Abstract
The preoperative FNA is an important investigation in the workup of a salivary gland pathology. A preoperative diagnosis is important to plan management and counsel patients accordingly. In this study, we aimed to assess the agreement between the preoperative FNA and the final histopathology report when reported by a head and neck and a non-head and neck pathologist. All patients with major salivary gland neoplasm having undergone a preoperative FNA before surgery from January 2012 to December 2019 at our hospital were included in the study. Analysis was done to check for concordance between head and neck and non-head and neck pathologists of the preoperative FNA and final histopathology. Three hundred and twenty-five patients were included in the study. The preoperative FNA could identify the tumour as benign or malignant in the majority (n = 228, 70.1%). The agreement between the preoperative FNA, frozen section diagnosis and the reporting of grade in the frozen section and the final HPR was slightly better with the head and neck pathologist (kappa = 0.429, kappa = 0.698 and kappa = 0.257), respectively, than with the non-head and neck pathologist (kappa = 0.387, kappa = 0.519 and kappa = 0.158), all of which was statistically significant (p < 0.001). The diagnosis made with the preoperative FNA and reporting in the frozen section had a fair agreement with the final histopathology when reported by a head and neck pathologist in comparison to a non-head and neck pathologist.
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References
Stenner M, Klussmann JP (2009) Current update on established and novel biomarkers in salivary gland carcinoma pathology and the molecular pathways involved. Eur Arch Otorhinolaryngol 266(3):333–341
Cho J, Kim J, Lee JS, Chee CG, Kim Y, Choi SI (2020) Comparison of core needle biopsy and fine-needle aspiration in the diagnosis of malignant salivary gland neoplasm: systematic review and meta-analysis. Head Neck 42(10):3041–3050
Schmidt RL, Hall BJ, Wilson AR, Layfield LJ (2011) A systematic review and meta-analysis of the diagnostic accuracy of fine-needle aspiration cytology for parotid gland lesions. Am J Clin Pathol 136(1):45–59
Rossi ED, Baloch Z, Pusztaszeri M, Faquin WC (2018) The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC): an ASC-IAC-sponsored system for reporting salivary gland fine-needle aspiration. J Am Soc Cytopathol 7(3):111–118
Cibas ES, Ali SZ (2009) The Bethesda System for Reporting Thyroid Cytopathology. Thyroid 19:1159–1165
Galli A, Tulli M, Giordano L et al (2020) Fine needle aspiration cytology for parotid neoplasms: risk of malignancy through inconclusive results and lower grade tumors. Eur Arch Otorhinolaryngol 277(3):841–851
McHugh ML (2012) Interrater reliability: the kappa statistic. Biochem Med (Zagreb) 22(3):276–282
Dhanani R, Iftikhar H, Awan MS, Zahid N, Momin SNA (2020) Role of fine needle aspiration cytology in the diagnosis of parotid gland tumors: analysis of 193 cases. Int Arch Otorhinolaryngol 24(4):508–512
Lin AC, Bhattacharyya N (2007) The utility of fine-needle aspiration in parotid malignancy. Otolaryngol Head Neck Surg 136:793–798
Jain S, Thiagarajan S (2021) Milan System for Reporting Salivary Gland Cytopathology: challenges to be tackled. Laryngoscope 131(4):1106
Jo VY, Krane JF (2018) Ancillary testing in salivary gland cytology: a practical guide. Cancer Cytopathol 126(Suppl 8):627–642
Farahani SJ, Baloch Z (2019) Retrospective assessment of the effectiveness of the Milan system for reporting salivary gland cytology: a systematic review and meta-analysis of published literature. Diagn Cytopathol 47(2):67–87
Olsen KD, Moore EJ, Lewis JE (2013) Frozen section pathology for decision making in parotid surgery. JAMA Otolaryngol Head Neck Surg 139(12):1275–1278
Chauhan N, Shah JA (2019) Parotid gland tumours: our experience. Indian J Otolaryngol Head Neck Surg 71(3):378–382
Wong DS, Li GK (2000) The role of fine-needle aspiration cytology in the management of parotid tumors: a critical clinical appraisal. Head Neck 22(5):469–473
Fernandes H, D’souza CR, Khosla C, George L, Katte NH (2014) Role of FNAC in the preoperative diagnosis of salivary gland lesions. J Clin Diagn Res 8(9):FC01-3
Wei S, Layfield LJ, LiVolsi VA, Montone KT, Baloch ZW (2017) Reporting of fine-needle aspiration (FNA) specimens of salivary gland lesions: a comprehensive review. Diagn Cytopathol 45(9):820–827
Geiger JL, Ismaila N, Beadle B et al (2021) Management of salivary gland malignancy: ASCO guideline. J Clin Oncol 39(17):1909–1941
Schmidt RL, Hunt JP, Hall BJ, Wilson AR, Layfield LJ (2011) A systematic review and meta-analysis of the diagnostic accuracy of frozen section for parotid gland lesions. Am J Clin Pathol 136(5):729–738
Mantsopoulos K, Bessas Z, Sievert M, Müller SK, Koch M, Agaimy A, Iro H (2022) Frozen section of parotid gland tumours: the head and neck pathologist as a key member of the surgical team. J Clin Med 11(5):1249
Lima RA, Tavares MR, Dias FL et al (2005) Clinical prognostic factors in malignant parotid gland tumors. Otolaryngol Head Neck Surg 133(5):702–708
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Jain, S., Thiagarajan, S., Shah, S. et al. Assessing the Agreement Between Preoperative Fine-Needle Aspiration Cytology (FNAC) Done for Major Salivary Gland Neoplasm When Reported by Head and Neck Pathologists and Non-head and Neck Pathologists with Its Final Histopathology. Indian J Surg Oncol 14, 53–59 (2023). https://doi.org/10.1007/s13193-022-01624-5
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DOI: https://doi.org/10.1007/s13193-022-01624-5