{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:56:41Z","timestamp":1786121801065,"version":"build-2736575974"},"reference-count":11,"publisher":"Index Copernicus","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Otolaryngol Pol"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<ns3:p>&lt;p&gt;&lt;b&gt;Introduction:&lt;\/b&gt; Fine-needle aspiration cytology (FNAC) is a standard preoperative diagnostic tool for salivary gland tumors, yet its sensitivity is widely debated.&lt;\/p&gt;&lt;p&gt;&lt;b&gt;Aim:&lt;\/b&gt; This study evaluates the diagnostic accuracy of FNAC compared to final histopathology, with a specific focus on institutional variability and the influence of tumor size on diagnostic yield.&lt;\/p&gt;&lt;p&gt;&lt;b&gt;Methods:&lt;\/b&gt; A retrospective, multicenter analysis was conducted on 1331 patients who underwent surgical resection for salivary gland tumors across five tertiary centers. After excluding incomplete records, 1031 patients with informative FNAC results were analyzed. Diagnostic performance (sensitivity, specificity, accuracy, and likelihood ratios) was calculated by comparing preoperative cytology with final histopathology. Statistical evaluations (Chi-square, Welch\u2019s t-test) assessed the impact of patient demographics, tumor dimensions (4 cm), and institutional location on diagnostic concordance.&lt;\/p&gt;&lt;p&gt;&lt;b&gt;Results:&lt;\/b&gt; The overall diagnostic accuracy of FNAC was 94.1%. The procedure demonstrated excellent specificity (98.4%) but suboptimal sensitivity (50.0%), confirming a high false-negative rate. Significant institutional variability was observed (p &amp;lt; 0.001), with local sensitivities ranging from 16.7% to 69.2%. Tumor size significantly impacted diagnostic accuracy (p = 0.0258), peaking in intermediate lesions (2\u20134 cm; 95.0%) but declining in both smaller (&amp;lt;2 cm; 93.7%) and larger&amp;nbsp;neoplasms (&amp;gt;4 cm; 91.9%). An independent review of 298 initially non-diagnostic aspirates revealed a substantial subset of histologically confirmed malignancies, demonstrating that non-informative cytological smears cannot be assumed benign.&lt;\/p&gt;&lt;p&gt;&lt;b&gt;Conclusions:&lt;\/b&gt; While FNAC provides highly specific evidence for salivary gland malignancies, its low sensitivity and susceptibility to institutional and size-dependent variables limit its reliability in ruling out cancer. High false-negative rates, particularly in tumors exceeding 4 cm, necessitate a multimodal diagnostic approach. Integrating core needle biopsy for challenging lesions and intraoperative frozen section analysis is crucial to mitigate cytopathological limitations and ensure appropriate surgical management.&lt;\/p&gt;<\/ns3:p>","DOI":"10.5604\/01.3001.0055.7280","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T10:37:11Z","timestamp":1780310231000},"page":"1-7","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Accuracy of Fine-Needle Aspiration Cytology in Salivary Gland Tumors: A 1331-Patient Multicenter Analysis of Institutional Variability and Size-Dependent Pitfalls"],"prefix":"10.5604","volume":"80","author":[{"given":"Ma\u0142gorzata","family":"Wierzchowska","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum in Bydgoszcz, Faculty of Health Sciences, Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6653-4599","authenticated-orcid":false,"given":"Pawe\u0142","family":"Burduk","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum in Bydgoszcz, Faculty of Health Sciences, Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Czech","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum in Bydgoszcz, Faculty of Health Sciences, Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0006-6352","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Wierzbicka","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Regional Specialist Hospital Wroclaw, Research & Development Centre, Wroclaw, Poland, Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland, Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaros\u0142aw","family":"Markowski","sequence":"additional","affiliation":[{"name":"Department of Laryngology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Piernicka-Dybich","sequence":"additional","affiliation":[{"name":"Department of Laryngology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wioletta","family":"Pietruszewska","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"\u015awierczy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewelina","family":"Bartkowiak","sequence":"additional","affiliation":[{"name":"Department and Clinic of