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Wakely PE, Lott-Limbach AA. Classic polymorphous adenocarcinoma: Fine needle aspiration cytopathology of eight cases. Cytopathology 2021; 32:789-794. [PMID: 34346533 DOI: 10.1111/cyt.13046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 07/26/2021] [Accepted: 08/01/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The cytopathology and diagnostic accuracy of salivary gland (SG) polymorphous adenocarcinoma (PAC) is the subject of a limited number of reports. We undertook a review of our experience with fine needle aspiration (FNA) biopsy and PAC. MATERIALS AND METHODS A search was made of our cytopathology files for PAC cases that also had histopathological confirmation. FNA biopsy smears and cell-blocks were performed and examined using standard techniques. RESULTS Eight FNA biopsy cases of histologically proven PAC from 7 patients [F:M = 1.3:1, age 39-75 years, mean = 58] met study inclusion. Metastatic aspirates were most common (4), followed by 3 primary cases and 1 locally recurrent neoplasm. Primary FNA sites included hard palate (1 case), lip (1), and lateral tongue (1); all metastatic sites were in the neck. A precise cytologic diagnosis was made in 38% of cases; however, when applying the Milan classification system, 100% could be categorised as either malignant or of uncertain malignant potential. Ancillary immunohistochemical testing performed in 44% of the cases was non-specific. Cytologic smears showed cellular uniformity and structural variety of cell groups with tubular, branching, cribriform, and convex patterns as well as variable, but occasionally abundant globular myxoid stroma leading to confusion with adenoid cystic carcinoma. CONCLUSION The imitative cytopathology of PAC with other SG neoplasms as well as its infrequency in routine FNA biopsy practice makes specific interpretation difficult, but using a classification system allows for appropriate patient management. Molecular testing in future specimens holds promise for enhancing diagnostic accuracy.
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Affiliation(s)
- Paul E Wakely
- Department of Pathology, The Ohio State University Wexner Medical Center, James Cancer Hospital and Solove Research Institute, Columbus, OH, USA
| | - Abberly A Lott-Limbach
- Department of Pathology, The Ohio State University Wexner Medical Center, James Cancer Hospital and Solove Research Institute, Columbus, OH, USA
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2
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Jiménez-Heffernan JA, Rodríguez-García AM, González-Peramato P, López-Ferrer P, Muñoz-Hernández P, Gordillo CH, Viguer JM, Vicandi B. Fine needle aspiration cytology of polymorphous adenocarcinoma of the salivary glands: A report of 11 patients and review of the literature. Diagn Cytopathol 2020; 48:1013-1020. [PMID: 32421929 DOI: 10.1002/dc.24473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Polymorphous adenocarcinoma (PAC) is a rare malignant tumor of the minor salivary glands. It has an infiltrative growth, variable architectural patterns, neurotropism and cellular monomorphism. Approximately 75% of the cases show a specific mutation in the protein kinase D1 (PRKD1) gene. Reflecting the rarity of the tumor and intraoral location, the cytologic experience is limited with few reported series. In this study we analyze our cytologic experience to determine if a preoperative diagnosis is possible. METHODS A retrospective study of 11 patients with PAC in which a cytologic study was available. A review of the literature was also performed. RESULTS Our study shows that PAC has relatively constant cytological features. The analysis of the cytological literature although it shows some heterogeneity, also reveals repetitive cytological findings. Smears are cellular with irregular groups some showing pseudopapillary branching morphology. Monolayered clusters and small acinar structures are also present. Most cases have small metachromatic globules embedded within the groups determining a cylindromatous pattern. Tumoral cells are small and uniform with scarce to moderate cytoplasm. Nuclei are round and oval with occasional grooves and small nucleoli. CONCLUSION PAC has characteristic cytological features that together with its location in minor salivary gland must make us consider it preoperatively. It may resemble basal cell adenoma and epithelial-rich pleomorphic adenoma so we should be cautious in the final diagnosis. Whenever possible, the characteristic cytomorphology of PCA should make us evaluate the mutational status of PRKD1 gene since it may permit a more accurate diagnosis.
