nach oben

Head and Neck Pathology

Erschienen in:

09.03.2018 | Invited Review

Diagnostic Approach to Fine Needle Aspirations of Cystic Lesions of the Salivary Gland

verfasst von: Liron Pantanowitz, Lester D. R. Thompson, Esther Diana Rossi

Erschienen in: Head and Neck Pathology | Ausgabe 4/2018

Einloggen, um Zugang zu erhalten

Abstract

Fine needle aspiration (FNA) has diagnostic and therapeutic value in the management of salivary gland cysts. Rendering an accurate diagnosis from an aspirated salivary gland cyst is challenging because of the broad differential diagnosis, possibility of sampling error, frequent hypocellularity of specimens, morphologic heterogeneity, and overlapping cytomorphology of many cystic entities. To date, there have been no comprehensive review articles providing a practical diagnostic approach to FNA of cystic lesions of salivary glands. This article reviews the cytopathology of salivary gland cysts employing 2017 World Health Organization terminology, addresses the accuracy of FNA, and presents The Milan System approach for reporting in cystic salivary gland cases. The utility of separating FNA specimens from salivary gland cysts, based upon the presence of mucin and admixed lymphocytes in cyst fluid is demonstrated. A reliable approach to interpreting FNA specimens from patients with cystic salivary gland lesions is essential to accurately determine which of these patients may require subsequent surgery.

Takita H, Takeshita T, Shimono T, Tanaka H, Iguchi H, Hashimoto S, Kuwae Y, Ohsawa M, Miki Y. Cystic lesions of the parotid gland: radiologic-pathologic correlation according to the latest World Health Organization 2017 Classification of Head and Neck Tumours. Jpn J Radiol. 2017;35:629–47.CrossRef

Ellis GL, Auclair PL. Tumors of the salivary glands. Washington DC: ARP Press; 2008.

Pusztaszeri M, Baloch Z, Faquin WC, Rossi ED, Tabatabai ZL. Atypia of undetermined significance. In: Faquin WC, Rossi ED, editors. The Milan system for reporting salivary gland cytopathology. Cham: Springer; 2018. pp. 43–54.

Wenig BM. Atlas of head and neck pathology. 3rd ed. Philadelphia: Elsevier; 2016.

Hegde PN, Prasad HLK, Kumar YS, Sajitha K, Roy PS, Raju M, Shetty V. A rare case of an epidermoid cyst in the parotid gland: which was diagnosed by fine needle aspiration cytology. J Clin Diagn Res. 2013;7:550–2.

Wang W, Li Y, Tang Y. Keratocystoma of the parotid gland: a case report and review of previous publications. Br J Oral Maxillofac Surg. 2015;53:655–7.CrossRef

Righi PD, Wells WA, Wagner JD, Kim SA, Anderson MW, Longardner NR. Odontogenic keratocyst of the mandible: an unusual cause of a parotid mass. Ann Plast Surg. 1998;41:89–93.CrossRef

Arora VK, Chopra N, Singh P, Venugopal VK, Narang S. Hydatid cyst of parotid: report of unusual cytological findings extending the cytomorphological spectrum. Diagn Cytopathol. 2016;44:770–3.CrossRef

Białek EW, Jakubowski W. Mistakes in ultrasound examination of salivary glands. J Ultrasonography. 2016;16:191–203.CrossRef

10.

Layfield L. Cytopathology of the head and neck. Chicago: ASCP Press; 1997.

11.

Firat P, Ersoz C, Uguz A, Onder S. Cystic lesions of the head and neck: cytohistological correlation in 63 cases. Cytopathology 2007;18:184–90.

12.

Chen KT. Diagnostic pitfalls in fine needle aspiration of cystic salivary gland lesions. Acta Cytol. 2007;51:675–6.

13.

Kim MW, Kim DW, Jung HS, Choo HJ, Park YM, Jung SJ, Baek HJ. Factors influencing the outcome of ultrasound-guided fine-needle aspiration for salivary gland lesion diagnosis. J Ultrasound Med. 2016;35:877–83.CrossRef

14.

Stewart CJ, MacKenzie K, McGarry GW, Mowat A. Fine-needle aspiration cytology of salivary gland: a review of 341 cases. Diagn Cytopathol. 2000;22:139–46.CrossRef

15.

Layfield LJ, Gopez EV. Cystic lesions of the salivary glands: cytologic features in fine-needle aspiration biopsies. Diagn Cytopathol. 2002;27:197–204.CrossRef

16.

Edwards PC, Wasserman P. Evaluation of cystic salivary gland lesions by fine needle aspiration: an analysis of 21 cases. Acta Cytol. 2005;49:489–94.CrossRef

17.

