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OBJECTIVE: This study aims to determine the clinicopathologic features of ameloblastoma, and to determine the sensitivity, specificity and accuracy of fine needle aspiration cytology (FNAC) in pre-operative assessment of ameloblastoma.
METHODS: A prospective study of patients with jaw swellings over a 9-month period. FNAC procedure was performed using disposable 5ml plastic syringes and 21-gauge needles. Smears were fixed, stained and the cytopathological features and diagnoses documented. Surgical biopsy was performed afterwards and the histological sections reviewed. Patients with the histopathological diagnosis of ameloblastoma were selected for the study. Data on clinico-radiologic features, cytopathologic and histopathologic diagnoses were collected analyzed. The cytopathologic and histopathologic findings were compared. The sensitivity, specificity and accuracy of FNAC in the diagnosis of ameloblastoma were determined.
RESULTS: There were 6 males (66.7%) and 3 females (33.3%) with a male to female ratio of 2:1 and mean age of 36 + 1.8 years. The most affected site was the mandible (n=6, 66.7%). Cytological smears of the ameloblastoma revealed mostly basaloid cells in clusters or discohesive patterns, occasionally associated with polyhedral or spindle cells. The most common cytological diagnosis was benign cystic tumour (n=6, 66.7%). Solid-multicystic ameloblastoma (n=6, 66.7%) was the most common histopathologic type. There was significant Pearson correlation of the cytological benignity and histopathological variants of ameloblastoma (p=0.013). The cytological benign nature of ameloblastoma showed sensitivity of 88.9%, specificity of 100% and accuracy of 88.9%.
CONCLUSION: There was significant association of the FNAC cytological diagnosis of benign lesion with the histopathologic variants of ameloblastoma, and a high sensitivity, specificity and accuracy for cytological diagnosis of the benign nature of the tumour.