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  • Title: Diagnostic role and limitations of FNAC in oral and jaw swellings.
    Author: Goyal S, Sharma S, Diwaker P.
    Journal: Diagn Cytopathol; 2015 Oct; 43(10):810-8. PubMed ID: 26173640.
    Abstract:
    BACKGROUND: Fine-needle aspiration cytology (FNAC) of oral lesions has not been widely utilized for diagnosis due to rarity and diversity of lesions, peculiar anatomy of maxillofacial region, difficulty in aspirating these lesions, and limited experience. Aim of this study was to determine the role of FNAC in the diagnosis of oral and jaw swellings. MATERIALS AND METHODS: One hundred and forty two patients underwent FNAC over a period of 7 years (2007-2013), of which 127 (89.4%) aspirates were diagnostic. Histopathologic correlation was available in 83 cases and diagnostic accuracy of FNAC was calculated. RESULTS: Of the minor salivary gland lesions, 41 out of 55 lesions (74.5%) were benign and 14 (25.4%) were malignant. Mucocele was the most common lesion in oral cavity (30 cases) and pleomorphic adenoma was the commonest salivary gland neoplasm (9 cases). Of the 72 non-salivary-gland lesions, 22 lesions were inflammatory, 4 were epidermal inclusion cysts, 21 were neoplastic, and the remaining 25 presented as radiolucent jaw bone lesions. Diagnostic accuracy of FNAC in our study was 91.6% with 6 false negatives and 1 false positive. Four glandular malignancies and one case of cystic ameloblastoma were misdiagnosed as false negative on cytology. CONCLUSION: Cytological features are diagnostic in certain inflammatory lesions of infective etiology and neoplastic conditions like Langerhans cell histiocytosis, lymphoma, plasmacytoma, Ewing's tumor, and squamous cell carcinoma. However, accurate subtyping of giant cell lesions, salivary gland tumors, odontogenic tumors, and cystic lesions may not be always feasible on FNAC. FNAC is highly accurate in early diagnosis of oral and jaw lesions.
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