The importance of team work of cytologist and surgeon in preoperative diagnosis of intraoral minor salivary gland tumours.

Trutin Ostović, Karmen and Lukšić, Ivica and Virag, Mišo and Macan, Darko and Müller, Danko and Manojlović, Spomenka (2012) The importance of team work of cytologist and surgeon in preoperative diagnosis of intraoral minor salivary gland tumours. Collegium Antropologicum, 36 (S2). pp. 151-7. ISSN 0350-6134

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Abstract

Tumours arising from oral minor salivary glands may exhibit an overlap of clinical and morphological features that may produce diagnostic and therapeutic dilemmas. The aim of this study is to asses the value of fine needle aspiration cytology (FNAC) in differentiation of benign and malignant tumours and to render a specific diagnosis. We evaluated the team work of surgeon and cytologist to improve diagnostic accuracy. Two steps are important for accuracy: sampling aspirate that should be done together by surgeon and cytologist and cytological microscopic analysis of the smears that should be performed by an experienced cytologist. The study included 132 patients with intraoral minor salivary gland tumours between 2002 and 2011. Adequate material was obtained from 121 (91.7%) patients. FNAC was usually performed by cytologist in a team with maxillofacial surgeon at cytology department that is more convenient for preparing the samples and especially for ROSE procedure (rapid-on site evaluation) of smears. In such a way the cytologist checked the adequacy of samples and decided whether some ancillary techniques should be used and therefore repeat FNAC. A total of 82 patients underwent surgery, 40 with malignant and 42 with benign tumours. Preoperative cytological diagnoses were compared with histopathological ones using histopathology as a gold standard. The most common benign tumour was pleomorphic adenoma and among malignant tumours adenoid cystic carcinoma. The most commonly affected site was the palate. The team work of surgeon and cytologist achieved specificity of 95.1%, sensitivity of 97.6% and diagnostic accuracy of 96.3%. We can conclude that although subclassification of some tumour types of salivary glands remains poor, FNAC is invaluable in patient triage and therefore should be considered in the first line investigations of these lesions by the cytologist and surgeon.

Abstract in Croatian

VAŽNOST TIMSKOG RADA CITOLOGA I KIRURGA U PREOPERACIJSKOJ DIJAGNOSTICI TUMORA MALIH ŽLIJEZDA SLINOVNICA U USNOJ ŠUPLJINI ----- Tumori malih žlijezda slinovnica u usnoj šupljini često uzrokuju dijagnostičke i terapijske dileme zbog preklapanja kliničkih i morfoloških karakteristika. Cilj ovog rada je utvrditi vrijednost aspiracijske citologije u razlikovanju dobroćudnih od zloćudnih tumora kao i određivanje točne vrste tumora. Željeli smo utvrditi da li timski rad kirurga i citologa može poboljšati dijagnostičku točnost citološke dijagnoze. Dva koraka su važna za točnost. Prvi je citološka punkcija koja se treba raditi timski, citolog zajedno s kirurgom, a drugi je citološka mikroskopska analiza razmaza punktata za što je potrebno veliko iskustvo. Ovo istraživanje uključuje 132 pacijenta s tumorom malih žlijezda slinovnica u usnoj šupljini i adekvatni materijal se dobio od njih 121 (91.7%) u razdoblju od 2002. do 2011. godine. Citološku punkciju tumora obavlja citolog zajedno s maksilofacijalnim kirurgom na citološkom odjelu što je važno zbog pripreme citoloških uzoraka odmah nakon punkcije, a naročito za hitnu mikroskopsku analizu punktatu. Na taj način citolog može odmah provjeriti adekvatnost punktata i odlučiti da li su potrebne dodatne tehnike, te ponoviti punkciju. Operirana su 82 pacijenta, 40 sa zloćudnim i 42 s dobroćudnim tumorom. Preoperacijska citološka dijagnoza je evaluirana patohistološkom dijagnozom nakon operacije. Najčešći benigni tumor je bio pleomorfni adenom, a od malignih tumora je najčešći bio adenoidni cistični karcinom. Najveći broj tumora je bio smješten u slinovnicama na nepcu. Timski rad kirurga i citologa ostvario je specifičnost 95,1%, osjetljivost 97,6% i dijagnostičku točnost 96,3%. Premda je citološka subklasifikacija pojedinih vrsta tumora malih žlijezda slinovnica manjkava, aspiracijska citologija je neprocjenjiva za trijažu pacijenata i zbog toga je neophodno kod svih lezija malih žlijezda slinovnica učiniti citološku punkciju u timu s kirurgom.

Item Type: Article
Departments: Katedra za maksilofacijalnu kirurgiju sa stomatologijom
Depositing User: Marijan Šember
Status: Published
Creators:
CreatorsEmail
Trutin Ostović, KarmenUNSPECIFIED
Lukšić, IvicaUNSPECIFIED
Virag, MišoUNSPECIFIED
Macan, DarkoUNSPECIFIED
Müller, DankoUNSPECIFIED
Manojlović, SpomenkaUNSPECIFIED
Date: November 2012
Date Deposited: 01 Mar 2013 12:44
Last Modified: 01 Mar 2013 12:44
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/1844

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