Objectives
Fine-needle aspiration (FNA) is useful in the evaluation of salivary
gland tumors, but currently no standard terminology or risk stratification
model exists.
Methods
FNA smears were reviewed and categorized based on cytonuclear
features, stromal characteristics, and background characteristics. Risk of
malignancy was calculated for each category. Classifications as benign,
neoplasm of uncertain malignant potential (NUMP), suspicious for malignancy,
and positive for malignancy were used to aggregate categories into similar
risk groups.
Results
Categorization of salivary gland aspirates into morphologic
categories resulted in the expected risk stratification. Grouping of
categories maintained risk stratification, providing classes with malignancy
risk as follows: benign, 2%; NUMP, 18%; suspicious for malignancy, 76%; and
positive for malignancy, 100%.
Conclusions
Salivary gland FNA categorization into commonly encountered
morphologic categories provides risk stratification, which translates to a
simplified classification scheme of benign, NUMP, suspicious, and positive
for malignancy similar to the paradigm in other organ systems.