Fine-needle cytology of intraglandular parotid lymph node: A useful procedure in the management of salivary gland nodules.

BACKGROUND: Enlarged intra-parotid lymph nodes (pLNs) may be misdiagnosed at ultrasound (US) being rare entities and because of their similarities to parotid nodules. Fine-needle cytology (FNC) is used in the preoperative diagnosis of parotid nodules, and may be used on pLNs to assess their nature and the underlying pathological processes. METHODS: Twenty consecutive pLNs underwent US-guided FNC and rapid on-site evaluation (ROSE). Flow cytometry (FC) was also performed in all the cases. Immunoglobulin heavy chain (IGH) gene rearrangement PCR was performed in five cases. Data obtained were checked by follow-up and histological controls, when available. RESULTS: Ultrasound-guided FNC and ROSE identified 20 pLNs. According to FNC-FC and PCR data, pLNs were diagnosed as reactive processes(18), FL (1) and B-cell, NHL NOS (1). Clinical follow-up (18 cases) and histological assessment (three cases) confirmed FNC-FC diagnoses of reactive processes and two NHL. CONCLUSIONS: Fine-needle cytology is a sensitive procedure in the identification of pLNs. FNC is useful in the management of pLNs; it allows a simple follow-up in case of reactive processes and surgical excision in case of NHL, thus sparing useless excisions for reactive processes.