Fine Needle Aspiration Cytology of Pleomorphic Adenoma

Viguer, José M.; Vicandi, Blanca; Jiménez‐Heffernan, José A.; López‐Ferrer, Pilar; Limeres, M A

doi:10.1159/000332705

Cited by 74 publications

(77 citation statements)

References 20 publications

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“…Few cases showed cystic change. Similar observations were made by studies done by Evans and Cruickshank, 12 Viguer JM et al 13 and Paul et al…”

Section: Discussionsupporting

confidence: 89%

Cytohistological Study of Salivary Gland Lesions

Subhashini¹,

N²,

Avanigadda³

et al. 2016

jemds

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BACKGROUND Salivary gland lesions are one of the palpable lesions subjected for Fine Needle Aspiration Cytology (FNAC) for diagnosis. Preoperative diagnosis helps in selection of appropriate treatment in every case.The aim of present study is to examine the cytological features of salivary gland lesions in aspirated smears and to evaluate the efficacy of FNAC in correlation with histopathological diagnosis in salivary gland lesions. MATERIALS AND METHODSThe study includes 52 patients with salivary gland lesions who came for FNAC, of which for 34 cases surgical specimens were received for Histopathological Examination (HPE). Diagnostic accuracy was studied by statistical analysis. RESULTSIn this study of 34 cases of correlation, maximum cases were obtained for pleomorphic adenoma making it the commonest benign tumour followed by malignancy. Parotid gland was the most common site involved in salivary gland lesions. FNAC diagnosis was consistent with HPE in 30 cases and inconsistent in 4 cases. CONCLUSIONFNAC is a highly reliable technique for pre-operative diagnosis of salivary gland tumours in the hands of experienced pathologists. Due to the minimally invasive nature of this technique, FNAC offers valuable information for planning of subsequent therapeutic management. BACKGROUND FNAC is useful in the diagnosis of salivary gland lesions and often influences management of the patient and allows for appropriate treatment planning. Non-neoplastic lesions can be distinguished from neoplastic and benign tumours from malignant ones. The complications of the FNAC are rare, making it one of the popular diagnostic tool. In this study the cytological spectrum of salivary gland lesions studied, HPE correlation was done for available cases. Statistical analysis like sensitivity, specificity and diagnostic accuracy was done. KEYWORDS FNAC, Salivary Gland Lesions, HPE. HOW TO CITE THIS ARTICLE:The results compared with other studies substantiate the findings of the series and affirms the usefulness of FNAC as a simple, cost effective and minimally invasive diagnostic tool in the evaluation of salivary gland lesions. Other, Competing Interest: None. Submission 19-11-2016, Peer Review 12-12-2016, Acceptance 19-12-2016, Published 26-12-2016. Corresponding Author: Dr. Kanchana Priyadarshini V. N, Assistant Professor, Department of Pathology, MIMS, Nellimarla-535217, Vizianagaram District, Andhra Pradesh. E-mail: kanpras@gmail.com DOI: 10.14260/jemds/2016/1714 Financial or MATERIALS AND METHODSThe present study includes aspiration smears of lesions from both major and minor salivary glands. These cases were referred to the cytology lab in the Department of Pathology. The study includes 52 cases of aspiration smears of which for 34 cases surgical specimens were received for HPE. After taking consent and relevant history, FNAC was done after local examination. Smears were stained with Haematoxylin and Eosin. Surgical specimens were examined, sections were given from representative area, processed and stained with...

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“…Few cases showed cystic change. Similar observations were made by studies done by Evans and Cruickshank, 12 Viguer JM et al 13 and Paul et al…”

Section: Discussionsupporting

confidence: 89%

Cytohistological Study of Salivary Gland Lesions

Subhashini¹,

N²,

Avanigadda³

et al. 2016

jemds

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“…Mucoepidermoid carcinoma represents the most common malignant tumor of the salivary gland [19]. However, in FNA-based studies its frequency varies from rare [6] to the most common salivary gland malignancy [8,18]. Although mucoepidermoid carcinoma was the most frequent carcinoma in our study, lymphomas were the most common form of malignancy.…”

Section: Discussionmentioning

confidence: 59%

“…In addition, we have taken into consideration swellings in the upper cervical region, which showed definitive features of either benign salivary gland tissue or its pathological lesions. The present study, involving 712 cases, is one of the largest reported in recent years [2,5,[7][8][9].…”

Section: Discussionmentioning

confidence: 84%

Role of Fine Needle Aspiration Cytology in the Diagnosis of Swellings in the Salivary Gland Regions: A Study of 712 Cases

