PURPOSE: The treatment strategy of parotid gland tumours depends mainly on the histopathological type of the lesion. Fine-needle aspiration biopsy (FNAB) is recommended in preoperative diagnostics. The aim of the study was to evaluate the FNAB standing in the diagnostic algorithm of parotid gland lesions and to correlate FNAB results in relation to the definitive histopathological diagnosis. MATERIAL AND METHODS: The retrospective analyses of 651 examined and consequently surgically treated parotid gland lesions at the Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague between 2006 and 2016 were used. Preoperative cytological results were consequently evaluated in relation to the definitive histopathological diagnosis. RESULTS: The cohort consisted of 367 women and 284 men (average age 58 years). FNAB was diagnostic in 604 (92.8%) patients and non-diagnostic in 47 (7.2%) patients. The result of FNAB was positive (suspicious for malignant tumour) in 89 (14.7%) patients and negative (benign) in 515 (85.3%) patients. Sensitivity of the examination was 80.00%, specificity was 93.82%, PPV 62.92%, NPV 97.28%, and LR + and LR- were 12.95 and 0.21, respectively, with an accuracy of 92.22%. CONCLUSION: Our results confirm the significant role of FNAB in the diagnostic algorithm of parotid gland lesions.

Department of Biology Faculty of Medicine in Pilsen Charles University Prague Czech Republic

Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine University Hospital Motol Charles University 5 Uvalu 84 150 06 Prague Czech Republic

Department of Pathology and Molecular Medicine 2nd Faculty of Medicine University Hospital Motol Charles University and Motol University Hospital Prague Czech Republic

Department of Pathology Faculty of Medicine and Health Technology Fimlab Laboratories and Tampere University Tampere Finland

Eur Arch Otorhinolaryngol. 2020 Oct;277(10):2939-2940. doi: 10.1007/s00405-020-05923-x. PubMed

Eur Arch Otorhinolaryngol. 2020 Oct;277(10):2941. doi: 10.1007/s00405-020-06269-0. PubMed

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Stárek I, Skálová A, Salzman R, Chovanec M, Zábrodský M, Gál P, Školoudik L, Rotnágl J, Pár I, Štrympl P (2017) Guidelines for diagnosis and treatment of parotid gland tumours. Otorinolaryngol Foniatr 66(3):119–126

El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ (2017) WHO Classification of head and neck tumours. International Agency for Research on Cancer, Lyon

Silva WP, Stramandinoli-Zanicotti RT, Schussel JL, Ramos GH, Ioshi SO, Sassi LM (2016) Accuracy, sensitivity and specificity of fine needle aspiration biopsy for salivary gland tumors: a retrospective study from 2006 to 2011. Asian Pac J Cancer Prev 17(11):4973–4976. https://doi.org/10.22034/APJCP.2016.17.11.4973 PubMed DOI PMC

Kholova I, Ludvikova M (2015) Repeated fine-needle aspiration improves the diagnostics in selected atypia of undetermined significance/follicular lesion of undetermined significance cases, but further studies are needed. Acta Cytol 59(1):120. https://doi.org/10.1159/000380845 PubMed DOI

Pusztaszeri M, Rossi ED, Baloch ZW, Faquin WC (2019) Salivary gland fine needle aspiration and introduction of the Milan Reporting System. Adv Anat Pathol 26(2):84–92. https://doi.org/10.1097/PAP.0000000000000224 PubMed DOI

Ali NS, Akhtar S, Junaid M, Awan S, Aftab K (2011) Diagnostic accuracy of fine needle aspiration cytology in parotid lesions. ISRN Surg 2011:721525. https://doi.org/10.5402/2011/721525 PubMed DOI PMC

Lukas J, Duskova J (2006) Fine-needle aspiration biopsy in the diagnostic of the tumors and non-neoplastic lesions of salivary glands. Bratisl Lek Listy 107(1–2):12–15 PubMed

Stramandinoli RT, Sassi LM, Pedruzzi PA, Ramos GH, Oliveira BV, Ogata DC, Ioshii SO (2010) Accuracy, sensitivity and specificity of fine needle aspiration biopsy in salivary gland tumours: a retrospective study. Med Oral Patol Oral Circ Bucal 15(1):e32–37. https://doi.org/10.4317/medoral.15.e32 DOI

Viguer JM, Vicandi B, Jimenez-Heffernan JA, Lopez-Ferrer P, Gonzalez-Peramato P, Castillo C (2010) Role of fine needle aspiration cytology in the diagnosis and management of Warthin's tumour of the salivary glands. Cytopathology 21(3):164–169. https://doi.org/10.1111/j.1365-2303.2009.00667.x PubMed DOI

