Concordance of fine-needle aspiration cytology and histopathology in parotid masses: the added role of MRI

Abstract

Background This retrospective study evaluated the concordance between fine-needle aspiration cytology and histopathology in parotid gland masses and assessed the diagnostic value of magnetic resonance imaging features. Methods Forty-two patients who underwent parotidectomy with available fine-needle aspiration cytology, magnetic resonance imaging, and histopathology results were included. fine-needle aspiration cytology-histopathology agreement was analysed for multicategorical and binary (benign vs. malignant) classifications. Magnetic resonance imaging findings, including signal intensity, contrast enhancement, cystic-like appearance and lesion size, were compared, and predictors of malignancy were evaluated using Firth logistic regression. Results Thirty-eight lesions (90.5 per cent) were benign and four (9.5per cent) were malignant. Fine-needle aspiration cytology-histopathology concordance was low for histological subtype differentiation (kappa = 0.082) but substantial for benign-malignant distinction (kappa = 0.636; p < 0.01). All lesions were T2-hyperintense, and cystic-like appearance was strongly associated with Warthin tumour (p = 0.001; odds ratio 38.5). Conclusion No magnetic resonance imaging or clinical variable independently predicted malignancy. Overall, these findings support fine-needle aspiration cytology as the cornerstone of pre-operative evaluation of parotid masses, with magnetic resonance imaging serving primarily for surgical planning.