An Underappreciated Cytomorphological Feature of Secretory Carcinoma of Salivary Gland on Fine Needle Aspiration Biopsy: Case Report with Literature Review

Hua, Yinan; Youens, Kenneth E.; Liu, Lina

doi:10.1007/s12105-021-01361-1

Cited by 4 publications

(7 citation statements)

References 24 publications

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“…Interestingly, whereas some studies have described cytoplasmic vacuoles containing colloidlike substances, 66 others have described well-defined bright pink cytoplasmic vacuoles. 67 An earlier study described two additional morphological patterns in SC FNA smears: (1) hypercellular smears composed of cellular fragments of variable size with sheet-like or papillary architecture together with occasional singly dispersed neoplastic cells and (2) a predominance of single neoplastic cells mixed with histiocytes and granular debris. 68 As with the other rare salivary gland neoplasms, the morphological features of SC often overlap with other more common neoplastic entities.…”

Section: Secretory Carcinomamentioning

confidence: 99%

“…Upon immunocytochemical analysis, SC is generally positive for S100 and mammaglobin, but negative for p63 and DOG1; by contrast, AciCC is usually positive for DOG1, but negative for S100 (only sometimes focally positive) p63 and mammaglobin; low-grade MEC instead is positive for p63 and negative for S100. 67 Notably, a major distinctive feature of SC is positive nuclear immunocytochemical staining for panTRK. 69 Regarding the presence of distinctive gene fusions, SC shows an ETV6::NTRK3 gene fusion in >90% of cases, and can thus be considered highly specific.…”

Section: Secretory Carcinomamentioning

confidence: 99%

“…Tumours also display single polygonal neoplastic cells of variable size with abundant vacuolar cytoplasm and round to oval nuclei. Interestingly, whereas some studies have described cytoplasmic vacuoles containing colloid‐like substances, 66 others have described well‐defined bright pink cytoplasmic vacuoles 67 . An earlier study described two additional morphological patterns in SC FNA smears: (1) hypercellular smears composed of cellular fragments of variable size with sheet‐like or papillary architecture together with occasional singly dispersed neoplastic cells and (2) a predominance of single neoplastic cells mixed with histiocytes and granular debris 68 …”

Section: Overview Of the Challenging Scenarios In Salivary Gland Fna ...mentioning

confidence: 99%

“…In this intricate scenario, immunocytochemistry has proven helpful in differential diagnosis. Upon immunocytochemical analysis, SC is generally positive for S100 and mammaglobin, but negative for p63 and DOG1; by contrast, AciCC is usually positive for DOG1, but negative for S100 (only sometimes focally positive) p63 and mammaglobin; low‐grade MEC instead is positive for p63 and negative for S100 67 . Notably, a major distinctive feature of SC is positive nuclear immunocytochemical staining for panTRK 69 …”

Section: Overview Of the Challenging Scenarios In Salivary Gland Fna ...mentioning

confidence: 99%

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Molecular testing in salivary gland cytopathology: A practical overview in conjunction with the Milan system

Carillo,

De Luca,

Pisapia

et al. 2024

Cytopathology

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Recently, significant advances in the molecular characterization of salivary gland neoplasms have facilitated the classification and diagnosis of specific diagnostic entities. In the highly challenging diagnostic scenario of salivary malignancies, molecular testing is increasingly being adopted in routine practice to refine the cytological diagnosis of salivary lesions. Here, we reviewed the most recent evidence in the field of salivary glands molecular cytopathology.

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Section: Secretory Carcinomamentioning

confidence: 99%

Section: Secretory Carcinomamentioning

confidence: 99%

Section: Overview Of the Challenging Scenarios In Salivary Gland Fna ...mentioning

confidence: 99%

Section: Overview Of the Challenging Scenarios In Salivary Gland Fna ...mentioning

confidence: 99%

See 2 more Smart Citations

Molecular testing in salivary gland cytopathology: A practical overview in conjunction with the Milan system

Carillo,

De Luca,

Pisapia

et al. 2024

Cytopathology

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“…Finally, a total of 17 studies were included in the evaluation (Fig. 1) [11,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31].…”

Section: Study Selectionmentioning

confidence: 99%

Efficacy of Fine-Needle Aspiration Cytology in Diagnosing Secretory Carcinoma of Salivary Gland: A Systematic Review and Meta-Analysis

