Background: Salivary gland lesions shows a wide morphological diversity with overlapping cytological features which makes the diagnosis challenging. Fine-needle aspiration cytology (FNAC) is commonly used as an initial diagnostic tool and correlation with histopathology is essential to assess its accuracy. Aim: To evaluate the diagnostic accuracy of FNAC in salivary gland lesions and correlate cytological findings with histopathology. Materials and methods: This prospective study included 50 patients with major and minor salivary gland lesions evaluated over a 3-year period at a tertiary care center. FNAC findings were compared with corresponding histopathological diagnosis which served as the gold standard. Results: Pleomorphic adenoma was the most frequent diagnosis on FNAC (58%) and histopathology (50%). Benign lesions constituted 62% of cases while malignant lesions accounted for 20%. FNAC showed good correlation for benign tumors particularly pleomorphic adenoma. The sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy of FNAC were 83.3%, 64.3%, 85.7%, 60%, and 78%, respectively. Diagnostic discrepancies were mainly observed in cystic, inflammatory and low-grade malignant lesions. Conclusion: FNAC is a reliable and minimally invasive initial diagnostic tool for salivary gland lesions, especially benign tumors. However histopathological examination remains essential for definitive diagnosis particularly in lesions with overlapping cytomorphology.

FNAC, Salivary gland lesions, Histopathology, Diagnostic accuracy