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Affiliation(s)
| | | | | | | | | | - Carlos H Gordillo
- Department of Pathology, University Hospital La Princesa, Madrid, Spain
| | - José M Viguer
- Department of Pathology, University Hospital La Paz, Madrid, Spain
| | - Blanca Vicandi
- Department of Pathology, University Hospital La Paz, Madrid, Spain
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Singh M, Sagar N, Yadav S, Aggarwal R, Mandal S, Khurana N, Jain S, Meher R. Utility of Fine Needle Aspiration in Diagnosis of Intraoral Minor Salivary Gland Tumors. J Cytol 2019; 37:53-57. [PMID: 31942099 PMCID: PMC6947729 DOI: 10.4103/joc.joc_62_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 10/08/2019] [Accepted: 10/13/2019] [Indexed: 11/20/2022] Open
Abstract
Objective: To evaluate the utility of intraoral fine-needle aspiration cytology (FNAC) in diagnosis of minor salivary gland neoplasms (MSGN) with application of Milan system of reporting salivary gland cytopathology; keeping histopathology as gold standard and to detail the cytological findings of MSGNs. Method: Retrospective study between Jan 2008 and June 2017 (appro × 10 years) on the cytology of the minor salivary gland tumor along with the histopathological correlation. The relevant clinical data was collected from the medical record. Result: Sixty-four cases of MSGNs were included in the study. The histodiagnosis of the 41 were available. Twenty-one cases were diagnosed as malignant, while rest 20 cases were reported as benign. The most common tumor diagnosed was pleomorphic adenoma (PA) (50% cases), followed by mucoepidermoid carcinoma (14%) and adenoid cystic carcinoma (12.5%). The most common site of MSGT was found to be hard palate (44%), followed by soft palate (23%), floor of the mouth (12%), lip (11%), buccal mucosa (5%), and tongue (5%) with no gender predilection. Sensitivity of FNAC for detection of malignancy was 81% while specificity 95%. For malignancies, positive predictive value for malignancies was 17/18 (94.4%) and negative predictive value was 19/23 (82.3%). According to Milan system out of 21 cases in category IV B, 4 cases were found malignant (Category VI), while 1/18 case in category VI turned out to be nonneoplastic lesion (Category II). Conclusion: FNAC is imperative in early diagnosis and subsequent management of MSGNs
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Affiliation(s)
- Meeta Singh
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Nishant Sagar
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Surekha Yadav
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Radhika Aggarwal
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Shramana Mandal
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Nita Khurana
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Shyama Jain
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Ravi Meher
- Department of ENT, Maulana Azad Medical College, New Delhi, India
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4
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Altin F, Alimoglu Y, Acikalin RM, Yasar H. Is fine needle aspiration biopsy reliable in the diagnosis of parotid tumors? Comparison of preoperative and postoperative results and the factors affecting accuracy. Braz J Otorhinolaryngol 2019; 85:275-281. [PMID: 29936215 PMCID: PMC9442885 DOI: 10.1016/j.bjorl.2018.04.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/18/2018] [Accepted: 04/25/2018] [Indexed: 11/29/2022] Open
Abstract
Introduction Fine needle aspiration biopsy is a valuable tool in preoperative evaluation of head and neck tumors. However, its accuracy in management of salivary gland tumors is debatable. Objective We aimed to investigate the efficacy and the accuracy of fine needle aspiration biopsy in parotid gland tumors. Methods Patients who underwent parotidectomy between January 2008 and June 2017 due to parotid gland tumor were examined retrospectively. Patients with both preoperative fine needle aspiration biopsy and postoperative surgical pathologies were included. Preoperative fine needle aspiration biopsy was categorized as benign, malignant or suspicious for malignancy. Surgical pathology was grouped as benign or malignant. Surgical pathology was compared with fine needle aspiration biopsy, and sensitivity, specificity, accuracy and agreement between both tests were investigated. Results 217 cases were evaluated and 23 cases were excluded because the fine needle aspiration biopsy diagnosis was non-diagnostic or unavailable. 194 cases were included. The mean age of the patients was 47.5 ± 15.88 (7–82). There were 157 benign, 37 malignant cases in fine needle aspiration biopsy, 165 benign and 29 malignant cases in surgical pathology. The most common benign tumor was pleomorphic adenoma (43.3%), and malignant tumor was mucoepidermoid carcinoma (4.13%). The diagnostic accuracy for fine needle aspiration biopsy when detecting malignancy was 86.52%. Sensitivity and specificity were 68.96% and 89.63% respectively. Positive predictive value was 54.05% and negative predictive value was 94.23%. There was moderate agreement between fine needle aspiration biopsy and surgical pathology (κ = 0.52). The sensitivity was 54.54% in tumors less than 2 cm while 77.77% in larger tumors. In tumors extending to the deep lobe, sensitivity was 80%. Conclusion Fine needle aspiration biopsy is an important diagnostic tool for evaluating parotid gland tumors. It is more accurate in detecting benign tumors. In tumors greater than 2 cm and extending to the deep lobe, the sensitivity of fine needle aspiration biopsy is high. The use of fine needle aspiration biopsy in conjunction with clinical and radiological evaluation may help to reduce false positive and false negative results.
