The comparative roles of fine-needle aspiration cytology, histopathology and MRI in the diagnosis of parotid tumours
Reviewed by Madhup K Chaurasia

The three modalities commonly used to diagnose parotid masses are fine-needle aspiration cytology, histopathology and MRI. The significance of each of these and a correlation between the three, along with one’s clinical input, takes one closer to a correct diagnosis and management. In a series of 42 cases, the authors assessed the role of each modality. Only 4 of these 42 parotid tumours were malignant. Fine-needle aspiration cytology did not agree closely with histopathology but it proved more reliable in differentiating between benign and malignant tumours. Tumour size did not help to differentiate between benign and malignant tumours or between histological subtypes. As for MRI, T2-weighted images did not discriminate between pleomorphic adenoma and Warthin’s tumour. The same applied to T1 signal and contrast enhancement. However, a cyst-like lesion on the MRI did correlate with Warthin’s tumour. The presence of MRI enhancement suggested less likelihood of malignancy, but not reliably so. The authors contend that FNAC remains the cornerstone for preoperative triage for parotid tumours. AI approaches may pick up high dimensional quantitative features from MRI, not seen visually, but this can only complement rather than replace radiologic or cytological approaches in making a diagnosis. However, there are only four malignant masses in this small series of 42 patients. This calls for pooled multicentre research on the same lines to confirm what this study reveals.

Concordance of fine-needle aspiration cytology and histopathology in parotid masses: the added role of MRI.
Atabey P, Arik SB.
J LARYNGOL OTOL 
2026;140(5):513–9.