%) were associated with a higher incidence of malignancy. CONCLUSIONS: Methodological interpretation of FNA results provides useful preoperative information and enables more reliable patient counseling and reduces pathologic surprises. Its enhancement of the preoperative recognition of malignant parotid tumors may alert more stringent attention to the operative margin and hence better tumor clearance.
Authors: D H Mallon; M Kostalas; F J MacPherson; A Parmar; A Drysdale; E Chisholm; S Sadek Journal: Ann R Coll Surg Engl Date: 2013-05 Impact factor: 1.891