Das¹,

Petkar²,

Al-Mane³

et al. 2004

Med Princ Pract

111

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Introduction: A mass in the salivary gland region often presents a diagnostic challenge with regard to its site of origin (salivary versus nonsalivary), benign or malignant nature, and tissue-specific diagnosis. The present study describes the utility of fine-needle aspiration (FNA) cytology in the diagnosis of these lesions. Subjects and Methods: Over a 6-year period (January 1994 to December 1999), 712 patients aged between 6 months and 91 years (median, 37 years) were subjected to FNA of swellings in their salivary gland regions. Male:female ratio was 1.28:1. The swellings were mostly located in the parotid (323 cases), submandibular (343 cases), and upper cervical region (27 cases). Swellings of oral (5 cases) and sublingual (2 cases) sites were rare. The lesions diagnosed by FNA cytology were compared among the major salivary glands. Cytologic diagnoses were correlated with histology in 45 cases. Results: Benign nonneoplastic lesions were the most common (73%), followed by neoplasms (20%), and those with atypical cytology (1%). Cytologic material was inadequate in 6% cases. Parotid gland region was involved more frequently by neoplasms (27.1%) than the submandibular gland region (13.7%, p < 0.0001). Inflammatory processes affected the submandibular gland region more commonly (42.0%) than the parotid (32.6%, p = 0.0164). Pleomorphic adenoma was the most common neoplasm (61.5%), followed by Warthin’s tumor (12.6%). Malignancies accounted for 10.5% of neoplasms. Frequency of involvement of parotid by Warthin’s tumor (16.7%) was significantly higher than that of submandibular gland (2.3%, p = 0.0191). However, the submandibular gland was more commonly affected by malignancy than the parotid gland (p = 0.0003). Sensitivity, specificity, and diagnostic accuracy of FNA cytology for all neoplastic lesions of the salivary gland were 94.6, 75.0, and 91.1%, respectively. The corresponding figures for malignancies were 60.0, 95.0, and 91.1%, respectively. Conclusion: FNA cytology is very useful for the diagnosis of salivary gland lesions. However, sampling and interpretation errors may occur. The low specificity for the diagnosis of neoplasms as a whole and the poor sensitivity for malignancies found in our study can be attributed to the relatively small number of benign nonneoplastic and malignancy cases with available histopathologic diagnoses.

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“…For example, the absence of myxoid elements and a predominance of spindle-shaped cells may lead to erroneously diagnosing a pleomorphic adenoma as a benign spindle cell mesenchymal tumor. In fact, the cytological similarities between pleomorphic adenoma and neurilemmoma have been described previously 8,16) . Furthermore, if MMCs with nuclear palisading arrangements in pleomorphic adenoma, as presented here, are aspirated for cytologic diagnosis or are included in a small biopsy specimen, the correct diagnosis of pleomorphic adenoma may be confused by a suspicion of myogenic or neurogenic tumor.…”

Section: Discussionmentioning

confidence: 70%

Pleomorphic adenoma with nuclear palisading arrangement of modified myoepithelial cells: Histopathologic and immunohistochemical study.

Takeda

Shimono

1999

Bull. Tokyo Dent. Coll.

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Pleomorphic adenomas with a nuclear palisading arrangement of spindle-shaped modified myoepithelial cells (MMCs), suggesting the appearance of palisading leiomyoma or Antoni's A type of neurilemmoma, are quite rare, and its cytologic nature has been poorly understood. This paper reports histologic and immunohistochemical findings of palisading MMCs in two cases of pleomorphic adenoma. Histologically, foci of spindle-shaped MMCs with nuclei in a palisading arrangement were scattered in the myxoid areas. Near the large foci of spindle-shaped MMCs with nuclear palisading arrangements, tiny foci of spindle-shaped MMCs forming nuclear palisading or rosettelike arrangements were seen. Such nuclear palisading arrangements of MMCs were suggestive of differentiation or transformation of MMCs into cells that were more smooth muscle in nature, supported by occasional existence of palisading leiomyoma in the myometrium and gastrointestinal tract. However, immunohistochemical findings of palisading MMCs in pleomorphic adenoma were similar to those of non-palisading MMCs, and showed no evidence of smooth muscle differentiation; neither palisading nor non-palisading MMCs in pleomorphic adenoma expressed desmin, muscle specific actin (HHF-35), alpha smooth muscle actin, or myoglobin.The biologic significance and formative mechanism of nuclear palisading arrangement of MMCs in pleomorphic adenoma could not be determined in the present study. However, if the MMCs with nuclear palisading arrangements in pleomorphic adenoma, presented here, are aspirated for cytologic diagnosis or are included in a small biopsy specimen, the correct diagnosis of pleomorphic adenoma may be confused by a suspicion of myogenic or neurogenic tumor.

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Fine Needle Aspiration Cytology of Pleomorphic Adenoma

Cited by 74 publications

References 20 publications

Cytohistological Study of Salivary Gland Lesions

Cytohistological Study of Salivary Gland Lesions

Role of Fine Needle Aspiration Cytology in the Diagnosis of Swellings in the Salivary Gland Regions: A Study of 712 Cases

Pleomorphic adenoma with nuclear palisading arrangement of modified myoepithelial cells: Histopathologic and immunohistochemical study.

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