Fine needle aspiration cytology of minor salivary gland tumors

Pal, Subrata; Mondal, Sajeeb; Bose, Kingshuk; Pradhan, Rajashree; Bandyapadhyay, Arindam; Bhattacharyya, Debasis

doi:10.4103/0973-1482.191055

Cited by 6 publications

(8 citation statements)

References 16 publications

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“…In line with existing literature [10][11][12][13][14][15][16], our study revealed an 80% agreement between the results of FNA across non-neoplastic, benign, and malignant instances and the final histopathological findings. Particularly in cases classified as malignant, our investigation showed a notable specificity rate of 98% for malignancies when FNA was utilized in conjunction with the Milan system, which falls within the reported range of 87-100% in the published literature [7,[9][10][11][12][13][14][15][16]19,20]. However, our study's sensitivity rate of 23% is low compared to the published literature (57.0-94.7%) [7,[9][10][11][12][13][14][15][16]19,20].…”

Section: Discussionsupporting

confidence: 90%

“…In terms of categorization, our findings revealed that the highest frequency of cases occurred within category IV-A (benign), followed by categories II (non-neoplastic) and VI (malignancy). These findings closely mirror outcomes by Pal et al [13], who analyzed parotid lesions over three years, revealing a similar distribution with a higher prevalence of non-neoplastic (29.5%) and benign (51.3%) cases as compared to malignant tumors (19.2%). Correspondingly, Sheetal et al [14], Yogambal et al [15], and Karuna et al [16] reported similar results, although their research covered salivary glands in a broader context rather than being exclusively confined to the parotid gland.…”

Section: Discussionsupporting

confidence: 88%

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Utility of the Milan System for Reporting Salivary Gland Cytopathology in Parotid Gland Masses: The Experience of Two Tertiary Centers

Alqaryan,

Alsalamah,

AlHajress

et al. 2023

Cureus

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BackgroundThe application of fine needle aspiration (FNA) in parotid masses via the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) enhances the diagnosis of these lesions alongside radiological investigations. ObjectivesOur objective was to assess the risk of malignancy, sensitivity, specificity, and false positive and negative results for each category of the MSRSGC. Additionally, we assessed the level of agreement between the FNA results using MSRSGC and post-resection histopathological diagnosis. MethodsWe conducted a retrospective chart review of parotid gland masses that received FNA and postoperative pathological diagnosis at King Saud University Medical City and King Fahad Medical City between 2018 and 2022. We summarized the categorical variables using frequencies and percentages. ResultsA total of 172 cases met the inclusion criteria. Males encompassed 102 patients (59.3%) of the study sample, and 89 (51.7%) of parotid masses were on the left side. The risk of malignancy for the MSRSGC categories was 37.5% (Category I), 9.0% (II), 50.0% (III), 4.7% (IVa), 50.0% (IVb), 100.0% (V), and 71.0% (VI). FNA had an overall success rate of 81%. The sensitivity was 64% and specificity was 94% for non-neoplastic masses. For benign masses, the sensitivity was 91% and specificity was 66%; however, the sensitivity was 40% and specificity was 97% for malignant lesions. We found that the percentage of agreement between the FNA and final pathology was 80%. ConclusionFNA using MSRSGC is a valuable preoperative clinical tool. However, the low sensitivity rates based on the diagnosis of malignant lesions should alert clinicians not to be overly reliant on biopsy results and instead defer to definitive surgical management.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 88%

Utility of the Milan System for Reporting Salivary Gland Cytopathology in Parotid Gland Masses: The Experience of Two Tertiary Centers

Alqaryan,

Alsalamah,

AlHajress

et al. 2023

Cureus

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“…Other cases were to exclude NHL (1) from Undifferentiated malignant neoplasm on basis of IHC. One case of Atypical Ewing's sarcoma which on IHC came out to be Centroblastic Lymphoma (1). Similar to the research conducted by Neval Zkaya, 17 we found that in twentynine instances, the original diagnosis of lymphoma was revised to benign/reactive, and in twenty of those cases, the underlying pathology was reactive hyperplasia (RH).…”

