title: Accuracy of fine-needle aspiration and imaging in the preoperative workup of salivary gland mass lesions treated surgically.
abstract: OBJECTIVE
  Fine-needle aspiration (FNA) biopsy and imaging are commonly used in the preoperative assessment of salivary gland mass lesions. The goal of this retrospective study was to clarify the role of FNA and imaging in the workup of salivary gland masses.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A computer search identified patients with an FNA of a salivary gland lesion with subsequent excision during a 10-year study period. Chart review of study patients was performed, and information on site of lesion, age, gender, radiologic diagnosis, pain in the tumor area, and facial paralysis was recorded and analyzed.
  
  
  RESULTS
  There were 543 patients who had an FNA and subsequent histopathology. The majority of the tumors were in the parotid gland (n = 492, 90.9%), followed by submandibular gland (n = 45, 8.3%). The incidence of malignancy across all sites was 29.7%. The mean patient age was 54.1 years, and 54.1% were female. The sensitivity and specificity of FNA were 85.7% and 99.5%, respectively. Positive predictive value (PPV) was 98.6%, and negative predictive value (NPV) was 94.3%. A total of 464 patients had available radiologic studies. For the radiological diagnoses, sensitivity was 81.8% and specificity was 67.3%, whereas PPV and NPV were 52.7% and 89.3%, respectively.
  
  
  CONCLUSIONS
  FNA is a reliable method of preoperatively assessing both benign and malignant salivary gland lesions. Preoperative imaging has a lower sensitivity and specificity than FNA in differentiating malignant from benign tumors. Older age, pain, and facial paralysis are clinical features independently associated with malignancy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
authors.forename: Geir
authors.initials: G
authors.lastname: Tryggvason
authors.forename: Michael P
authors.initials: MP
authors.lastname: Gailey
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Hulstein
authors.forename: Lucy H
authors.initials: LH
authors.lastname: Karnell
authors.forename: Henry T
authors.initials: HT
authors.lastname: Hoffman
authors.forename: Gerry F
authors.initials: GF
authors.lastname: Funk
authors.forename: Chris S
authors.initials: CS
authors.lastname: Jensen
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Van Daele
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011859:Radiography; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D012680:Sensitivity and Specificity