Nodular oncocytic hyperplasia: Can cytomorphology allow for the preoperative diagnosis of a nonneoplastic salivary disease?

Abstract

Although oncocytosis demonstrates some overlap with Warthin tumor and oncocytoma, it lacks the diagnostic findings specific to oncocytic salivary gland malignancies such as salivary duct carcinoma, acinic cell carcinoma, mammary analog secretory carcinoma, and mucoepidermoid carcinoma. Despite current limitations in the understanding of oncocytic salivary gland lesions, the presence of a paucicellular specimen comprised of small groups of oncocytic cells should raise the possibility of oncocytosis in the differential diagnosis and can favor it in elderly patients with multiple salivary nodules. Cancer Cytopathol 2017;125:627-34. © 2017 American Cancer Society.

The key radiologic and cytomorphologic features of oncocytic and oncocytoid lesions of the salivary gland

“…While both oncocytoma and NOH are characterized by the presence of oncocytes, compared to oncocytoma, NOH specimens will generally be less cellular and contain fewer single cells . As noted, squamous differentiation can be seen in a minority of cases of NOH, and very rarely a mucoid matrix may be present, both of which might raise the possibility of MEC . However, even in this setting, NOH will lack the intermediate and mucus cell types seen in MEC.…”

“…NOH can be bilateral in up to 40% of cases. This condition generally affects middle‐aged to elderly patients, with a median age in the late 50s to mid 60s, with a majority of cases occuring in women . The lesions have been described as developing over the course of several months to years .…”

“…Cytologically, NOH classically demonstrates a uniform population of bland oncocytes, often in clusters, in the absence of lymphocytes or more basophilic cells . Specimens most frequently demonstrate low cellularity . Rare variant morphologies have been focally noted, including the presence of spindled cells, squamous differentiation, and mild nuclear pleomorphism, each occurring in up to a quarter of cases .…”

“…The differential diagnosis for NOH is broad and includes a number of benign lesions such as oncocytoma and WT as well as mucoepidermoid carcinoma (MEC). NOH will lack the dual cell population that is characteristic of WT and generally lacks the lymphocytic and granular background . While both oncocytoma and NOH are characterized by the presence of oncocytes, compared to oncocytoma, NOH specimens will generally be less cellular and contain fewer single cells .…”

Oncocytic Lesions of Salivary Glands with Morphological and Immunohistochemical Finding

“…[6] Tüm onkositik neoplaziler fosfotungstik asit hematoksilen (PTAH) ile histokimyasal reaktivite gösterirken, onkositomda p63 ile bazal hücrelerde boyanma mevcuttur, SOX10, DOG1 ile boyanma göstermez. [13] Onkositom ve WT boşaltım ve çizgili kanal differansiasyonu gösterir. AciCCA, seröz asini ve interkalar kanal differansiasyonu gösterir.…”