Section: Lymphomassupporting

confidence: 78%

Role of immunohistochemistry as a real mentor in diagnostic histopathology

Agarwal,

Ete,

Saxena

2023

IJPO

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: The goals and objectives of this study are to find out the number of cases where IHC was used to solve discrepant cases of histopathology. This gives an idea as to what percentage of cases required IHC for diagnostic evaluation. : This research is a combined retrospective and prospective analysis of a three-year time frame, beginning in January 2017 and ending in December 2019. Only those cases of benign and malignant neoplasms which have undergone IHC in our department are part of this study. Total of 67 cases were studied using routine H&E and IHC stain. Slides were evaluated by light microscopy. Using specific monoclonal or polyclonal antibodies, paraffin sections were stained immunohistochemically (IHC) using a Peroxidase antiperoxidase (PAP) technique.: There were a total of 23,558 biopsy reports made in the field of surgical pathology. Out of a total of 67 cases requested for IHC, 36 cases (53.7%) had histopathological diagnosis concordant with IHC diagnosis. While in 25 cases (37.31%) histopathological diagnosis was discordant with IHC diagnosis. In 6 cases (8.95%) conclusive diagnosis could not be derived.: From this study, we concluded that IHC plays a significant role in the definitive typing and grading of tumours. When trying to characterise a tumour, it's best to use an antigenic profile of both positive and negative markers, which may be achieved by a panel method consisting of well-chosen antibodies. It also brings about the conclusion that internal and external quality control plays an important part in routine Histopathology, which should not be undermined. Both QC and IHC must be made a routine part of Histopathology. Since we began comparing histology and IHC diagnosis three years ago, we've seen a significant uptick in the quality of our performance evaluations, patient care, and general laboratory practises.

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“…Further, the aspirated material can also be used for microbiological culture, immunophenotyping and molecular analysis for confirming the cytological diagnosis. While the FNAC of palpable lesions in major SGs is relatively easy, the FNAC of intraoral SGs is challenging as many times aspirates are not cellular as these intraoral sites are often difficult to approach and sometimes inaccessible [10][11][12]. In such cases, radiological-guided FNAC may be advised for better yield of aspirates for subsequent cytological diagnosis.…”

Section: Fnac: a Vital Diagnostic Tool In Salivary Gland Pathologymentioning

confidence: 99%

“…Majority of intraoral minor SG tumours are malignant in contrast to major SG tumours where benign tumours outnumber the malignant ones [4]. While some studies documents mucoepidermoid carcinoma (MEC) as the most common malignant tumour of minor SGs, other studies documents adenoid cystic carcinoma (ADCC) or pleomorphic adenoma (PA) as the most common tumour [5][6][7][8][9][10]. This difference in frequency of these histological types may be attributed to the differences in geographic location, race and varied clinical presentation.…”

Section: Introductionmentioning

confidence: 99%

Cytopathology of Intraoral Salivary Gland Tumours and Tumour-Like Lesions: Diagnostic Challenges and Pitfalls

Chaurasia¹,

Kapoor²

2022

Oral Cancer - Current Concepts and Future Perspectives

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Fine needle aspiration cytology is an important diagnostic tool in cytopathology. There are many challenges and pitfalls encountered in intraoral salivary gland cytopathology as tumours of these glands show morphological diversity and overlapping features. There are often variable solid-cystic components, metaplastic or necrotic changes, fibrosis, hyalinisation and haemorrhage accounting for heterogeneity of these tumours. The tumour profile of intraoral salivary gland is quite different from the major salivary glands and needs special attention. A low-grade malignant tumour may sometimes mimic a benign neoplasm or a non-neoplastic lesion resulting in a false negative diagnosis. Moreover, misinterpretation and failure to recognize subtle morphological and architectural patterns of cells also pose diagnostic challenges. In this chapter, we intend to highlight the key cytopathological features of intraoral salivary gland tumours and tumour-like lesions with emphasis to overcome diagnostic challenges and pitfalls to avoid misdiagnosis which will aid in planning further management and treatment.

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Fine needle aspiration cytology of minor salivary gland tumors

Cited by 6 publications

References 16 publications

Utility of the Milan System for Reporting Salivary Gland Cytopathology in Parotid Gland Masses: The Experience of Two Tertiary Centers

Utility of the Milan System for Reporting Salivary Gland Cytopathology in Parotid Gland Masses: The Experience of Two Tertiary Centers

Role of immunohistochemistry as a real mentor in diagnostic histopathology

Cytopathology of Intraoral Salivary Gland Tumours and Tumour-Like Lesions: Diagnostic Challenges and Pitfalls

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