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A COMPARISON OF ULTRASOUND GUIDED CORE NEEDLE BIOPS VS FNAC FOR THE DIAGNOSIS OF SALIVARY GLAND MASSES

Dr. Syed jalal ud din, Dr.Hira Jamil, Dr.Azka Areej

Objective: To evaluate the efficacy of fine needle aspiration cytology (FNAC) and ultrasound-guided core needle biopsy (US-CNB) in the histopathological diagnosis of salivary gland lesions. Study Design: A prospective cross-sectional study. Place and Duration: In the Pathology, Surgery and Medicine Department of Mayo Hospital Lahore for One year duration from June 2017 to June 2018.Methodology: A total of 108 patients, ranging from 13 to 72 years, with the inflammation of the salivary glands ranging from 1.5 to 8.5cms having 63(58.3%) males and 45(41.7%) females, with ages between 13-72 years were selected for the study. FNAC and US-CNB were performed in all cases, followed by excisional biopsy. FNAC diagnosis was compared with US-CNB histological findings and excisional biopsy in all cases. The diagnosis was divided into three groups including neoplastic, non-neoplastic, benign and malignant neoplastic lesions. Cystic lesions were excluded from the study.Results: There were 70 (64.8%) lesions in the parotid gland and 38 (35.2%) in the submandibular gland. Neoplastic lesions were detected in 27 (25%) cases with FNAC and in 29 (26.8%) cases with the US-CNB. Benign neoplastic lesions were detected in 45 cases (41.7%) with FNAC, and 54 cases (50%) by US-CNB. Malignant neoplastic lesions were reported in 36 cases (33.3%) with FNAC, and 25 cases (23.1%) in the US-CNB. Comparison with excisional biopsy revealed 14 false positive and 8 false negative cases by FNAC; On the other hand, the US-CNB is no false + and has shown one false- case. While the sensitivity of US-CNB was 96.2% and its specificity was 100%, the sensitivity of FNAC was 74.2% and the specificity was 81.8%. Conclusion: US-CNB has potential benefits with an accuracy equal to that of biopsy, which is almost no exception to FNAC. It can be done in the outpatient clinic and can help reduce the need and cost of surgical biopsy. Key words: Fine needle aspiration cytology (FNAC), ultrasound guided thick needle biopsy (US-CNB), excisional biopsy, salivary glands.

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