barw Judi Clinical Journal 3105-4102 2026 06 15 Fine-Needle Aspiration Cytology and Salivary Gland Tumors: A Cross-Sectional Study 8 14 10.70955/JCJ.2026.02 eng Aras J. Qaradakhy Radiology Department, Shorsh Teaching Hospital, Shorsh Street, Sulaymaniyah, Iraq Ari M. Abdullah Department of Pathology, Sulaymaniyah Teaching Hospital, Zanko Street, Sulaymaniyah, Iraq Karzan M. Salih Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Sarwat T. San Ahmed Sulaimani Teaching Hospital, Zanko Street, Sulaymaniyah, Iraq Mariwan L. Fatah College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq Hawbir Adil Mohammed Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Imad S. Sedeeq Department of General Surgery, Balsam Private Hospital, 30-meter Street, Erbil, Iraq Imad J. Habibullah Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Muhammed Bag A. Ali Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Rawa S. Ahmed Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Shamal H. Qadir Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Abdullah A. Qadir College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq Shko H. Hassan Zad Organization, Saeed Kaban Street, Judi Tower, Sulaymaniyah, Iraq Harun A. Ahmed College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq Ayman M. Mustafa Kscien Organization for Scientific Research (Middle East Office), Hamdi Street, Sulaymaniyah, Iraq 0009-0005-4254-4182 2026 05 25 Introduction: Salivary gland neoplasms are relatively rare and diverse, requiring accurate preoperative diagnosis. Although the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) has improved diagnostic consistency, fine-needle aspiration cytology (FNAC) performance remains variable. This study aims to assess FNAC’s diagnostic accuracy in salivary gland tumors and determinants affecting its performance. Methods: This cross-sectional study was conducted at a tertiary care center and included patients with suspected salivary gland tumors. The FNAC was performed using a 22–24-gauge needle. All cases underwent histopathological examination. FNAC accuracy was assessed by comparing findings with final histopathological diagnosis, calculating sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Two diagnostic settings were defined based on MSRSGC categories. Results: Among 272 FNAC cases, 232 (85.3%) originated from the parotid gland. The mean patient age was 44.90 years, with 151 (55.5%) females. Histopathological examination identified 11 (4.0%) non-neoplastic lesions, 241 (88.6%) benign tumors, and 20 (7.4%) malignant tumors. FNAC sensitivity was 84.6% in Setting 1 and 88.2% in Setting 2. The FNAC success was significantly lower for submandibular gland lesions (OR = 0.218, p-value= 0.002). Conclusion: Salivary gland FNAC is a minimally invasive, safe, and cost-effective diagnostic technique that may serve as an appropriate first-line investigation in the evaluation of major salivary gland lesions.