Diagnostic Role of Fine Needle Aspiration Cytology (FNAC) in Oral and Maxillofacial Masses: A Descriptive Cross-Sectional Study

Fine Needle Aspiration Cytology (FNAC) in Oral and Maxillofacial Masses

Abstract

Oral and maxillofacial swellings comprise a wide spectrum of inflammatory, benign, and malignant conditions that often present with overlapping clinical and radiological features. Objectives: To determine the diagnostic accuracy of fine needle aspiration cytology in oral and maxillofacial swellings using histopathology as the reference standard. Methods: The research is a descriptive cross-sectional study that was undertaken at the Department of Oral and Maxillofacial Surgery, Jinnah Post-Graduate Medical Centre, Karachi, within a period of four months from December 2025 to March 2026, after receiving the consent of the IRB. Non-probability consecutive sampling was used to select a total of 139 adult patients who had palpable oral and maxillofacial swellings. FNAC was done in aseptic conditions, and cytological results were compared to histopathology, which was taken as the reference standard. The results of FNAC were compared to the histopathological results based on a 2x2 contingency table. Results: A total of 139 patients with oral and maxillofacial swellings were analyzed, predominantly middle-aged males from urban areas, with most lesions present for ≤6 months. FNAC showed strong diagnostic performance against histopathology, with overall sensitivity of 89.7%, specificity of 93.0%, and diagnostic accuracy of 91.4%. Performance was highest in inflammatory lesions, followed by malignant and benign lesions. Cytological features showed typical biphasic epithelial and myoepithelial patterns without malignancy in benign cases, supporting FNAC as a reliable diagnostic tool. Conclusions: Fine needle aspiration cytology is a reliable first-line diagnostic tool for oral and maxillofacial swellings, demonstrating high accuracy in distinguishing inflammatory, benign, and malignant lesions.