Croonenborghs TM, Van Hevele J, Scheerlinck J, Nout E, Schoenaers J, Politis C (2019) A multicentre retrospective clinico-histopathological review of 250 patients after parotidectomy. Int J Oral Maxillofac Surg. https://doi.org/10.1016/j.ijom.2019.03.963 PubMed DOI

Edizer DT, Server EA, Yigit O, Yildiz M (2016) Role of fine-needle aspiration biopsy in the management of salivary gland masses. Turk Arch Otorhinolaryngol 54(3):105–111. https://doi.org/10.5152/tao.2016.1700 PubMed DOI PMC

Christensen RK, Bjorndal K, Godballe C, Krogdahl A (2010) Value of fine-needle aspiration biopsy of salivary gland lesions. Head Neck 32(1):104–108. https://doi.org/10.1002/hed.21151 PubMed DOI

Cohen EG, Patel SG, Lin O, Boyle JO, Kraus DH, Singh B, Wong RJ, Shah JP, Shaha AR (2004) Fine-needle aspiration biopsy of salivary gland lesions in a selected patient population. Arch Otolaryngol Head Neck Surg 130(6):773–778. https://doi.org/10.1001/archotol.130.6.773 PubMed DOI

Cho HW, Kim J, Choi J, Choi HS, Kim ES, Kim SH, Choi EC (2011) Sonographically guided fine-needle aspiration biopsy of major salivary gland masses: a review of 245 cases. AJR Am J Roentgenol 196(5):1160–1163. https://doi.org/10.2214/AJR.10.4256 PubMed DOI

Carrillo JF, Ramirez R, Flores L, Ramirez-Ortega MC, Arrecillas MD, Ibarra M, Sotelo R, Ponce-De-Leon S, Onate-Ocana LF (2009) Diagnostic accuracy of fine needle aspiration biopsy in preoperative diagnosis of patients with parotid gland masses. J Surg Oncol 100(2):133–138. https://doi.org/10.1002/jso.21317 PubMed DOI

Elagoz S, Gulluoglu M, Yilmazbayhan D, Ozer H, Arslan I (2007) The value of fine-needle aspiration cytology in salivary gland lesions, 1994–2004. ORL J Otorhinolaryngol Relat Spec 69(1):51–56. https://doi.org/10.1159/000096717 PubMed DOI

Di Napoli A, Mallel G, Bartolazzi A, Cavalieri E, Becelli R, Cippitelli C, Ruco L (2015) Nodular lymphocyte-predominant hodgkin lymphoma in a warthin tumor of the parotid gland: a case report and literature review. Int J Surg Pathol 23(5):419–423. https://doi.org/10.1177/1066896915582263 PubMed DOI

Fundakowski C, Castano J, Abouyared M, Lo K, Rivera A, Ojo R, Gomez-Fernandez C, Messinger S, Sargi Z (2014) The role of indeterminate fine-needle biopsy in the diagnosis of parotid malignancy. Laryngoscope 124(3):678–681. https://doi.org/10.1002/lary.24341 PubMed DOI

Tabatabai ZL, Auger M, Kurtycz DF, Laser A, Souers RJ, Laucirica R, Barkan GA, Crothers BA, Khalbuss WE (2015) Performance characteristics of adenoid cystic carcinoma of the salivary glands in fine-needle aspirates: results from the College of American Pathologists Nongynecologic Cytology Program. Arch Pathol Lab Med 139(12):1525–1530. https://doi.org/10.5858/arpa.2013-0173-CP PubMed DOI

Vicandi B, Jimenez-Heffernan JA, Lopez-Ferrer P, Gonzalez-Peramato P, Patron M, Viguer JM (2012) Fine needle aspiration cytology of basal cell adenoma of the salivary gland: a cytohistological correlation study of 35 cases. Cytopathology 23(5):315–319. https://doi.org/10.1111/j.1365-2303.2011.00899.x PubMed DOI

Behzatoglu K, Bahadir B, Huq GE, Kaplan HH (2005) Spontaneous infarction of a pleomorphic adenoma in parotid gland: diagnostic problems and review. Diagn Cytopathol 32(6):367–369. https://doi.org/10.1002/dc.20268 PubMed DOI

Wangsiricharoen S, Lekawanvijit S, Rangdaeng S (2017) Agreement between rapid on-site evaluation and the final cytological diagnosis of salivary gland specimens. Cytopathology 28(4):321–328. https://doi.org/10.1111/cyt.12428 PubMed DOI

Tommola E, Tommola S, Porre S, Kholova I (2019) Salivary gland FNA diagnostics in a real-life setting: one-year-experiences of the implementation of the Milan System in a Tertiary Care Center. Cancers (Basel). https://doi.org/10.3390/cancers11101589 DOI

