Fine Needle Aspiration Cytology of Pleomorphic Adenoma

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Abstract
To assess the value of fine needle aspiration cytology (FNAC) in the diagnosis of pleomorphic adenoma and to determine the cytologic variations responsible for diagnostic errors. We retrospectively studied 212 cases cytologically diagnosed as pleomorphic adenoma. In 184 a histologic diagnosis was available. Fourteen cases of histologically proven pleomorphic adenomas with a previously erroneous cytologic diagnosis were also reviewed. This study was based on those cases with a histologic diagnosis. The sensitivity and specificity of the cytologic diagnosis of pleomorphic adenoma in our series were 92.6% and 98.4%, respectively. In relation to malignancy, the series showed six false negative and three false positive diagnoses. In those cases correctly diagnosed on aspiration (175), a typical cytologic appearance, with no diagnostic difficulties, was observed in 118 cases (67.4%); the remainder showed cytologic variations. Cellular atypia (20.6%), cystic transformation (7%) and the presence of a cylindromatous pattern (5%) resembling adenoid cystic carcinoma were the most common cytologic variations observed and responsible for the majority of the errors. The cytologic variations in FNAC of pleomorphic adenoma must be considered in order to avoid important errors in the preoperative management of and surgical approach to salivary gland lesions.

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