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Affiliation(s)
- Fazilet Altin
- Health Sciences University, Haseki Training and Research Hospital, Otolaryngology Department, Istanbul, Turkey.
| | - Yalcin Alimoglu
- Health Sciences University, Haseki Training and Research Hospital, Otolaryngology Department, Istanbul, Turkey
| | - Resit Murat Acikalin
- Health Sciences University, Haseki Training and Research Hospital, Otolaryngology Department, Istanbul, Turkey
| | - Husamettin Yasar
- Health Sciences University, Haseki Training and Research Hospital, Otolaryngology Department, Istanbul, Turkey
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5
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Vander Poorten V, Triantafyllou A, Skálová A, Stenman G, Bishop JA, Hauben E, Hunt JL, Hellquist H, Feys S, De Bree R, Mäkitie AA, Quer M, Strojan P, Guntinas-Lichius O, Rinaldo A, Ferlito A. Polymorphous adenocarcinoma of the salivary glands: reappraisal and update. Eur Arch Otorhinolaryngol 2018; 275:1681-1695. [PMID: 29761209 DOI: 10.1007/s00405-018-4985-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 04/26/2018] [Indexed: 12/29/2022]
Abstract
Although relatively rare, polymorphous adenocarcinoma (PAC) is likely the second most common malignancy of the minor salivary glands (MiSG). The diagnosis is mainly based on an incisional biopsy. The optimal treatment comprises wide surgical excision, often with adjuvant radiotherapy. In general, PAC has a good prognosis. Previously, PAC was referred to as polymorphous low-grade adenocarcinoma (PLGA), but the new WHO classification of salivary gland tumours has also included under the PAC subheading, the so-called cribriform adenocarcinoma of minor salivary glands (CAMSG). This approach raised controversy, predominantly because of possible differences in clinical behaviour. For example, PLGA (PAC, classical variant) only rarely metastasizes, whereas CAMSG often shows metastases to the neck lymph nodes. Given the controversy, this review reappraises the definition, epidemiology, clinical presentation, diagnostic work-up, genetics, treatment modalities, and prognosis of PAC of the salivary glands with a particular focus on contrasting differences with CAMSG.
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Affiliation(s)
- Vincent Vander Poorten
- Department of Oncology-Section Head and Neck Oncology, Otorhinolaryngology-Head and Neck Surgery and Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium. .,Multidisciplinary Salivary Gland Society, Geneva, Switzerland.
| | - Asterios Triantafyllou
- School of Dentistry, University of Liverpool, Liverpool, UK.,Pathology Department, Liverpool Clinical Laboratories, Liverpool, UK
| | - Alena Skálová
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, Czech Republic
| | - Göran Stenman
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Department of Pathology and Genetics, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden
| | - Justin A Bishop
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Esther Hauben
- Department of Imaging and Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Henrik Hellquist
- Epigenetics and Human Disease Laboratory, CBMR, Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal
| | - Simon Feys
- Department of Oncology-Section Head and Neck Oncology, Otorhinolaryngology-Head and Neck Surgery and Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Remco De Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Antti A Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Miquel Quer
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Orlando Guntinas-Lichius
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland.,Department of Otorhinolaryngology, Institute of Phoniatry/Pedaudiology, Jena University Hospital, Jena, Germany
| | | | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
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6
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Ramírez-Pérez F, González-García R, Hernández-Vila C, Monje-Gil F, Ruiz-Laza L. Is fine-needle aspiration a reliable tool in the diagnosis of malignant salivary gland tumors? J Craniomaxillofac Surg 2017; 45:1074-1077. [DOI: 10.1016/j.jcms.2017.03.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 02/16/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022] Open
