Fine-Needle Aspiration of Secondary Neoplasms Involving the Salivary Glands

Abstract

Metastases or secondary deposits account for 16% of the malignant neoplasms involving the major salivary glands. A correct diagnosis of a secondary neoplasm is important to avoid unnecessary radical surgery and to guide further therapy. Fine-needle aspiration biopsy (FNAB) is an excellent noninvasive diagnostic tool for evaluating salivary gland lesions. We reviewed 36 secondary malignant salivary gland neoplasms evaluated by FNAB. Ancillary studies were performed in selected cases. Follow-up included clinical correlation and review of histologic material. For 4 adenocarcinomas, 4 squamous cell carcinomas, 1 undifferentiated carcinoma, 1 cutaneous basal cell carcinoma, 10 cutaneous melanomas including 1 desmoplastic variant, 3 osteosarcomas, 11 non-Hodgkin lymphomas, and 2 multiple myelomas, there was 1 false-negative FNAB result. The desmoplastic melanoma was interpreted as reactive lymphoid hyperplasia. A malignant diagnosis was given in all remaining cases except the secondary basal cell carcinoma, which was diagnosed as a neoplasm with basal cell features. FNAB is a reliable tool to differentiate hematologic malignant neoplasms and melanomas from other salivary gland neoplasms. A complete knowledge of the clinical history, review of previous pathologic materials, and, in some instances, the use of ancillary studies are crucial for recognizing solid malignant neoplasms secondarily involving the salivary glands.

Accuracy of Fine Needle Aspiration Cytology of Salivary Gland Lesions: Routine Diagnostic Experience in Bangkok, Thailand

“…Metastatic carcinomas were mainly from squamous cell carcinoma of larynges (two cases) and undifferentiated carcinoma of nasopharynx (one case). The majority of metastases were arising in the head and neck region as well as in the series of others (Seifert et al, 1986;Gnepp, 1991;Zhang et al, 2000). Previous studies found that most of metastases to salivary glands develop from primary squamous cell carcinoma of the skin (head and neck) or from melanomas of this region but hematogeneous metastases are relatively rare and mainly from the lung, kidney and breast (Seifert et al, 1986;Gnepp, 1991).…”

“…We agree that it is important to differentiate a primary neoplasm from a secondary malignant neoplasm to avoid unnecessary surgery and to guide subsequent management but the distinction between primary and secondary squamous cell carcinoma on cytology alone is impossible. The clinical history and the previous histopathological reports can be helpful for indicating as metastases neoplasms (Klijanienko & Vielh, 1998;Zhang et al, 2000).…”

Primary neuroendocrine small cell undifferentiated carcinoma of the parotid gland

“…The exclusion of lymphoma in our case was due to the lack of expression of CD45, the absence of lymphoglandular bodies, and the expression of other differentiation markers. Metastatic tumours are some of the most common malignancies throughout the salivary glands and may account for 10-16% of all malignant neoplasms of the major salivary glands [15,16]. Exclusion of metastatic pulmonary small cell carcinoma and metastatic Merkel cell carcinoma is warranted to make a diagnosis of salivary gland small cell carcinoma.…”

Clinicopathological profile of salivary gland swellings in Kumaon region of Uttarakhand

“…9 In cases of malignancy like carcinoma ex pleomorphic adenoma chances of false negative are there as heterogenecity plays an important role in these tumours. 10 Studies done in past also reveal good sensitivity in cases of metastatic lesions as metastatic cells can easily be identified as compared to their other cell variants 11 . Various studies done in past have reported a diagnostic accuracy of 86-98% for cytological diagnosis of salivary gland neoplasms.…”