Kala,

Gupta,

Thapliyal

2024

Acta Cytologica

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Background: The diagnosis of salivary gland secretory carcinoma (SC) in fine needle aspiration specimens is challenging, because it’s low-grade nature makes it difficult to differentiate it from various benign or malignant salivary gland neoplasms. Currently, the gold standard is demonstration of ETV6-NTRK3 fusion gene. However, the decision for ordering this costly molecular testing can be facilitated by the correct recognition of its cytomorphological features. Objectives: The primary objective is to determine the accuracy of fine-needle aspiration cytology (FNAC) in diagnosis of salivary gland SC. The secondary objective is to recognize varied cytomorphological patterns, characteristic features of SC and differentiate it from other neoplasms. Method: PubMed/MEDLINE, Science Direct, Embase, Cochrane review and PROSPERO databases were searched for studies having all the following key search terms: (“secretory carcinoma of salivary gland” OR “mammary analogue secretory carcinoma of salivary gland”) AND (“Cytology”OR “Cytological features” OR “aspirate” OR “cytodiagnosis”) published in the time frame of 2010 to June 2023. Studies reporting cytological features of the salivary gland tumors which were confirmed/diagnosed as secretory carcinoma on molecular investigation, were included in the systematic review. Finally, seventeen studies reporting a total of 45 cases were included in the metanalysis. Results: The sensitivity of the FNAC in diagnosing SC in salivary gland is 27.7% (95% CI16.6-42.5%). The LR+ (positive likelihood ratio) was 0.654 (0.344-1.245), LR- (negative likelihood ratio) was 1.023 (0.538- 1.946) and diagnostic odds ratio was 0.421(0.129-1.374). The molecular testing and/or immunohistochemistry performed on cell block increased the diagnostic accuracy. Conclusion: Recognition of subtle cytomorphological patterns, i.e., papillary formation, clusters and singly dispersed cells along with presence of fine intracytoplasmic vacuolations were the characteristic findings in majority of cases, confirmed with diagnostic molecular profiling. This may be helpful in identification of this rare entity with limited published literature and help in increasing diagnostic accuracy.

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Salivary Gland Secretory Carcinoma; Review of 13 Years World‐Wide Experience and Meta‐Analysis

Yosefof,

Boldes,

Dan

et al. 2023

The Laryngoscope

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ObjectivesSecretory Carcinoma is a malignant salivary gland tumor, initially described in 2010. This rare tumor is associated with the translocation t(12;15) (p13;q25), resulting in the fusion gene ETV6‐NTRK3. Since this tumor is quite rare, most publications describe only small cohorts of patients. We aimed to investigate the clinical, pathological, and prognostic features of this newly defined malignant entity.Data SourcesPubmed, Google Scholar, and Web of Science databases.Review MethodsAll published articles between 2010 and 2023 were reviewed. Search terms included the terms “Mammary Analogue Secretory Carcinoma” and “Secretory Carcinoma”. All articles published in English reporting on Secretory Carcinoma of salivary glands were retrieved.ResultsOne‐hundred and 12 retrospective articles reporting a total of 674 patients were included, with 52% males and a mean age of 44.9 ± 18.9. The event rate for patients with advanced‐stage disease (Stage 3/4) at presentation was 24.1% (95% CI 17.6%–31.9%, I2 = 9.2%), 14.6% for regional metastases (95% CI 10.5%–20%, I2 = 12%), and the event rate of distant metastasis was 8.4% (95% CI 5.5%–12.7%, I2 = 4.2%). Adjuvant radiotherapy was administered for 30.3% of patients (95% CI 24.1%–37.2%, I2 = 21.5%). The recurrence rate was 19% (95% CI 15.1%–23.8%, I2 = 5%). Survival outcomes showed a 17.2% death of disease rate for Secretory Carcinoma patients (95% CI 13.5%–21.8%, I2 = 7.3%).ConclusionsSecretory Carcinoma is a rare and relatively newly defined entity arising in the parotid gland most commonly. Characterized as a low‐grade tumor, the majority of patients are diagnosed at an early stage, without regional or distant disease, and the prognosis is relatively good.Level of EvidenceN/A Laryngoscope, 2023

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An Underappreciated Cytomorphological Feature of Secretory Carcinoma of Salivary Gland on Fine Needle Aspiration Biopsy: Case Report with Literature Review

Cited by 4 publications

References 24 publications

Molecular testing in salivary gland cytopathology: A practical overview in conjunction with the Milan system

Molecular testing in salivary gland cytopathology: A practical overview in conjunction with the Milan system

Efficacy of Fine-Needle Aspiration Cytology in Diagnosing Secretory Carcinoma of Salivary Gland: A Systematic Review and Meta-Analysis

Salivary Gland Secretory Carcinoma; Review of 13 Years World‐Wide Experience and Meta‐Analysis

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