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7
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Goyal S, Sharma S, Diwaker P. Diagnostic role and limitations of FNAC in oral and jaw swellings. Diagn Cytopathol 2015; 43:810-8. [PMID: 26173640 DOI: 10.1002/dc.23308] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 04/04/2015] [Accepted: 06/22/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Fine-needle aspiration cytology (FNAC) of oral lesions has not been widely utilized for diagnosis due to rarity and diversity of lesions, peculiar anatomy of maxillofacial region, difficulty in aspirating these lesions, and limited experience. Aim of this study was to determine the role of FNAC in the diagnosis of oral and jaw swellings. MATERIALS AND METHODS One hundred and forty two patients underwent FNAC over a period of 7 years (2007-2013), of which 127 (89.4%) aspirates were diagnostic. Histopathologic correlation was available in 83 cases and diagnostic accuracy of FNAC was calculated. RESULTS Of the minor salivary gland lesions, 41 out of 55 lesions (74.5%) were benign and 14 (25.4%) were malignant. Mucocele was the most common lesion in oral cavity (30 cases) and pleomorphic adenoma was the commonest salivary gland neoplasm (9 cases). Of the 72 non-salivary-gland lesions, 22 lesions were inflammatory, 4 were epidermal inclusion cysts, 21 were neoplastic, and the remaining 25 presented as radiolucent jaw bone lesions. Diagnostic accuracy of FNAC in our study was 91.6% with 6 false negatives and 1 false positive. Four glandular malignancies and one case of cystic ameloblastoma were misdiagnosed as false negative on cytology. CONCLUSION Cytological features are diagnostic in certain inflammatory lesions of infective etiology and neoplastic conditions like Langerhans cell histiocytosis, lymphoma, plasmacytoma, Ewing's tumor, and squamous cell carcinoma. However, accurate subtyping of giant cell lesions, salivary gland tumors, odontogenic tumors, and cystic lesions may not be always feasible on FNAC. FNAC is highly accurate in early diagnosis of oral and jaw lesions.
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Affiliation(s)
- Surbhi Goyal
- Department of Pathology, University College of Medical Sciences, Dilshad Garden, Delhi, 110095, India
| | - Sonal Sharma
- Department of Pathology, University College of Medical Sciences, Dilshad Garden, Delhi, 110095, India
| | - Preeti Diwaker
- Department of Pathology, University College of Medical Sciences, Dilshad Garden, Delhi, 110095, India
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8
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Singhal N, Khurana U, Handa U, Punia RPS, Mohan H, Dass A, Gupta V. Intraoral and Oropharyngeal Lesions: Role of Fine Needle Aspiration Cytology in the Diagnosis. Indian J Otolaryngol Head Neck Surg 2015; 67:381-7. [PMID: 26693456 DOI: 10.1007/s12070-015-0875-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 06/24/2015] [Indexed: 12/13/2022] Open
Abstract
The oral cavity is affected by a wide range of pathologic lesions, for which a morphologic diagnosis is required for proper management. Fine needle aspiration (FNA) is being increasingly used for preliminary diagnoses of such lesions. This is retrospective analysis of intraoral and oropharyngeal lesions diagnosed with FNAC over a period of 7 years. Out of total 55 cases, a definite diagnosis could be made on cytology in 50 cases (90.9 %). These 50 cases were further included in the study. Thirty cases were reported as non-neoplastic and 20 as neoplastic (11 benign and nine malignant). The diagnoses were made taking into account the background material (blood, mucin) and the predominant cells present (neutrophils, lymphoid cells, macrophages, hemosiderin laden macrophages, squamous cells, basaloid cells, spindle cells, giant cells). Histopathological diagnosis was available in 17 cases and corresponded with FNA diagnosis in 16 cases (94.12 %). No significant complications were seen in patients undergoing these FNAs. It can be concluded that FNA is a simple and rapid diagnostic test that can be useful for preliminary assessment of oral and oropharyngeal lesions.
