Diagnostic accuracy of FNA cytology for diagnosis of salivary gland tumors in pediatric patients

Background: Salivary gland tumors are rare in pediatric patients and include both benign and malignant types. Although fine-needle aspiration cytology is widely used to diagnose salivary gland tumors in adults, such diagnostic techniques in pediatric patients are still poorly applied and studied. Nevertheless, a preoperative diagnostic definition of salivary gland lesions is highly recommended to plan a correct surgical management and to avoid over-treatment of inflammatory or reactive lesions.

Methods: The authors performed a retrospective analysis on a series of salivary gland lesions-both neoplastic and non-neoplastic-in pediatric patients who underwent fine-needle aspiration. When obtainable, the corresponding histological diagnoses were retrieved. The authors calculated the diagnostic sensitivity and specificity of fine-needle aspiration in this clinical setting and evaluated the diagnostic agreement between cytology and histology.

Results: The series included 34 cases of salivary gland lesions in patients aged <20 years, including 21 benign neoplasms and 6 malignant neoplasms. Cytological samples were adequate for diagnosis in 32 of 34 cases, and a definitive cytological diagnosis was achieved in 29 of 34 cases. Cytology demonstrated a sensitivity of 0.92 and a specificity of 0.86 for the diagnosis of salivary gland tumors, and a comparison between the diagnostic performance of cytology and histology demonstrated statistically significant concordance between the 2 techniques.

Conclusions: Fine-needle aspiration cytology shows high accuracy in the diagnosis of pediatric salivary gland tumors, with diagnostic sensitivity and specificity similar to those reported for adult patients.