J Pathol Transl Med.  2015 Mar;49(2):136-143. 10.4132/jptm.2015.01.03.

Accuracy of Core Needle Biopsy Versus Fine Needle Aspiration Cytology for Diagnosing Salivary Gland Tumors

• Song IH
• Song JS
• Sung CO
• Roh JL
• Choi SH
• Nam SY
• Kim SY
• Lee JH
• Baek JH
• Cho KJ

• KMID: 2381368
• DOI: http://doi.org/10.4132/jptm.2015.01.03

Abstract

BACKGROUND
Core needle biopsy is a relatively new technique used to diagnose salivary gland lesions, and its role in comparison with fine needle aspiration cytology needs to be refined.
METHODS
We compared the results of 228 ultrasound-guided core needle biopsy and 371 fine needle aspiration procedures performed on major salivary gland tumors with their postoperative histological diagnoses.
RESULTS
Core needle biopsy resulted in significantly higher sensitivity and more accurate tumor subtyping, especially for malignant tumors, than fine needle aspiration. No patient developed major complications after core needle biopsy.
CONCLUSIONS
We recommend ultrasoundguided core needle biopsy as the primary diagnostic tool for the preoperative evaluation of patients with salivary gland lesions, especially when malignancy is suspected.

Keyword

Salivary gland neoplasms; Biopsy, large-core needle; Biopsy, fine-needle; Parotid gland; Submandibular gland

MeSH Terms

Biopsy, Fine-Needle*
Biopsy, Large-Core Needle*
Diagnosis
Humans
Parotid Gland
Salivary Gland Neoplasms
Salivary Glands*
Submandibular Gland

Figure

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  Fig. 1. Examples of low grade carcinomas diagnosed as false-negatives by fine needle aspiration cytology. (A) Adenoid cystic carcinoma in surgical specimens. (B) Core needle biopsy shows similar architectural findings. (C) Low cellularity and lack of obvious cellular atypia in fine needle aspiration cytology were interpreted as pleomorphic adenoma. (D) Mucoepidermoid carcinoma in surgical specimens. (E) Core needle biopsy shows intermediate and mucous cells. (F) Cystic background and presence of oncocytoid components in fine needle aspiration cytology led to the misdiagnosis of Warthin tumor.

• 

  Fig. 2. Difficult samples for both core needle biopsy and fine needle aspiration. (A) Surgical specimen of basal cell adenocarcinoma shows extracapsular invasion which cannot be confirmed in core needle biopsy (B) or fine needle aspiration cytology (C). (D) Epithelial-myoepithelial structures of epithelial-myoepithelial carcinoma can be mistaken for those of pleomorphic adenoma in both core needle biopsy (E) and fine needle aspiration cytology (F), because of the lack of obvious cellular atypia.

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