Publication: Parotid Swellings Misdiagnosed by Fine Needle Aspiration Cytology: It’s Impact on Patient Management
Date
2025
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Fine needle aspiration cytology (FNAC) is an important tool for diagnosis of parotid
swellings and the correct diagnosis is key to the appropriate treatment.
Objective
To evaluate the impact of the misdiagnosis of parotid swellings by fine needle
aspiration cytology on patient management.
Method
It was a descriptive cross-sectional study carried out by the reviewing the medical
record of patients who had undergone parotid surgery from January 2015 to
December 2022 in the Department of ENT-Head and Neck Surgery, TU Teaching
Hospital, Nepal. Patient demographic data, fine needle aspiration cytology result and
histopathological report were collected for evaluation. The study was approved by
institute’s institutional review committee.
Result
Of the total of 80 patients included in the study, sixteen cases were misdiagnosed by
fine needle aspiration cytology compared to the histopathological report. The rate
of false positive and false negative cases in the study was 3.75% and 5%. The false
positive cases received extensive surgery than would be required. However, due to
the use of magnetic resonance imaging for evaluation, false negative cases did not
receive under treatment. In general, 5% of the patients had undergone unnecessary
surgery due to misdiagnoses.
Conclusion
Fine needle aspiration cytology misdiagnoses about one in five cases of parotid
swelling. Misdiagnosis leads to incorrect or inadequate treatment. None of
the investigations is very sensitive and specific in identifying the salivary gland
swellings. Therefore, clinical awareness, radiological characteristics and pathological
information should be taken into account together for final treatment planning.
KEY WORDS
Cytology, Diagnostic error, Histopathology, Neoplasm, Parotid gland
Description
Tripathi P,1 Acharya K,1 Kharel B2
1Department of ENT-Head and Neck Surgery
Maharajgunj Medical Campus and TU Teaching Hospital
Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
2Department of ENT-Head and Neck Surgery
National Academy of Medical Sciences
Bir Hospital, Kathmandu, Nepal
Keywords
Cytology, Diagnostic error, Histopathology, Neoplasm, Parotid gland