Intraoral and transoral fine needle aspiration. A review of 25 cases.

During a four year period, 25 intraoral and transoral fine needle aspirations were performed. The sites aspirated were the parapharyngeal space (7), palate (4), floor of mouth (3), tongue (3) and a variety of other intraoral sites (8). Squamous cell carcinoma, the most common malignancy encountered, was correctly diagnosed in six cases. Other malignancies correctly diagnosed were 2 malignant lymphomas, 1 mucoepidermoid carcinoma and 1 adenoid cystic carcinoma. One malignant case called "carcinoma, probably adenoid cystic carcinoma" proved to be a mucoepidermoid carcinoma. One case called "suspicious for squamous carcinoma" was found to be a branchial cleft cyst. In another case a diagnosis of carcinoma in situ of the tongue was suggested and confirmed by subsequent biopsy, but the underlying adenoid cystic carcinoma was missed. Of seven benign entities, five were correctly diagnosed by fine needle aspiration (FNA), and in three cases the FNA diagnosis was equivocal. Unsatisfactory aspirates were obtained in four cases. Despite some obvious problems, we consider FNA to be especially useful for the evaluation of parapharyngeal masses, which are usually not accessible to routine surgical biopsy, and for palatal masses, which are usually submucosal and therefore often difficult to biopsy.