LEF‐1: Diagnostic utility in distinguishing basaloid neoplasms of the salivary gland

Schmitt, Alessandra C.; Griffith, Christopher C.; Cohen, Cynthia; Siddiqui, Momin T.

doi:10.1002/dc.23820

Cited by 26 publications

(18 citation statements)

References 11 publications

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“…EpCAM expression has been shown in 97.6% of adenoid cystic carcinomas and its intensity is correlated with a poor prognosis but it cannot be used for a differential diagnosis on cytological samples [18]. LEF-1 has been shown to be positive in benign basaloid neoplasm tests [19]. Griffith et al, have developed a user-friendly pattern approach for the sequential use of ancillary tests [20].…”

Section: Discussionmentioning

confidence: 99%

A 4-Year Retrospective Analysis of Salivary Gland Cytopathology Using the Milan System for Reporting Salivary Gland Cytology and Ancillary Studies

Dubucs

Basset

d’Aure³

et al. 2019

Cancers

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The cytopathology of salivary glands presents major challenges due to the heterogeneity of benign and malignant neoplasms, which is reflected in the large range of WHO 2017 Classifications. Fine needle aspiration (FNA) of salivary gland tumours is still the favoured initial approach as it results in good sensitivity and specificity. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was published in 2018 and comprises seven categories. We report results from a 4-year retrospective analysis of 328 salivary gland FNAs which were reviewed and classified according to the MSRSGC. We assess the risk of neoplasm, the risk of malignancy and the contribution of ancillary studies to the diagnosis. Benign neoplasms were the most frequent diagnosis (44.2%). Malignant and suspicious for malignancy were identified in 11.3% and 4.9% of diagnosed cases, respectively. Histopathological analysis after surgery was available for 216 (65.8%) of the cases. All malignant cases were confirmed post-surgery, and 68.8% of suspicious for malignancy were confirmed as malignant tumours. Immunocytochemistry was informative in 72.3% of cases. Immunocytochemistry and FISH provided the definitive diagnosis in 23.7% and 33% of cases, respectively. In conclusion, the MSRSGC is more effective when specific features of neoplasms can be identified. Ancillary studies help to further characterise salivary gland tumours and thereby increase the accuracy of MSRSGC.

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Section: Discussionmentioning

confidence: 99%

A 4-Year Retrospective Analysis of Salivary Gland Cytopathology Using the Milan System for Reporting Salivary Gland Cytology and Ancillary Studies

Dubucs

Basset

d’Aure³

et al. 2019

Cancers

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“…Additionally diffuse strong positive staining for CD 117 (c-Kit) has been reported in 90% of cases of adenoid cystic carcinoma 23. Positive LEF-1 (Lymphoid enhancer binding factor 1) has been reported to favor a benign neoplasm with higher percentage of staining observed in pleomorphic adenoma and basal cell adenoma while a higher percentage of LEF-1 negative staining has been reported in adenoid cystic carcinoma 24. In cases wherein the differential diagnosis includes benign and malignant neoplasms characterized by oncocytic cells associated with cyst content with proteinaceous material that resembles mucin, and scattered cells with foamy cytoplasm without overt features of high grade malignancy, a panel of antibodies might be utilized to aid accurate classification of these lesions.…”

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confidence: 99%

Risk stratification of salivary gland cytology utilizing the Milan system of classification

Savant

Cao

Chau

et al. 2018

Diagnostic Cytopathology

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Background The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is based on risk stratification. Our study is a retrospective review of salivary gland fine needle aspiration cytology (FNAC) with the goal of determining the risk of malignancy (ROM) in each of the categories proposed by the MSRSGC. Methods FNAC of salivary gland lesions with corresponding surgical resection specimens were retrieved over a 5‐year period. Metastatic tumors were excluded. BothFNAC and corresponding surgical resections were reviewed blindly and classified as per criteria published by the MSRSGC. The ROM for each of the diagnostic categories was determined and compared with the ROM published by the MSRSGC. Results The total number of entities and ROM in 199 reviewed cases were as follows: Nondiagnostic 18 (9.2%) (ROM 0%), non‐neoplastic 4(2%) (ROM 0%), atypia of undetermined significance (AUS) 12(6%) (ROM 33%), benign neoplasm 118(59.2%) (ROM 0.8%), salivary gland neoplasm of uncertain malignant potential (SUMP) 22(11%) (ROM 40.9%), suspicious for malignancy 3(1.5%) (ROM 100%), malignant 22(11%) (ROM 100%). Conclusion The ROM reported in our study was mostly concordant with ROM published by the MSRSGC. This classification is helpful for the management of categories; nondiagnostic, non‐neoplastic, benign neoplasm, suspicious for malignancy and malignant. The management is not standardized for the category, salivary gland neoplasm of uncertain malignant potential, as clinical information plays an important role in planning surgical procedures at an individual basis. Further studies will need to be performed using this new classification to help define appropriate management and predict ROM more accurately.

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“…A recent study described the utility of LEF-1 in categorizing basal cell neoplasms of the salivary glands [17]. This immunohistochemical tool, which can be applied to cytological cell block specimens, seems very promising but it needs validation on larger studies.…”

Section: Discussionmentioning

confidence: 99%

Potential Difficulties in Cytological Approach of Basal Cell Adenoma of Salivary Glands: The Experience of a Single Institution

Nicola¹,

Onorati²,

Lancia³

et al. 2018

Acta Cytologica

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Objective: Basal cell adenoma (BCA) is an uncommon benign epithelial neoplasm of salivary glands, which was first described by Kleinsasser and Klein in 1967 and which derives its name from the monomorphic basaloid appearance of tumor cells. This tumor represents 1–2% of all salivary gland epithelial tumors; the most common site of occurrence is the parotid gland. It usually arises in adults over 50 years of age with slight female prevalence. Study Design: We analyzed 5 cases of parotid lesions investigated by fine needle aspiration cytology at a single institution between 2002 and 2018. Results: Our series was composed by 3 women and 2 men with a mean age of 62 years. The most important cytological criteria we observed were cohesive sharp-angled clusters of regular basaloid cells, palisaded by p63-positive myoepithelial cells, and bordered by basement membrane-like hyaline membrane in the absence of a myxochondroid stroma. Overall features were consistent with the diagnosis of BCA. Conclusions: Our aim is to highlight the cytological features of these rare lesions improving the awareness of cytological pitfalls of salivary gland basaloid neoplasms. Moreover, the goal of this paper is to add to the literature 5 additional cases of these unusual tumors.

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LEF‐1: Diagnostic utility in distinguishing basaloid neoplasms of the salivary gland

Cited by 26 publications

References 11 publications

A 4-Year Retrospective Analysis of Salivary Gland Cytopathology Using the Milan System for Reporting Salivary Gland Cytology and Ancillary Studies

A 4-Year Retrospective Analysis of Salivary Gland Cytopathology Using the Milan System for Reporting Salivary Gland Cytology and Ancillary Studies

Risk stratification of salivary gland cytology utilizing the Milan system of classification

Potential Difficulties in Cytological Approach of Basal Cell Adenoma of Salivary Glands: The Experience of a Single Institution

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