Otolaryngology and Laryngological Oncology, Pozna\u0144 University of Medical Sciences, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4736-152X","authenticated-orcid":false,"given":"Dominik","family":"Stodulski","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Faculty of Medicine, Medical University of Gdansk, Poland,Department of Otolaryngology, University Clinical Center in Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Zieli\u0144ski","sequence":"additional","affiliation":[{"name":"Center for Statistical Analysis, Nicolaus Copernicus University, Torun, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogus\u0142aw","family":"Mikaszewski","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Faculty of Medicine, Medical University of Gdansk, Poland,Department of Otolaryngology, University Clinical Center in Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3689","reference":[{"key":"638425r1","doi-asserted-by":"crossref","unstructured":"Sood S., McGurk M., Vaz F.: Management of Salivary Gland Tumours: United KingdomNational Multidisciplinary Guidelines. J Laryngol Otol., 2016; 130(S2): S142\u2013S149.","DOI":"10.1017\/S0022215116000566"},{"key":"638425r2","unstructured":"Chraba\u0144ska M., Kiczmer P., Drozdzowska B.: Salivary gland lesions: diagnostic reliability and challenges of fine needle aspiration cytology. J Clin Exp Pathol., 2021; 14(1): 54\u201362."},{"key":"638425r3","doi-asserted-by":"crossref","unstructured":"Peravali R.K., Bhat H.H.K., Upadya V.H., Agarwal A., Naag S.: Salivary Gland Tumors: A Diagnostic Dilemma! J Maxillofac Oral Surg., 2014; 14(Suppl 1): 438\u2013442.","DOI":"10.1007\/s12663-014-0665-1"},{"key":"638425r4","doi-asserted-by":"crossref","unstructured":"Geiger J.L., Ismaila N., Beadle B. et al.: Management of Salivary Gland Malignancy: ASCO Guideline. J Clin Oncol., 2021; 39(17): 1909\u20131941.","DOI":"10.1200\/JCO.21.00449"},{"key":"638425r5","doi-asserted-by":"crossref","unstructured":"Griffith C.C., Pai R.K., Schneider F. et al.: Salivary Gland Tumor Fine-NeedleAspiration Cytology: A Proposal for a Risk Stratification Classification. AmJ Clin Pathol., 2015; 143(6): 839\u2013853.","DOI":"10.1309\/AJCPMII6OSD2HSJA"},{"key":"638425r6","doi-asserted-by":"crossref","unstructured":"Kasturi M., Riti S., Pantula N.V.: Diagnostic accuracy of fine needle aspirationcytology in salivary gland lesions at a tertiary care hospital in Raipur, Chhattisgarh, India. MGM Journal of Medical Sciences., 2025; 12(3): 458\u2013468.","DOI":"10.4103\/mgmj.mgmj_218_25"},{"key":"638425r7","doi-asserted-by":"crossref","unstructured":"Nakaguro M.: Diagnostic clues and pitfalls in salivary gland fine-needle aspiration cytology. Semin Diagn Pathol., 2024; 41(4): 207\u2013211.","DOI":"10.1053\/j.semdp.2024.04.003"},{"key":"638425r8","doi-asserted-by":"crossref","unstructured":"Saharti S., Aljohani R.: Performance Characteristics of Milan Systemfor Reporting Salivary Gland Cytopathology. Diagn Cytopathol., 2026;54(4): 264\u2013269.","DOI":"10.1002\/dc.70028"},{"key":"638425r9","doi-asserted-by":"crossref","unstructured":"Kumar A., Khan J., Kaur G. et al.: Ultrasonography-Guided Fine Needle Aspiration Cytology Versus Histopathology: Diagnostic Consistency in SalivaryGland Neoplasms. Cureus., 2024; 16(9): e69552.","DOI":"10.7759\/cureus.69552"},{"key":"638425r10","doi-asserted-by":"crossref","unstructured":"Song I.H., Song J.S., Sung C.O. et al.: Accuracy of Core Needle Biopsy VersusFine Needle Aspiration Cytology in Salivary Gland Tumors. J Pathol TranslMed., 2015; 49(2): 136\u2013143.","DOI":"10.4132\/jptm.2015.01.03"},{"key":"638425r11","doi-asserted-by":"crossref","unstructured":"Cho J., Kim J., Lee J.S. et al.: Comparison of core needle biopsy and fine-needleaspiration in diagnosis of malignant salivary gland neoplasm: Systematic review and meta-analysis. Head Neck., 2020; 42(10): 30413050.","DOI":"10.1002\/hed.26377"}],"container-title":["Otolaryngologia Polska"],"original-title":[],"link":[{"URL":"https:\/\/otolaryngologypl.com\/gicid\/pdf\/01.3001.0055.7280","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/otolaryngologypl.com\/gicid\/pdf\/01.3001.0055.7280","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T07:14:35Z","timestamp":1786086875000},"score":1,"resource":{"primary":{"URL":"https:\/\/otolaryngologypl.com\/gicid\/01.3001.0055.7280"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,6,1]]}},"URL":"https:\/\/doi.org\/10.5604\/01.3001.0055.7280","relation":{},"ISSN":["0030-6657","2300-8423"],"issn-type":[{"value":"0030-6657","type":"print"},{"value":"2300-8423","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,1]]}}}