Fine needle aspiration cytology yields low sensitivity and specificity in the diagnosis of oral and maxillofacial swellings: A cross-sectional study of 82 cases

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Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu

Abstract

Aim: To assess the role of Fine needle aspiration cytology (FNAC) in diagnosing oral and maxillofacial lumps and jaw swellings with histopathological correlation.
Materials and methods: The lumps and swellings of 82 cases of oral and maxillofacial region were included in the present cross-sectional study, after obtaining clearance from the institutional human ethical committee. Only those cases were included, where both FNAC and biopsy were performed for diagnosis. The biopsy specimen were processed with modified fast-processing technique. Clinical, cytological and histopathological data were recorded in Microsoft Excel and analyzed using the XLSTAT add-on statistical software. True positive (TP), true negative (TN), false positive (FP), and false negative (FN) values were assessed followed by evaluation of sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV).
Results: The mean age of occurrence was 41.4 ±17.32  years with a male preponderance. There were 52 jaw lesions, while the remaining 30 cases belonged to the category of soft tissue lumps/swellings. Low specificity and sensitivity were noted for the diagnosis of jaw swelling and lumps of minor salivary gland lesions. FNAC was fruitful in the diagnosis of keratinizing odontogenic cysts, tuberculosis and metastatic lesions. There was a difference in turn-around time between cytological and histopathology.
Conclusion: The role of FNAC in the cytological diagnosis of minor salivary glands lumps and intra-osseous jaw swelling is limited. FNAC may be reserved only for selective cases where biopsy is not indicated.

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