title: Diagnostic difficulties in the interpretation of fine needle aspirate samples in salivary lesions: diagnostic pitfalls revisited.
abstract: OBJECTIVE
  To present our experience in diagnostic errors and pitfalls on aspiration cytology of salivary region in a high volume of cases.
  
  
  METHODS
  In a retrospective review of cytology files of a head and neck referral center from 1990 to 2005, the false positive and false negative interpretations on fine needle aspiration (FNA) of salivary lesions were retrieved. These records and slides were reviewed to identify cytologic characteristics that contributed to false diagnosis.
  
  
  RESULTS
  Of a total of 1,040 salivary FNA samples, 376 cases had a final histologic diagnosis with interpretations of benign or malignant. The sensitivity and specificity for correct interpretation of benign and malignant were 87% and 96%, respectively. The most common false negative cases were acinic cell carcinoma, epithelial myoepithelial carcinoma, adenoid cystic carcinoma and basal cell adenocarcinoma. Benign cases with false positive diagnosis were Warthin tumor and pleomorphic adenoma. Selected positive and negative discordant cases are also discussed.
  
  
  CONCLUSIONS
  Knowledge of cytologic overlaps and pitfalls on salivary gland FNA, as well as clinical and radiologic features, may help clinicians arrive at the appropriate diagnosis and reduce false interpretations. Several clinically important pitfalls with nonsalivary tumors of jaw and skin are demonstrated in our series.
authors.affiliation: Department of Cytopathology, Dr. Daneshbod Pathology Laboratory, Shiraz, Iran. y@daneshbod.com
authors.forename: Yahya
authors.initials: Y
authors.lastname: Daneshbod
authors.forename: Khosrow
authors.initials: K
authors.lastname: Daneshbod
authors.forename: Bijan
authors.initials: B
authors.lastname: Khademi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012469:Salivary Glands / Q000473:pathology*; D012680:Sensitivity and Specificity; D055815:Young Adult