Allison DB, Mc Cuiston AM, Kawamoto S, Eisele DW, Bishop JA, Maleki Z. Cystic salivary gland lesions: utilizing fine needle aspiration to optimize the clinical management of a broad and diverse differential diagnoses. Diagn Cytopathol. 2017;45:800–7.CrossRef

18.

Madrigal E, Chhieng D, Harshan M. Cytologic-histologic correlation of cystic non-mucinous and mucinous salivary gland lesions. J of Am Soc Cytopathol. 2017;6:S82.CrossRef

19.

Baloch Z, Field AS, Katabi N, Wenig BM. The Milan system for reporting salivary gland cytopathology. In: Faquin WC, Rossi ED, editors. The Milan system for reporting salivary gland cytopathology. Cham: Springer; 2018. pp. 1–9.

20.

Moatamed NA, Naini BV, Fathizadeh P, Estrella J, Apple SK. A correlation study of diagnostic fine-needle aspiration with histologic diagnosis in cystic neck lesions. Diagn Cytopathol. 2009;37:720–6.CrossRef

21.

Bajwa MS, Nicolai P, Varvares MA. Clinical management. In: Faquin WC, Rossi ED, editors. The Milan system for reporting salivary gland cytopathology. Cham: Springer; 2018. pp. 157–68.

22.

Faquin WC, Powers CN. Cystic and mucinous lesions: mucocele and low-grade mucoepidermoid carcinoma. In: Faquin WC, Powers CN, editors. Salivary gland cytopathology. Boston: Springer; 2008. p. 159181.CrossRef

23.

Stojanov IJ, Malik UA, Woo SB. Intraoral salivary duct cyst: clinical and histopathologic features of 177 cases. Head Neck Pathol. 2017;11:469–76.CrossRef

24.

de Brito Monteiro BV, Bezerra TM, da Silveira ÉJ, Nonaka CF, da Costa Miguel MC. Histopathological review of 667 cases of oral mucoceles with emphasis on uncommon histopathological variations. Ann Diagn Pathol. 2016;21:44–6.CrossRef

25.

Khalbuss WE, Monaco SE, Pantanowitz L. Quick compendium of cytopathology. Chicago: ASCP Press. 2013.

26.

Gong X, Xiong P, Liu S, Xu Q, Chen Y. Ultrasonographic appearances of mucoepidermoid carcinoma of the salivary glands. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114:382–7.CrossRef

27.

Elsheikh TM, Chute DJ. Tumors of the salivary glands: benign and low-grade malignancies. In: Baloch ZW, Elsheikh TM, Faquin WC, Vielh P, editors. Head and neck cytohistology. Cambridge: Cambridge University Press; 2014. pp. 76–109.

28.

Joseph TP, Joseph CP, Jayalakshmy PS, Poothiode U. Diagnostic challenges in cytology of mucoepidermoid carcinoma: report of 6 cases with histopathological correlation. J Cytol. 2015;32:21–4.CrossRef

29.

Wade TV, Livolsi VA, Montone KT, Baloch ZW. A correlation of mucoepidermoid carcinoma: emphasizing the rare oncocytic variant. Patholog Res Int. 2011;2011:135796.

30.

Hang JF, Shum CH, Ali SZ, Bishop JA. Cytological features of the Warthin-like variant of salivary mucoepidermoid carcinoma. Diagn Cytopathol. 2017;45:1132–6.CrossRef

31.

Williamson JD, Simmons BH, el-Naggar A, Medeiros LJ. Mucoepidermoid carcinoma involving Warthin tumor. A report of five cases and review of the literature. Am J Clin Pathol. 2000;114:564–70.CrossRef

32.

Chin S, Kim HK, Kwak JJ. Oncocytic papillary cystadenoma of major salivary glands: three rare cases with diverse cytologic features. J Cytol. 2014;31:221–3.CrossRef

33.

Budnick S, Simpson RHW. Cystadenoma. In: El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ, editors. WHO classification of head and neck tumors. Lyon: International Agency for Research on Cancer; 2017. p. 191.

34.

Başak K, Kiroğlu K. Multiple oncocytic cystadenoma with intraluminal crystalloids in parotid gland: case report. Medicine (Baltimore). 2014;93:e246.CrossRef

35.

Kawahara A, Harada H, Mihashi H, Akiba J, Kage M. Cytological features of cystadenocarcinoma in cyst fluid of the parotid gland: diagnostic pitfalls and literature review. Diagn Cytopathol. 2010;38:377–81.

36.