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Affiliation(s)
- Niti Singhal
- Department of Pathology, Government Medical College & Hospital, Sector-32 B, Chandigarh, 160040 India
| | - Ujjawal Khurana
- Department of Pathology, Government Medical College & Hospital, Sector-32 B, Chandigarh, 160040 India
| | - Uma Handa
- Department of Pathology, Government Medical College & Hospital, Sector-32 B, Chandigarh, 160040 India
| | - R P S Punia
- Department of Pathology, Government Medical College & Hospital, Sector-32 B, Chandigarh, 160040 India
| | - Harsh Mohan
- Department of Pathology, Government Medical College & Hospital, Sector-32 B, Chandigarh, 160040 India
| | - Arjun Dass
- Department of Otorhinolaryngology, Government Medical College & Hospital, Sector-32 B, Chandigarh, 160040 India
| | - Vikas Gupta
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Saket Nagar, Bhopal, 462024 Madhya Pradesh India
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9
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Tyagi R, Dey P. Diagnostic problems of salivary gland tumors. Diagn Cytopathol 2015; 43:495-509. [DOI: 10.1002/dc.23255] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 12/17/2014] [Indexed: 02/03/2023]
Affiliation(s)
- Ruchita Tyagi
- Department of Cytopathology and Gynecological Pathology; Postgraduate Institute of Medical Education and Research; Chandigarh India
| | - Pranab Dey
- Department of Cytopathology and Gynecological Pathology; Postgraduate Institute of Medical Education and Research; Chandigarh India
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10
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Singh S, Garg N, Gupta S, Marwah N, Kalra R, Singh V, Sen R. Fine needle aspiration cytology in lesions of oral and maxillofacial region: Diagnostic pitfalls. J Cytol 2011; 28:93-7. [PMID: 21897540 PMCID: PMC3159298 DOI: 10.4103/0970-9371.83461] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Fine needle aspiration cytology (FNAC) of oral and maxillofacial region has not been widely utilized for diagnosis due to diversity of lesion types, heterogeneity of cell populations and difficulties in reaching and aspirating these lesions. Aim: Our aim was to demonstrate the effectiveness of this cheap and simple procedure for the diagnosis of tumor and tumor like lesions of oral and maxillofacial region. In addition, we sought to highlight probable causes of errors in the cases showing lack of correlation between cytological and histological diagnoses. Materials and Methods: The study was conducted on 50 patients of all age groups with various palpable lesions in the oromaxillofacial region. A comparison between cytological and histological diagnosis was done wherever biopsy material was available. Results: The rate of unsatisfactory FNA was 4%. There were six false negative cases but no false positive case. The sensitivity of our study ranged from 77.7 to 75% including and excluding the suspicious cases, respectively. Specificity and positive predictive value was 100%. Conclusion: FNAC is a minimally invasive, highly accurate and cost-effective procedure for the assessment of patients with oromaxillofacial lesions. When applied in a proper manner, FNAC can help avoid a surgical biopsy in many cases.
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Affiliation(s)
- Sunita Singh
- Departments of Pathology, Pt. B. D. Sharma PGIMS, Rohtak, India
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11
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Fine-Needle Aspiration Cytology of Salivary Gland Lesions: A Systematic Review. J Oral Maxillofac Surg 2010; 68:2146-53. [DOI: 10.1016/j.joms.2009.09.064] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Revised: 07/07/2009] [Accepted: 09/15/2009] [Indexed: 10/19/2022]
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12
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Barrese JL, Lau S, Chen BT, Maghami E. Nonparotid parapharyngeal oncocytoma: a case report and literature review. Head Neck 2010; 32:800-5. [PMID: 19787785 DOI: 10.1002/hed.21237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Oncocytoma is a rare, benign salivary neoplasm composed of mitochondria-rich cells called oncocytes. Although oncocytoma usually occurs in the parotid glands, it has much less commonly been reported to occur in minor salivary gland tissues. Although there have been a few reported cases of oncocytomas being found in the parapharyngeal space, most if not all cases seem to be extensions of deep lobe parotid tumors. We present a case of a 73-year-old man with a previous history of prostate cancer that had the incidental finding of an (18)F-fluorodeoxyglucose (FDG) image of a highly avid parapharyngeal space lesion noted on a follow-up positron emission tomography-computed tomography (PET/CT) scan. Excision of the mass, through a transcervical approach, demonstrated it to be an isolated oncocytoma of the parapharyngeal space, noncontiguous with the parotid gland. Based on our literature search, this may be the first such reported case. A brief review of the available literature examining the known body of knowledge regarding these neoplasms is presented.
