Comparison of the efficacy of the palpation versus ultrasonography-guided fine-needle aspiration cytology in the diagnosis of salivary gland lesions

Background: Fine-needle aspiration cytology (FNAC) is the initial investigation for salivary gland swellings. The aim of this study was to study the utility of ultrasonography (USG) as an adjunct to cytology in the diagnosis of salivary gland lesions and to compare the two methods, palpation-guided and ultrasound-guided FNAC in diagnosis of salivary gland lesions. Materials and Methods: The study comprised of 45 patients presenting with a salivary gland swelling. All the patients were subjected to USG examination and FNA of the swellings-both by palpation method and ultrasound guided, in each case. Further, the cytological features of all the cases were studied comparing the findings on palpation-guided versus USG-guided FNAC. Histopathological correlation was also done wherever possible. Results: Number of inadequate aspirations decreased and the number of lesions detected increased on using USG-guided FNAC. Only two cases were false negative on USG-guided FNAC, and there were no false positive cases. While on palpation-guided FNAC, three cases came out to be false negatives, and one was seen to be false positive. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive values were higher for USG-guided FNAC than for palpation-guided FNAC. Conclusion: We concluded that though differentiation of salivary gland masses was difficult on USG alone due to nonspecific USG findings, combination of ultrasound with FNAC certainly improved the diagnostic efficiency. USG guidance led to more representative, meticulous sampling which helped in providing a correct diagnosis in the majority of cases.