Khatib Y, Dande M, Patel RD, Kane SV. Cytomorphological findings and histological correlation of papillary cystadenocarcinoma of the parotid: not always a low-grade tumor. Indian J Pathol Microbiol. 2016;59:368–71.CrossRef

37.

Schneller J, Solomon M, Webber CA, Nasim M. Mucinous cystadenocarcinoma of the parotid gland: report of a case with fine needle aspiration findings and histologic correlation. Acta Cytol. 2001;45:605–9.CrossRef

38.

Bernier JL, Bhaskar SN. Lymphoepithelial lesions of salivary glands; histogenesis and classification based on 186 cases. Cancer 1958;11:1156–79.CrossRef

39.

Upile T, Jerjes W, Al-Khawalde M, Kafas P, Frampton S, Gray A, Addis B, Sandison A, Patel N, Sudhoff H, Radhi H. Branchial cysts within the parotid salivary gland. Head Neck Oncol. 2012;4:24.CrossRef

40.

Michelow P, Dezube BJ, Pantanowitz L. Fine needle aspiration of salivary gland masses in HIV-infected patients. Diagn Cytopathol. 2012;40:684–90.CrossRef

41.

Ahamed AS, Kannan VS, Velaven K, Sathyanarayanan GR, Roshni J, Elavarasi E. Lymphoepithelial cyst of the submandibular gland. J Pharm Bioallied Sci. 2014;6(Suppl 1):S185–7.CrossRef

42.

Gadodia A, Seith A, Sharma R. Unusual presentation of Sjögren syndrome: multiple parotid cysts. Ear Nose Throat J. 2012;91:E17–9.

43.

Wu L, Cheng J, Maruyama S, Yamazaki M, Tsuneki M, Lu Y, He Z, Zheng Y, Zhou Z, Saku T. Lymphoepithelial cyst of the parotid gland: its possible histopathogenesis based on clinicopathologic analysis of 64 cases. Hum Pathol. 2009;40:683–92.CrossRef

44.

Gupta N, Gupta R, Rajwanshi A, Bakshi J. Multinucleated giant cells in HIV-associated benign lymphoepithelial cyst-like lesions of the parotid gland on FNAC. Diagn Cytopathol. 2009;37:203–4.CrossRef

45.

Iwai T, Baba J, Murata S, Mitsudo K, Maegawa J, Nagahama K, Tohnai I. Warthin tumor arising from the minor salivary gland. J Craniofac Surg. 2012;23:e374–6.CrossRef

46.

Patel DK, Morton RP. Demographics of benign parotid tumours: Warthin’s tumour versus other benign salivary tumours. Acta Otolaryngol. 2016;136:83–6.CrossRef

47.

Sagiv D, Witt RL, Glikson E, Mansour J, Shalmon B, Yakirevitch A, Wolf M, Alon EE, Slonimsky G, Talmi YP. Warthin tumor within the superficial lobe of the parotid gland: a suggested criterion for diagnosis. Eur Arch Otorhinolaryngol. 2017;274:1993–6.CrossRef

48.

Medeiros LJ, Rizzi R, Lardelli P, Jaffe ES. Malignant lymphoma involving a Warthin’s tumor: a case with immunophenotypic and gene rearrangement analysis. Hum Pathol. 1990;21:974–7.CrossRef

49.

Ballo MS, Shin HJ, Sneige N. Sources of diagnostic error in the fine-needle aspiration diagnosis of Warthin’s tumor and clues to a correct diagnosis. Diagn Cytopathol. 1997;17:230–4.CrossRef

50.

Parwani AV, Ali SZ. Diagnostic accuracy and pitfalls in fine-needle aspiration interpretation of Warthin tumor. Cancer 2003;99:166–71.CrossRef

51.

Viguer JM, Vicandi B, Jiménez-Heffernan JA, López-Ferrer P, González-Peramato P, Castillo C. Role of fine needle aspiration cytology in the diagnosis and management of Warthin’s tumour of the salivary glands. Cytopathology 2010;21:164–9.CrossRef

52.

Seifert G, Thomsen S, Donath K. Bilateral dysgenetic polycystic parotid glands. Morphological analysis and differential diagnosis of a rare disease of the salivary glands. Virchows Arch A. 1981;390:273–88.CrossRef

53.

Kumar KA, Mahadesh J, Setty S. Dysgenetic polycystic disease of the parotid gland: report of a case and review of the literature. J Oral Maxillofac Pathol. 2013;17:248–52.CrossRef

54.

Koudounarakis E, Willems S, Karakullukcu B. Dysgenetic polycystic disease of the minor and submandibular salivary glands. Head Neck. 2016;38:E2437–9.CrossRef

55.

