Salivary Gland Tumors

Concordance of Ultrasound Findings and Anatomopathological Diagnosis by Ultrasound-guided Fine Needle Aspiration

Abstract

Salivary gland (SG) tumors are rare, with an overall incidence of 0.4 to 13.5 per 100,000 individuals annually; including a heterogeneous variety of different degrees of aggressiveness. Ultrasonography is an accessible, rapid tool for the study of SGs and provides a lot of information in terms of morphological characteristics.  Ultrasound-guided fine needle aspiration (FNA) is a useful and safe procedure that enables obtaining samples for cytological diagnosis.

The aim of this work is to review the ultrasound characteristics of focal lesions of SGs with the cytopathologic results obtained by ultrasound-guided FNA technique.

A retrospective analysis was conducted on 20 patients treated at “Hospital Italiano” located in Córdoba, Argentina, between 2016 to 2020 (M/F: 11/9); age range 43-81 years, (16 parotid glands and 4 submaxillary glands). Results were described using relative and absolute frequencies. Five patients had to be excluded due to insufficient sample and two because the cytological diagnosis was made by histological study of the surgical specimen. The final number of patients was 13, and no complications were reported.

Of the total number of patients included in the study, there were 11 lesions with solid characteristics, all of which were hypoechogenic, and 2 lesions with a liquid appearance on ultrasonographic examination. None of the patients experienced complications.

Pleomorphic adenoma (n=8) was the most frequent tumor diagnosed cytopathologically with ultrasound characteristics of a solid hypoechogenic lesion, 5 in the parotid gland and 3 in the submaxillary gland.

A hypoechogenic solid lesion was observed in the parotid gland with histological diagnosis compatible with metastasis in relation to hidden tumor.

Two cases were lesions with liquid ultrasound characteristics: an abscess and a simple cyst. Two hypogenic solid lesions correspond to adenopathies.

Of the 8 lesions cytologically diagnosed as pleomorphic adenoma, 5 (63%) underwent surgery showing histopathologic concordance.

In conclusion, ultrasound is a useful tool for characterizing lesions in SG, and FNA is an effective technique for obtaining samples. The combination of both allows an effective diagnosis; and we observed concordance with the results of pathologic anatomy.