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A case of metastases to the submaxillary gland from breast carcinoma is reported. The patient, a 68-year-old female, had been operated for a stage II N+ breast carcinoma 4 years before. She then received six courses of CMF adjuvant program. A literature review is presented concerning the 8 well-documented cases reported.

BACKGROUND The degree of applicability of the Bethesda System 2001 (TBS 2001) for cervicovaginal cytology to a public health setting is unknown, and extrapolations from available data are unwarranted. METHODS A “before/after” study design was used to evaluate the impact of TBS 2001 on an organized, population‐based screening program in northern Italy. Between 2003–2004, 6 cytology laboratories converted from TBS 1991 to TBS 2001. A set of screening indicators based on TBS 2001 (85,012 patients) were compared with those based on TBS 1991 (199,833 patients) by means of their laboratory‐ and patient age‐standardized ratio with a 95% confidence interval (CI). RESULTS The prevalence of cervical intraepithelial neoplasm (CIN)2‐3/carcinoma was stable between the 2 populations. TBS 2001 had no effect on the unsatisfactory rate (1.99% vs. 2.03% for TBS 1991) nor on follow‐up compliance rate (93.2% vs. 92.3%). The reporting rate of atypical squamous cells (ASC) decreased from 17.1 to 14.7 per 1000 (ratio, 0.86; 95% CI, 0.81–0.91), the total positivity rate from 31.1 to 29.0 per 1000 (ratio, 0.93; 95% CI, 0.90–0.97), and the ASC:SIL (squamous intraepithelial lesion) ratio from 1.38 to 1.16. Compared with the ASCUS (ASC of undetermined significance) reports of TBS 1991, the predictive value for CIN2‐3/carcinoma decreased from 5.2 to 3.5% (ratio, 0.68; 95% CI, 0.48–0.93) among ASCUS reports, but increased from 5.1 to 17.2% (ratio, 3.41; 95% CI, 1.64–6.28) among ASC‐cannot exclude high grade lesion (ASC‐H) reports. ASC‐H had a 5.01‐fold (95% CI, 2.23–10.2) greater predictive value than ASCUS. CONCLUSIONS TBS 2001 is applicable to cervical screening in a public health setting. Cancer (Cancer Cytopathol) 2006;. © 2006 American Cancer Society.

Fine-needle aspiration cytology (FNAC) is a minimally invasive procedure usually well tolerated, easy to perform, quick, cheap and easy to repeat in case of doubts or non-diagnostic results. Echography is also a fast, cheap and non-invasive tool; however, the role of FNAC and echography in the diagnosis of salivary gland pathology is not universally recognised. Three hundred and fifty-seven patients with a cytological diagnosis at FNAC, and 247 of these who were also studied with echography, were enrolled for this retrospective study. The final histopathological diagnoses, obtained after surgery, were then compared to the preoperative FNAC diagnoses and echographic findings. From the analysis of our data, the overall FNAC specificity resulted 93%, sensitivity 83%, and diagnostic accuracy 92%. Echography sensibility was 57.1% specificity 98.2%, while positive and negative predictive value were respectively 80% and 94.8%. While echography can be useful in order to provide a better characterization of salivary gland lesions, FNAC can then be considered a safe diagnostic tool with reliable sensitivity and specificity for the assessment of salivary gland pathology and thus for selecting patients and indicating the best surgical treatment.It has been reported that major salivary gland tumours represent approximately 3% of all head and neck tumours; 80% involve parotid gland and 75% are benign neoplasms (l). According to the most recent WHO histological classification (2005) there is a broad spectrum of different histotypes of major salivary gland tumours (2), thus it is necessary to make a correct preoperative diagnosis in order to decide the best surgical/therapeutical approach. In this way, in order to perform a correct preoperative assessment, we used fine needle aspiration cytology (FNAC) and echography.FNAC is a minimally invasive method that does not require anaesthesia; it is well tolerated by the patient, easy to perform, quick, with rare complications, cheap and can be easily repeated in case of doubts or non-diagnostic results in order to reach a more accurate diagnosis (3). Echography is also a fast, cheap and non invasive tool. However, the role of FNAC and echography in the diagnosis of salivary gland pathology is not universally recognised (4, 5). Since its use is still controversial, most ENT surgeons prefer intraoperative frozen section examination to preoperative FNAC (6-7).The aim of this study is to show the accuracy and reliability of FNAC for the diagnosis of benign and malign tumours of major salivary glands through the evaluation of its diagnostic accuracy-sensibility,

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