FINE NEEDLE ASPIRATION CYTOLOGY VS CORE NEEDLE BIOPSY IN SALIVARY GLAND LESIONS: EXPERIENCE FROM A TERTIARY CARE ENT CENTRE IN SALEM, INDIA

Abstract

Background: Salivary gland lesions present a wide histopathological spectrum, making accurate preoperative diagnosis essential for appropriate clinical management. Fine needle aspiration cytology (FNAC) is widely used as an initial diagnostic modality; however, its limitations include inadequate sampling and lack of architectural detail. Core needle biopsy (CNB) has emerged as an alternative technique with potentially higher diagnostic accuracy.

Objectives: To compare the diagnostic performance of FNAC and CNB in salivary gland lesions using final histopathological diagnosis as the reference standard.

Methodology : This hospital-based observational comparative study was conducted at a tertiary care ENT centre in Salem, India. Forty patients with clinically or radiologically detected salivary gland lesions underwent both FNAC and ultrasound-guided CNB. Cytological and histological findings were compared with final histopathology. Sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy were calculated for both modalities.

Results: Of the 40 cases, 25 (62.5%) were benign and 15 (37.5%) were malignant on final histopathology. FNAC demonstrated a sensitivity of 66.7%, specificity of 88.0%, and overall diagnostic accuracy of 80.0%. CNB showed superior performance with a sensitivity of %, specificity of 96.0%, and overall diagnostic accuracy of 95.0%. The rate of inconclusive results was higher with FNAC (20%) compared to CNB (5%). Both procedures were safe, with no major complications observed.

Conclusion: CNB offers higher diagnostic accuracy and fewer inconclusive results compared to FNAC in salivary gland lesions. FNAC remains a useful initial diagnostic tool, while CNB should be employed in cases with indeterminate FNAC results or suspected malignancy.