Layfield LJ, Gopez EV. Histologic and fine-needle aspiration cytologic features of polycystic disease of the parotid glands: case report and review of the literature. Diagn Cytopathol. 2002;26:324–8.CrossRef

56.

Granter SR, Renshaw AA, Cibas ES. Nontyrosine crystalloids in fine-needle aspiration specimens of the parotid gland: a report of two cases and review of the literature. Diagn Cytopathol. 1999;20:44–6.CrossRef

57.

Nasuti JF, Gupta PK, Fleisher SR, LiVolsi VA. Nontyrosine crystalloids in salivary gland lesions: report of seven cases with fine-needle aspiration cytology and follow-up surgical pathology. Diagn Cytopathol. 2000;22:167–71.CrossRef

58.

Pantanowitz L, Goulart RA, Cao QJ. Salivary gland crystalloids. Diagn Cytopathol. 2006;34:749–50.CrossRef

59.

Kuwabara H, Ishizaki S, Akashi S, Yuki M, Shibayama Y. α-Amylase crystalloid granuloma in the parotid gland. Diagn Cytopathol. 2015;43:114–6.CrossRef

60.

Gould AR, Van Arsdall LR, Hinkle SJ, Harris WR. Tyrosine-rich crystalloids in adenoid cystic carcinoma: histochemical and ultrastructural observations. J Oral Pathol. 1983;12:478–90.CrossRef

61.

Raubenheimer EJ, van Heerden WF, Thein T. Tyrosine-rich crystalloids in a polymorphous low-grade adenocarcinoma. Oral Surg Oral Med Oral Pathol. 1990;70:480–2.CrossRef

62.

Lemos LB, Baliga M, Brister T, Cason Z. Cytomorphology of tyrosine-rich crystalloids in fine needle aspirates of salivary gland adenomas. Acta Cytol. 1997;41:1709–13.CrossRef

63.

Takeda Y. Crystalloid granuloma of the parotid gland: a previously undescribed salivary gland lesion. J Oral Pathol Med. 1991;20:234–6.CrossRef

64.

Horie Y, Ikawa S, Ishizu Y. Crystalloid granuloma of the parotid gland: a case report. Pathol Int. 1994;44:535–9.CrossRef

65.

Yada N, Kashima K, Daa T, Urabe S, Kondo Y, Yokoyama S. α-Amylase crystalloid granuloma of the parotid gland: case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114:e43–8.CrossRef

66.

Ho C, Sasaki CT, Prasad ML. Crystalloid granulomas of the parotid gland mimicking tumor: a case report with review of the literature. Int J Surg Pathol. 2013;21:282–6.CrossRef

67.

Srivastava S, Chougule A, Gupta N, Srinivasan R. Crystalloid granuloma with amylase crystalloids in submandibular gland cytology. Diagn Cytopathol. 2016;44:66–7.CrossRef

68.

Skalova A, Bell D, Bishop JA, Inagaki H, Seethala R, Vielh P. Secretory carcinoma. In: El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ, editors. WHO classification of head and neck tumors. Lyon: International Agency for Research on Cancer; 2017. pp. 177–8.

69.

Bishop JA, Yonescu R, Batista DA, Westra WH, Ali SZ. Cytopathologic features of mammary analogue secretory carcinoma. Cancer Cytopathol. 2013;121:228–33.CrossRef

70.

Samulski TD, LiVolsi VA, Baloch Z. The cytopathologic features of mammary analog secretory carcinoma and its mimics. Cytojournal 2014;11:24.CrossRef

71.

Griffith CC, Stelow EB, Saqi A, Khalbuss WE, Schneider F, Chiosea SI, Seethala RR. The cytological features of mammary analogue secretory carcinoma: a series of 6 molecularly confirmed cases. Cancer Cytopathol. 2013;121:234–41.CrossRef

72.

Kai K, Minesaki A, Suzuki K, Monji M, Nakamura M, Tsugitomi H, Kuratomi Y, Aishima S. Difficulty in the cytodiagnosis of mammary analogue secretory carcinoma: survey of 109 cytologists with a case originating from a minor salivary gland. Acta Cytol. 2017;61:469–76.CrossRef

73.

Gonzalez MF, Akhtar I, Manucha V. Additional diagnostic features of mammary analogue secretory carcinoma on cytology. Cytopathology 2018;29:100–3.CrossRef

74.

Bajaj J, Gimenez C, Slim F, Aziz M, Das K. Fine-needle aspiration cytology of mammary analog secretory carcinoma masquerading as low-grade mucoepidermoid carcinoma: case report with a review of the literature. Acta Cytol. 2014;58:501–10.CrossRef

75.

