Diagnostic concordance between FNAC and histopathology in salivary gland lesions: a retrospective analysis

Abstract

Background: Cytological diagnosis of salivary gland lesions is often difficult due to the wide morphological diversity of these tumors, the continual addition of new entities in WHO classifications, and the striking heterogeneity within individual tumors. Moreover, the significant overlap in cytological features between benign and malignant lesions makes accurate distinction and definitive diagnosis particularly challenging. Methods: This was a retrospective observational study conducted in the Department of Pathology, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India. A total 136 Cytology cases and 66 Histopathology cases were retrieved from the Lab Information System and hospital record which were received between July 2022 to June 2026. FNAC and Histopathology slides were reviewed by two pathologists at different time and their diagnoses were correlated and final decision was made by their common consensus. Result:  The findings highlight that salivary gland lesions were most common among young and middle-aged adults, particularly between 20 and 40 years. Submandibular gland was the most frequently involved site and Pleomorphic Adenoma was the most common benign tumour. There were nine discrepant cases between FNAC and histopathology diagnoses highlights the diagnostic challenges in salivary gland lesions. Conclusion: FNAC continues to serve as a reliable, minimally invasive diagnostic method for salivary gland lesions, showing strong concordance with histopathology in common benign and inflammatory conditions. Nonetheless, discrepancies highlight its limitations in identifying specific tumour subtypes and malignant lesions.