Accuracy of fine needle aspiration cytology in the preoperative diagnosis of malignant non-odontogenic tumors of the orofacial region

Diagn Cytopathol. 2021 Mar;49(3):381-387. doi: 10.1002/dc.24665. Epub 2020 Nov 16.

Abstract

Background: This study aims to determine the association between preoperative cytopathological diagnosis and the histopathological diagnosis of orofacial non-odontogenic tumors. It is also, to determine the sensitivity, specificity and accuracy of fine needle aspiration cytology (FNAC) in the preoperative diagnosis of orofacial malignant non-odontogenic tumors in a Nigerian population.

Methods: A 9-month prospective study in which preoperative FNAC followed by open biopsy for confirmatory histopathological evaluation was performed for consenting patients with orofacial swellings. Patients histopathologically diagnosed as non-odontogenic tumors were selected for the study.

Results: There were 40 (83.3%) histopathologically diagnosed non-odontogenic tumors. The female to male ratio was 1.7:1 and the patients' mean age was 36 + 21.9 years. The mandible (n = 4, 10.0%) and the preauricular area (n = 4, 10.0%) were the most common sites affected. The cytopathological diagnosis showed 28 (70.0%) of the lesions were malignant, 7 (17.5%) were benign neoplasms and 5 (12.5%) were reactive/inflammatory swellings. The histopathological diagnosis was predominantly malignant (n = 29, 72.5%), consisting mostly of non-Hodgkin's lymphoma (n = 12, 30.0%). There was significant association (P = .000) between cytopathological diagnosis and histopathological diagnosis of the malignant orofacial non-odontogenic tumors. The sensitivity of FNAC to detect malignant orofacial nonodontogenic tumors was 93.1%, the specificity was 90.9%, the positive predictive value was 96.4%, the negative predictive values was 83.3% and the accuracy was 92.5%.

Conclusion: The accuracy of FNAC in the diagnosis of orofacial malignant non-odontogenic orofacial tumors is high and hence recommended as a routine preoperative diagnostic tool.

Keywords: FNAC; diagnosis; nonodontogenic tumors.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biopsy, Fine-Needle / methods
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / diagnosis
  • Neoplasms / pathology
  • Parotid Neoplasms / diagnosis*
  • Parotid Neoplasms / pathology*
  • Prospective Studies
  • Young Adult