Fine Needle Aspiration Cytology, Tru-cut Needle Biopsy and Incisional Biopsy in Jaw Swellings. A Clinico-Pathological Comparative Study

Abstract

In this study, 35 patients with jaw swellings were investigated. We attempted at evaluation of the diagnostic role of fil"le needle aspiration cytology (FNAC) and tru-cut needle biopsy (TCNB) compared to excisional/ incisional biopsy of these swellings. Our results comprised 21 (60%) odontogenic tumors and 14 (40%) tumors of non-dental origin. Odontogenic tumors presented clinically as unilateral painless jaw swelling, and their radiography showed radiolucent lesion in the vicinity of affected tooth or teeth, which may be displaced or missed. Our results showed that sensitivity ofFNAC was 75.8%. FNAC could reach a reliable cytological diagnosis in 3 ameloblastomas, 4 ossifying fibromas, one pleomorphic adenoma and 3 out of 4 malignant tumors. However, we could not reach to cytological diagnosis but highlighted the nature of lesions in cases of myxomas, basal cell adenoma, giant cell granuloma, cholesterol granuloma, and benign fibrous histiocytoma. FNAC of the 8 cysts was consistent with benign cystic lesion with squamous epithelium lining. Our results revealed that sensitivity of TCNB was 90.3%. TCNB could achieve diagnosis in swellings in which FNAC were unsatisfactory (2 fibrous hyperplasia, one sclerozing hemoangioma, and one fibrolipoma). TCNB enabled definite diagnosis of 2 granuloma pyogenicum in which FNAC failed to verify the exact nature of the lesion. TCNB verified the exact diagnosis of vast majority of epithelial cysts, all ameloblastomas, all ossifying fibromas, all myxomas, and all benign minor salivary gland tumors. Excisional biopsy diagnosis of the 8 epithelial cysts was 3 radicular, 2 dentigerous, and 3 eruption cysts. Excisional biopsy confirmed TCNB in cases of fibrous hyperplasia, fibrolipoma, sclerosing hemangioma and granuloma pyogenicum in which FNAC was unsatisfactOJy.