A comparative study between fine needle aspiration cytology findings and histopathological report of major salivary gland neoplasm in a tertiary hospital of Bangladesh.

Salivary gland tumours are relatively uncommon and most of the tumours arise from parotid gland. Fine needle aspiration cytology (FNAC) is advised preoperatively as diagnostic tool but sometimes found to shown both false positive and false negative results. This study was aimed to find out distribution of neoplasm of major salivary glands and also to explore the sensitivity and specificity of FNAC. The present cross sectional study was done in the Dept. of Otolaryngology Head and Neck Surgery, BSMMU from January 2007 to December 2008. A total number of 60 gender-matched patients with major salivary neoplasm, confirmed by FNAC, were recruited in the study. Operated salivary gland specimens were sent for histopathological examination, histopathological findings were compared. Overall male to female ratio was 1:1. Out of 60 cases, 47 (78.3%) patients had parotid and 13 (21.7%) patients submandibular gland neoplasm. Male to female ratio for parotid tumour was 1:1.1 and for submandibular 1.6:1. Mean age of the patients was 44.5 with range of 14-85 years. Of the total 60 cases 47 (78.3%) were benign and 13 (21.7%) malignant. Out of 47 parotid tumour 85.1% were benign and 14.9% malignant. Among the parotid tumour 97% were superficial lobe and 3.0% deep lobe. In case of submandibular gland 53.84% were benign and 46.15% tumour malignant. According to the sides of involvement, 25 (53.2%) cases of parotid neoplasm tumour were in the left and 22 (46.8%) the right. In submandibular gland the distribution was 7 (53.8%) and 6 (46.16%) respectively. Statistically incidence of parotid tumour was significantly higher than submandibular tumour (p < 0.05). Out of 60 cases in 56 (93.3%) preoperative FNAC and postoperative histopathological findings were same. There was 1.7% false positive and 5% were false negative results. Sensitivity, specificity of FNAC were 80% and 97.8% respectively. Positive predictive value was 92.3% and negative predictive 93.6% for FNAC.FNAC though cheap and safe but its diagnostic accuracy was 93.3%.Histopathologial examination remained to be of value for diagnostic confirmation of major salivary gland neoplasm.

Intraoperative serum parathyroid hormone level is an indicator of hypocalcaemia in total thyroidectomy patients.

Postoperative hypocalcaemia is the most frequent and common complication after total thyroidectomy. It is necessary to diagnose or to predict hypocalcaemia immediately after total thyroidectomy for minimizing complications. A prospective observational study was carried out in the Department of Clinical Pathology in collaboration with Department of Microbiology & Immunology, Department of Surgery, Department of Otolaryngology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Department of Otolaryngology, Dhaka Medical College & Hospital (DMC&H), Dhaka, during the period of September 2010 to August 2011 to evaluate intraoperative (20 minutes after total thyroidectomy) parathyroid hormone (PTH) measurement as a predictor of post thyroidectomy hypocalcaemia. Total 65 patients were enrolled in this study those came for total thyroidectomy. Postoperative hypocalcaemia developed in 25 cases. Intraoperative PTH was assessed and significant correlation was found between intraoperative PTH level and development of hypocalcaemia. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of intraoperative serum PTH for prediction of post total thyroidectomy hypocalcaemia were 84.0%, 85.0%, 84.6%, 77.8%, and 89.5% respectively. Because of the high sensitivity, specificity and accuracy of intraoperative serum PTH of this study, the early prediction of hypocalcaemia could be made by single assay of intraoperative serum PTH level at 20 minutes after total thyroidectomy.