Fine-needle aspiration cytology: a reliable tool in the diagnosis of salivary gland lesions.

BACKGROUND: Fine-needle aspiration cytology (FNAC) is used as the main initial diagnostic investigation for lumps in the head and neck region. Major salivary glands and some minor salivary glands are easily accessible; therefore, they are optimal targets for FNAC. The aim of this study was to discuss the advantages and pitfalls of FNAC as compared to histopathology in the salivary gland lesions. MATERIAL AND METHODS: A total of 127 FNAC were carried out on salivary gland lesions from January 2006 to December 2010--a 5-year period. Histopathological follow-up data were obtained in 56 cases. The study was conducted to examine the sensitivity, specificity, and accuracy of FNAC for salivary gland swellings in comparison with histopathology. RESULTS: The male-to-female ratio was 2.4:1. Parotid gland was involved in 51.1%, submandibular gland in 37%, sublingual gland in 4.7%, and minor salivary glands in 7% of patients. There were 55.9% cases of non-neoplastic lesions and 44.1% cases of neoplastic lesions on biopsy. Sensitivity, specificity, positive predictive value, and negative predictive value of FNAC for malignant neoplastic lesions were 84.61%, 86.48%, 68.75%, and 94.11%, respectively, whereas for benign neoplastic lesions, they were 84.61%, 91.66%, 91.6%, and 85%, respectively. CONCLUSION: Fine-needle aspiration cytology is found to be a good sensitive and specific technique for the diagnosis of most of the salivary gland lesions. FNAC should be adopted as an initial investigation for all salivary gland swellings in conjunction with other investigations where appropriate.

Correlation between dental caries experience and mutans streptococci counts using saliva and plaque as microbial risk indicators in 3-8 year old children. A cross Sectional study.

OBJECTIVES: Determination of the relative amounts of mutans streptococcus in both saliva and plaque and to study its correlation with dental caries in children. STUDY DESIGN: The study comprised of 60 children aged 3-8 years divided into 2 groups (30 children in each): Group A- Children with more than 4 carious teeth and Group B- Children without caries. Saliva and plaque was collected from children of both the groups with the help of Dentocult SM strip test kit (Orion Diagnostic). Following incubation, mutans streptococcus scores (from 0 to 3) in each individual was evaluated and compared between both the groups. RESULTS: On comparing the two groups, mean ± SD of saliva score and plaque score was 2.40 ± 0.675 and 2.40 ± 0.621 respectively in group A, whereas it was 0.60 ± 0.498 and 0.83 ± 0.531 in children of group B showing a significant correlation (p = < 0.001) between mutans streptococci scores in both saliva and plaque and dental caries experience. CONCLUSIONS: There is a direct and strong co-relation between the salivary and plaque mutans streptococcus counts and caries activity in children aged 3-8 years. Key words:Mutans streptococci, dentocult, dental caries.

Fibrosarcoma of the mandible: a diagnostic dilemma.

Fibrosarcoma is a malignant mesenchymal neoplasm of fibroblasts that rarely affects oral cavity and can cause local recurrences or metastasis. The aetiologic factors are still unknown, but many authors have reported the radiation therapy history as an important aetiological factor, followed by trauma and underlying conditions like Paget's disease, fibrous dysplasia or chronic osteomyelitis. Fibrosarcoma of mandible is rare, with an incidence which ranges from 0-6.1% of all primary fibrosarcomas of the bone. This paper has described a case of a swelling in the mandible of a 17-years old female who had a radiolucency in association with crown of an impacted tooth and foci of radiopacity, which led to a misdiagnosis of either an odontogenic lesion or a bone tumour, but proved to be a fibrosarcoma on histopathological and immunohistochemistry investigations.

A disguised tuberculosis in oral buccal mucosa.

Tuberculosis is a major cause of morbidity and mortality worldwide. It is a chronic granulomatous disease that can affect any part of the body, including the oral cavity. Oral lesions of tuberculosis, though uncommon, are seen in both the primary and secondary stages of the disease. This article presents a case of tuberculosis of the buccal mucosa, manifesting as non-healing, non-painful ulcer. The diagnosis was confirmed based on histopathology, sputum examination and immunological investigation. The patient underwent anti-tuberculosis therapy and her oral and systemic conditions improved rapidly. Although oral manifestations of tuberculosis are rare, clinicians should include them in the differential diagnosis of various types of oral ulcers. An early diagnosis with prompt treatment can prevent complications and potential contaminations.