Schmidt RL, Hall BJ, Layfield LJ (2011) A systematic review and meta-analysis of the diagnostic accuracy of ultrasound-guided core needle biopsy for salivary gland lesions. Am J Clin Pathol 136(4):516–526. https://doi.org/10.1309/AJCP5LTQ4RVOQAIT PubMed DOI

Bajwa MS, Mitchell DA, Brennan PA (2014) Is it time we adopted a classification for parotid gland cytology? Br J Oral Maxillofac Surg 52(2):99–101. https://doi.org/10.1016/j.bjoms.2013.11.006 PubMed DOI

Cibas ES, Ali SZ, Conference NCITFSotS (2009) The Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol 132(5):658–665. https://doi.org/10.1309/AJCPPHLWMI3JV4LA PubMed DOI

Cibas ES, Ali SZ (2017) The 2017 Bethesda system for reporting thyroid cytopathology. J Am Soc Cytopathol 6(6):217–222. https://doi.org/10.1016/j.jasc.2017.09.002 PubMed DOI

Nayar R, Wilbur DC (2015) The Bethesda system for reporting cervical cytology: definitions, criteria, and explanatory notes. Springer International Publishing, Berlin DOI

Rosenthal DL, Wojcik EM, Kurtycz DFI (2015) The Paris system for reporting urinary cytology. Springer International Publishing, Berlin

Bajwa MS, Rose SJ, Mairembam P, Nash R, Hotchen D, Godden D, Alam P, Daborn L, Spedding AV, Brennan PA (2016) Feasibility of a novel classification for parotid gland cytology: a retrospective review of 512 cytology reports taken from 4 United Kingdom general hospitals. Head Neck 38(11):1596–1603. https://doi.org/10.1002/hed.24482 PubMed DOI

Kilavuz AE, Songu M, Imre A, Arslanoglu S, Ozkul Y, Pinar E, Ates D (2018) Application of Sal classification to parotid gland fine-needle aspiration cytology: 10-year retrospective analysis of 312 patients. Head Neck 40(5):937–942. https://doi.org/10.1002/hed.25056 PubMed DOI

Faquin WC, Rossi ED, Baloch Z, Barkan GA, Foschini MP, Kurtycz DFI, Pusztaszeri M, Vielh P (2018) The Milan System for Reporting Salivary Gland Cytopathology. Springer International Publishing, Berlin DOI

Viswanathan K, Sung S, Scognamiglio T, Yang GCH, Siddiqui MT, Rao RA (2018) The role of the Milan System for reporting salivary gland cytopathology: a 5-year institutional experience. Cancer Cytopathol 126(8):541–551. https://doi.org/10.1002/cncy.22016 PubMed DOI

Layfield LJ, Baloch ZW, Hirschowitz SL, Rossi ED (2018) Impact on clinical follow-up of the Milan System for salivary gland cytology: a comparison with a traditional diagnostic classification. Cytopathology 29(4):335–342. https://doi.org/10.1111/cyt.12562 PubMed DOI

Thiryayi SA, Low YX, Shelton D, Narine N, Slater D, Rana DN (2018) A retrospective 3-year study of salivary gland FNAC with categorisation using the Milan reporting system. Cytopathology 29(4):343–348. https://doi.org/10.1111/cyt.12557 PubMed DOI

Miesbauerová M, Kholová I, Skálová A (2019) Minireview: The new system of unified evaluation of fine needle aspiration cytology of salivary glands: what is new in the Milan system for reporting of salivary glands lesions? Cesk Patol 55(1):61–65

Farahani SJ, Baloch Z (2019) Retrospective assessment of the effectiveness of the Milan system for reporting salivary gland cytology: A systematic review and meta-analysis of published literature. Diagn Cytopathol 47(2):67–87. https://doi.org/10.1002/dc.24097 PubMed DOI

Douville NJ, Bradford CR (2013) Comparison of ultrasound-guided core biopsy versus fine-needle aspiration biopsy in the evaluation of salivary gland lesions. Head Neck 35(11):1657–1661. https://doi.org/10.1002/hed.23193 PubMed DOI

Zbaren P, Triantafyllou A, Devaney KO, Poorten VV, Hellquist H, Rinaldo A, Ferlito A (2018) Preoperative diagnostic of parotid gland neoplasms: fine-needle aspiration cytology or core needle biopsy? Eur Arch Otorhinolaryngol 275(11):2609–2613. https://doi.org/10.1007/s00405-018-5131-0 PubMed DOI

Utility of fine-needle aspiration biopsy (FNAB) in parotid pleomorphic adenoma diagnosis and management

Review of surgical techniques and guide for decision making in the treatment of benign parotid tumors