Oza N, Sanghvi K, Shet T, Patil A, Menon S, Ramadwar M, Kane S. Mammary analogue secretory carcinoma of parotid: Is preoperative cytological diagnosis possible? Diagn Cytopathol. 2016;44:519–25.CrossRef

76.

Ali SZ. Acinic-cell carcinoma, papillary-cystic variant: a diagnostic dilemma in salivary gland aspiration. Diagn Cytopathol. 2002;27:244–50.CrossRef

77.

Shet T, Ghodke R, Kane S, Chinoy RN. Cytomorphologic patterns in papillary cystic variant of acinic cell carcinoma of the salivary gland. Acta Cytol. 2006;50:388–92.CrossRef

78.

Mosunjac MB, Siddiqui MT, Tadros T. Acinic cell carcinoma-papillary cystic variant. Pitfalls of fine needle aspiration diagnosis: Study of five cases and review of literature. Cytopathology 2009;20:96–102.CrossRef

79.

Kumar U. Acinic cell carcinoma papillary-cystic variant: diagnostic pitfalls in fine needle aspiration cytology. J Clin Diagn Res. 2017;11:ED05–6.

80.

Jayaram G, Othman MA, Kumar M, Krishnan G. Papillary cystic type of acinic cell carcinoma of parotid: fine needle aspiration cytological features of a high grade variant with oncocytic metaplasia. Malays J Pathol. 2002;24:107–12.

81.

Said-Al-Naief N, Carlos R, Vance GH, Miller C, Edwards PC. Combined DOG1 and mammaglobin immunohistochemistry is comparable to ETV6-breakapart analysis for differentiating between papillary cystic variants of acinic cell carcinoma and mammary analogue secretory carcinoma. Int J Surg Pathol. 2017;25:127–40.CrossRef

82.

Al-Abbadi M. Metastases and rare primary neoplasms of salivary glands. In: Al-Abbadi M, editor. Salivary gland cytology. A color atlas. Wiley: Hoboken; 2011. pp. 215–41.CrossRef

83.

Squillaci S, Marchione R, Piccolomini M. Cystic sebaceous lymphadenoma of the parotid gland: case report and review of the literature. Pathologica 2011;103:32–9.

84.

Shilpi, Ahmad Ansari F, Bahadur S, Katyal A, Narula A, Nargotra N, Singh S. Sclerosing polycystic adenosis: a rare tumor misdiagnosed as retention cyst on fine needle aspiration cytology. Diagn Cytopathol. 2017;45:640–4.CrossRef

Titel: Diagnostic Approach to Fine Needle Aspirations of Cystic Lesions of the Salivary Gland
verfasst von: Liron Pantanowitz
Lester D. R. Thompson
Esther Diana Rossi
Publikationsdatum: 09.03.2018
Verlag: Springer US
Erschienen in: Head and Neck Pathology / Ausgabe 4/2018
Elektronische ISSN: 1936-0568
DOI: https://doi.org/10.1007/s12105-018-0904-8

Neu im Fachgebiet Pathologie

Open Access 15.04.2024 | Biomarker | Schwerpunkt: Next Generation Pathology

Springer Medizin

Diagnostic Approach to Fine Needle Aspirations of Cystic Lesions of the Salivary Gland

Abstract

Neu im Fachgebiet Pathologie

Molekularpathologische Untersuchungen im Wandel der Zeit

Vergleichende Pathologie in der onkologischen Forschung

Gastrointestinale Stromatumoren

Personalisierte Medizin in der Onkologie

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2018

A Retrospective 20-Year Analysis of Proliferative Verrucous Leukoplakia and Its Progression to Malignancy and Association with High-risk Human Papillomavirus

Clinicopathological and Immunohistochemical Study of Head and Neck Langerhans Cell Histiocytosis from Latin America

Spongiotic Gingival Hyperplasia Synchronously Involving Multiple Sites: Case Report and Review of the Literature

Systemic Non-Hodgkin T Cell Lymphomas Presenting in the Head and Neck Region: An Institutional Experience of a Rare Entity

Regarding the Use of the Term “Cementum” in Fibro-Osseous Lesions of the Craniofacial Skeleton

Sclerosing Epithelioid Fibrosarcoma of the Jaw: Late Recurrence from a Low Grade Fibromyxoid Sarcoma

Neu im Fachgebiet Pathologie

Molekularpathologische Untersuchungen im Wandel der Zeit

Vergleichende Pathologie in der onkologischen Forschung

Gastrointestinale Stromatumoren

Personalisierte Medizin in der Onkologie