Fine-Needle Aspiration Biopsy of Salivary Gland Lesions in a Selected Patient Population

Abstract

Fine-needle aspiration biopsy (FNAB) is controversial in the evaluation of salivary gland lesions. Routine use of FNAB in the evaluation of all salivary gland masses is not absolutely necessary. Well-defined parotid masses are generally treated with surgical resection whether FNAB indicates benign or malignant disease. The extent of surgery and decisions regarding management of the facial nerve are made based on intraoperative findings rather than results of FNAB. However, there are clinical scenarios in which FNAB can be a useful diagnostic tool. Fine-needle aspiration biopsy may be useful in evaluating poorly defined salivary gland masses, and to confirm clinical suspicion of malignant disease in order to counsel patients before surgery. Fine-needle aspiration biopsy may be useful in diagnosing metastatic carcinoma, especially with submandibular gland masses, and to help distinguish surgically treatable from nonsurgical pathologic conditions, such as lymphoma. Fine-needle aspiration biopsy may also be useful in evaluation of salivary gland masses in patients who are poor surgical candidates.