Fine Needle Aspiration Biopsies of the Head and Neck: The Surgical Pathologist's Perspective

Cerilli, Lisa A.; Wick, Mark R.

doi:10.1177/106689690000800107

Cited by 10 publications

(11 citation statements)

References 85 publications

(53 reference statements)

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“…Fine‐needle aspiration (FNA) of a salivary gland tumor is a well‐established diagnostic procedure that aids management decisions. The challenges in accurately identifying salivary gland lesions and distinguishing these from their morphologic mimics based on cytology alone are well known . The positive predictive value of salivary gland cytology is often related to the technique of acquisition, quality of the smears, the experience of the cytopathologist as well as the availability of material for ancillary tests such as immunohistochemistry and flow cytometry …”

Section: Introductionmentioning

confidence: 99%

The Milan System for Reporting Salivary Gland Cytopathology—Proposed modifications to improve clinical utility

et al. 2019

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Background Fine‐needle aspiration of a salivary gland lesion is a well‐established diagnostic procedure that aids management decisions. Recently, the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) classification has been proposed in order to improve the reproducibility and communication in the management of salivary gland lesions. Methods A total of 375 patient's cytological reports collected between January 2010 and December 2017 were reviewed and reclassified according to MSRSGC and a risk of malignancy was calculated for each of the category. Results The rate of malignancy in MSRSGC classification was 19.0%, 11.8%, 25.0%, 5.5%, 50.0%, 71.4%, and 94.6% for each of the category (I, II, III, IVa, IVb, V, and VI), respectively. Conclusion The MSRSGC classification is a valuable tool in everyday practice. The modified version of MSRSGC aims to improve the surgical relevance and facilitate uniform management.

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Section: Introductionmentioning

confidence: 99%

The Milan System for Reporting Salivary Gland Cytopathology—Proposed modifications to improve clinical utility

et al. 2019

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“…Clinical evaluation and differential diagnosis of tumor masses developed in the lateral cervical area can be difficult, because of the heterogeneity of the lesions likely involved. [ 1 , 2 ] Most frequently these can be enlarged neck lymph nodes (inflammatory or metastatic causes), other inflammatory pathology, thyroid gland disorders, or salivary gland tumors. On rare occasions, branchial cysts, thyroglossal duct cysts, carotid glomus tumors, and cysts or tumors of the skin annexes can also be diagnosed.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of fine-needle aspiration cytology in the diagnosis of lateral cervical nonthyroid tumors

Iacob¹,

Zazgyva²,

Ormenișan³

et al. 2016

Medicine

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Given that the clinical and radiological examinations of lateral cervical masses are not always sufficient for deciding on appropriate management, the cytological examination of the material obtained by fine-needle aspiration might be an efficient tool in the preoperative investigation of these lesions.In this prospective cross-sectional study we evaluated the efficacy and diagnostic accuracy of fine-needle aspiration cytology in the assessment of lateral cervical nonthyroid tumors, by comparing its results with those of histopathology.A total of 58 patients with lateral cervical masses were included. Preoperative cytological results were compared with the histopathologic examination of surgical specimens.Both cytology and histology indicated that malignant tumors outnumbered benign lesions (62% vs 38%), with 88.9% of malignancies presenting in patients aged >50 years, but cytology was less effective at differentiating between benign and nontumor lesions. Cytology had 76.5% specificity and 78.1% sensitivity for identifying malignant lateral cervical lesions, and there was a concordance between the two diagnostic tests (McNemar test, P = 0.17, κ = 0.50, P <0.001).Fine-needle aspiration cytology is a simple, quick, and effective procedure that can aid in the preoperative evaluation of lateral cervical masses by differentiating benign tumors and inflammatory processes from malignancies and thus help in determining a subsequent therapeutic strategy.

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“…Fine-needle aspiration (FNA) cytology has become the standard procedure in diagnosing head and neck cancers. 1 Therefore, the identification of metastatic NPC on cytological smears is crucial. This would be the indication for searching the nasopharynx for the primary, especially in occult carcinoma.…”

mentioning

confidence: 99%

Fine‐needle aspiration cytology of metastatic nasopharyngeal carcinoma in cervical lymph nodes: Comparison with metastatic squamous‐cell carcinoma, and Hodgkin's and non‐Hodgkin's lymphoma

Kollur¹,

Hag²

2002

Diagnostic Cytopathology

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Our objective was to study the cytomorphological features of metastatic nasopharyngeal carcinoma (NPC) as compared to squamous-cell carcinoma (SCC) of nonnasopharyngeal origin, Hodgkin's lymphoma (HL), and non-Hodgkin's (NHL) lymphoma in the neck lymph nodes. The aim of this study was to find simple cytological criteria using routine stains that can help in differentiating between these entities. All fine-needle aspiration (FNA) smears of metastatic NPC, SCC, HL, and NHL from neck nodes available in our files were included in this study. Nodal disease was the first clinical manifestation in all cases of NPC, and all the lesions were of the nonkeratinizing type. The cytomorphological features of metastatic NPC, SCC, HL, and NHL have been described. Metastatic NPC and HL had a similar reactive lymphoid background, with eosinophils, plasma cells, and sometimes epithelioid-cell granulomas. The bizarre cells of NPC showed some resemblance to Reed-Sternberg cells of HL. However, the latter can be distinguished from the former on the basis of bulky, pale gray, vacuolated cytoplasm and vesicular nuclei with sharply demarcated prominent macronucleoli. In NPC, the neoplastic cells form distinct aggregates contrasting with the normal lymphoid cells in the background, which was different from the monotonous dispersed population of cells in NHL. Moreover, bizarre cells, prominent nucleoli, and the presence of plasma cells, eosinophils, and granulomas were not common features of NHL. The smears of metastatic SCC revealed keratinized malignant cells in all cases, while eosinophils and plasma cells were absent in the background. Plasma cells were seen intimately related to tumor cells in all cases of NPC. In conclusion, metastatic NPC can be differentiated from metastatic SCC of nonnasopharyngeal origin, HL, and NHL on the basis of simple nuclear and cytoplasmic features of malignant cells and their background. The presence of plasma cells intermingling with tumor-cell clusters is a good indicator of nasopharyngeal origin. On the other hand, a nasopharyngeal origin is unlikely in the presence of keratinized malignant cells.

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Fine Needle Aspiration Biopsies of the Head and Neck: The Surgical Pathologist's Perspective

Cited by 10 publications

References 85 publications

The Milan System for Reporting Salivary Gland Cytopathology—Proposed modifications to improve clinical utility

The Milan System for Reporting Salivary Gland Cytopathology—Proposed modifications to improve clinical utility

Effectiveness of fine-needle aspiration cytology in the diagnosis of lateral cervical nonthyroid tumors

Fine‐needle aspiration cytology of metastatic nasopharyngeal carcinoma in cervical lymph nodes: Comparison with metastatic squamous‐cell carcinoma, and Hodgkin's and non‐Hodgkin's lymphoma

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