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Affiliation(s)
- James L Barrese
- Otolaryngology/Head and Neck Surgery, University of Southern California, Los Angeles, California, USA
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13
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Ashraf A, Shaikh AS, Kamal F, Sarfraz R, Bukhari MH. Diagnostic reliability of FNAC for salivary gland swellings: A comparative study. Diagn Cytopathol 2009; 38:499-504. [DOI: 10.1002/dc.21211] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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14
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Saleh HA, Clayman L, Masri H. Fine needle aspiration biopsy of intraoral and oropharyngeal mass lesions. Cytojournal 2008; 5:4. [PMID: 18373853 PMCID: PMC2329665 DOI: 10.1186/1742-6413-5-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2007] [Accepted: 03/28/2008] [Indexed: 11/19/2022] Open
Abstract
Background Fine needle aspiration (FNA) biopsy has been rarely used in oral and oropharyngeal lesions. The goal of this study was to assess the value and accuracy of FNA biopsy in the diagnosis of oral and oropharyngeal lesions particularly in regards to discriminating benign from malignant tumors. Methods Sixteen cases of FNA biopsies obtained of various intraoral and oropharyngeal masses or lesions performed at our institution during the eight-year period from 1998 to 2006 were retrospectively reviewed. The aspiration cytologic diagnoses were correlated with the histologic examination of the corresponding resected lesions. Results Sixteen cases of intraoral lesions evaluated by FNA biopsies during the period of 1998–2006 were reviewed. The sites of involvement were: lip [1], maxillary sinus [3], pharynx/oropharynx [5], floor of mouth [4], buccal mucosa [2] and peritonsillar area [1]. Patients' age ranged from 30 to 87 with an average of 54 years. Male to female ratio was 1:3. Cytologically, 7 cases were diagnosed as suspicious/malignant, and 9 cases as benign (including 6 benign neoplasm, 1 atypical, and 2 reactive or "descriptive"). Fifteen cases had corresponding surgical resection for histologic examination, of these, 9 cases were interpreted as malignant, and 6 as benign. There were no false positive diagnoses of malignancy on FNA. Two cases were interpreted as benign or atypical cytologically, but were found to be malignant on histologic examination. Conclusion FNA biopsy of intraoral and oropharyngeal masses is a valuable procedure for the initial evaluation of various lesions. It provides helpful information about these lesions and avoids hasty or unnecessary surgical biopsy. It is a rapid and relatively noninvasive procedure. Furthermore, aspiration biopsy is an important tool in the diagnosis and management of these lesions, both neoplastic and non-neoplastic, and can be sometimes complemented by ancillary studies for more accurate interpretation. However, its sensitivity in the diagnosis of malignancy is lower than that of histologic samples. This is probably due to the superficial nature and small size of these lesions, the limited space for maneuvering the needle and difficulty in immobilizing the lesion to obtain adequate samples, rather than to interpretation or inherent limitations of the technique itself.
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Affiliation(s)
- Husain A Saleh
- Department of Pathology, Sinai-Grace Hospital/Detroit Medical Center, Wayne State University, Detroit, Michigan, USA.
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15
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Abstract
Warthin's Tumor (WT) or papillary cystadenoma lymphomatosum is typically located in parotid gland. Extraparotid localization of WTs (EPWT) was rarely described in ectopic salivary tissue in the latero-cervical and para-parotid lymph nodes. Localization in the hard palate is exceptional. This paper describes pre-surgical diagnostic work up and surgical management of a solitary WT localized in the hard palate as found in a 27-year-old Caucasian woman. With consideration of uncertain pre-surgical diagnosis obtained with FNAC, intraoperative histologic examination of frozen sections was planned. Conservative surgical approach was performed. After WT was diagnosed with histology, a local bone curettage was made. Clinical and radiographic follow-up at 12th month was negative for relapse.
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Affiliation(s)
- Roberto Becelli
- Maxillo-Facial Surgery Department of La Sapienza University, Il Faculty of Medicine and Surgery at Sant'Andrea Hospital, Rome, Italy
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16
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Unal M, Polat A, Akbaş Y, Pata Y. Polymorphous low-grade adenocarcinoma of the tongue. Auris Nasus Larynx 2004; 31:85-8. [PMID: 15041060 DOI: 10.1016/j.anl.2003.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2003] [Indexed: 11/29/2022]
Abstract
Polymorphous low-grade adenocarcinoma has been recently recognized as a distinct entity with a predilection for minor salivary glands. We present an unusual case of polymorphous low-grade adenocarcinoma of the tongue. Only a few cases located at the tongue have been reported in the English literature. Current literature concerning the histopathological and clinical features of this tumor was discussed.
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Affiliation(s)
- Murat Unal
- Department of Otorhinolaryngology, Mersin University School of Medicine, Zeytinlibahce cad., 33079 Mersin, Turkey.
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