Fine needle aspiration cytology of oral and oropharyngeal lesions with an emphasis on the diagnostic utility and pitfalls.
OBJECTIVE
This study was undertaken to evaluate the diagnostic utility and pitfalls of fine needle aspiration cytology (FNAC) in oral and oropharyngeal lesions.


METHODS
This was a retrospective audit of oral and oropharyngeal lesions diagnosed with FNAC over a period of six years (2005-2010).


RESULTS
Oral/oropharyngeal lesions [n=157] comprised 0.35% of the total FNAC load. The age ranged 1-80 years with the male: female ratio being 1.4:1. Aspirates were inadequate in 7% cases. Histopathology was available in 73/157 (46.5%) cases. Palate was the most common site of involvement [n=66] followed by tongue [n=35], buccal mucosa [n=18], floor of the mouth [n=17], tonsil [n=10], alveolus [n=5], retromolar trigone [n=3], and posterior pharyngeal wall [n=3]. Cytodiagnoses were categorized into infective/inflammatory lesions and benign cysts, and benign and malignant tumours. Uncommon lesions included ectopic lingual thyroid and adult rhabdomyoma of tongue, and solitary fibrous tumor (SFT), and leiomyosarcoma in buccal mucosa. A single false-positive case was dense inflammation with squamous cells misinterpreted as squamous cell carcinoma (SCC) on cytology. There were eight false-negative cases mainly due to sampling error. One false-negative case due to interpretation error was in a salivary gland tumor. The sensitivity of FNAC in diagnosing oral/oropharyngeal lesions was 71.4%; specificity was 97.8% with diagnostic accuracy of 87.7%.


CONCLUSIONS
Salivary gland tumors and squamous cell carcinoma (SCC) are the most common lesions seen in the oral cavity. FNAC proves to be highly effective in diagnosing the spectrum of different lesions in this region. Sampling error is the main cause of false-negative cases in this region.
Department of Cytology and Gynaecologic Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Nalini
N
Gupta
Tarak
T
Banik
Arvind
A
Rajwanshi
Bishan D
BD
Radotra
Naresh
N
Panda
Pranab
P
Dey
Radhika
R
Srinivasan
Raje
R
Nijhawan
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000473:pathology*; D009059:Mouth Diseases / Q000473:pathology*; D009061:Mouth Mucosa / Q000473:pathology; D009960:Oropharynx / Q000473:pathology*; D010159:Palate / Q000473:pathology; D014066:Palatine Tonsil / Q000473:pathology; D010608:Pharyngeal Diseases / Q000473:pathology*; D014059:Tongue / Q000473:pathology; D055815:Young Adult