Salivary Gland Tumors: A Diagnostic Dilemma!

Peravali, Ranjit Kumar; Bhat, H Hari Kishore; Upadya, Varsha Haridas; Agarwal, Anmol; Naag, Sushma

doi:10.1007/s12663-014-0665-1

Cited by 17 publications

(19 citation statements)

References 18 publications

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“…FNAB results in false diagnoses such as ACC or pleomorphic adenoma in 33% of cases,18 as occurred in our patient. Therefore, using additional diagnostic tools during the presurgical period, such as incisional biopsy or additional MRI techniques, as well as frozen sectional biopsy during surgery, is helpful for the differential diagnosis and the development of additional treatment plans.…”

Section: Discussionsupporting

confidence: 45%

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Adenoid cystic carcinoma of the sublingual gland: A case report

Song

2016

Imaging Sci Dent

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Adenoid cystic carcinoma (ACC) of the sublingual gland is an extremely rare neoplasm. The clinicopathological characteristics of ACC are slow-growing swelling with or without ulceration, perineural spread, local recurrence, and distant metastasis. This report describes a 58-year-old male who had a slowly growing swelling without ulceration on the right side of the mouth floor that had been present for 1 month. In a radiological examination, the mass showed multilocular cystic features and no bony or tongue muscle invasion. No enlarged cervical lymph nodes were detected. Excisional biopsy and histological analysis showed that the lesion was ACC. In addition to reporting a rare case of ACC, this report also discusses the differential diagnosis and treatment of ACC with a review of the relevant literature.

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Section: Discussionsupporting

confidence: 45%

“…The differential diagnosis of lesions originating from the sublingual glands includes pleomorphic adenoma, acinic cell carcinoma, and mucoepidermoid carcinoma 1819. Pleomorphic adenomas are the most common benign tumor in the salivary glands 19.…”

Section: Discussionmentioning

confidence: 99%

Adenoid cystic carcinoma of the sublingual gland: A case report

Song

2016

Imaging Sci Dent

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“…FNAC is an easy and widely accepted diagnostic tool for the diagnosis of salivary gland lesions, as it is easy to perform as well as cost effective, however the absence of classical features in many of the lesions of the salivary gland in cytology smears may present as a diagnostic difficulty to the cytopathologists . According to the literature sensitivity of FNAC for salivary gland neoplasms is low (62–97.6%) .…”

Section: Discussionmentioning

confidence: 99%

“…The sensitivity for distinction between neoplastic and non‐neoplastic disease in parotid is quite variable and is reported to be between 79 and 100% . The malignant nature of the tumor can be discerned, however the type of tumor is difficult to determine …”

Section: Discussionmentioning

confidence: 99%

“…Due to the overlapping morphological features, Ca ex PA as well as PA may be difficult to differentiate from epithelial myoepithelial carcinoma, polymorphous low grade carcinoma, and basal cell adenoma/adenocarcinoma . For the determination of the specific nature of malignant salivary tumor as well as a precise classification and grade, FNAC cannot be relied upon . The reasons could be the needle miss in a hetereogeneous tumor, the malignant component can be missed in cases where it is too small and the benign component may be missed in cases where the entire gland is being replaced by carcinoma .…”

Section: Discussionmentioning

confidence: 99%

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Carcinoma ex pleomorphic adenoma: A diagnostic challenge on cytology

Singh

Agarwal

Pujani

et al. 2017

Diagnostic Cytopathology

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Carcinoma ex pleomorphic adenoma (Ca ex PA) is a malignant neoplasm arising from primary or recurrent benign pleomorphic adenoma. It is rare with an annual incidence rate of 0.17 tumors per million. Histopathology remains the gold standard for the diagnosis of Ca ex PA, with only a handful of cases reported on cytology. In our case a 66-year-old male presented with the right parotid mass for 5 years rapidly increasing for the last 3 months. Fine needle aspiration cytology (FNAC) smears showed malignant tumor cells in clusters along with benign myoepithelial cells in chondromyxoid background. Histopathologically, highly pleomorphic malignant epithelial cells in sheets along with foci of comedonecrosis and areas corresponding to benign pleomorphic adenoma were observed on careful scrutiny. Immunohistochemistry revealed positivity for cytokeratin (CK 7) and gross cystic disease fluid protein 15 (GCDFP-15) while CK5/6 and high molecular weight CK (34 βE12) were negative in the malignant tumor cells. So, the final impression was Ca ex PA with salivary duct carcinoma as malignant component. We hereby report this case to highlight the significance of FNAC in the diagnosis of Ca ex PA which can be easily missed on cytopathology. However, it is important to corroborate the cytological findings with clinical suspicion of malignancy as well as radiology. Diagn. Cytopathol. 2017;45:651-654. © 2017 Wiley Periodicals, Inc.

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Role of nuclear morphometry in diagnosis of salivary gland neoplasms

Chaurasia

Gupta

Mayank

et al. 2020

Diagnostic Cytopathology

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Background: Fine needle aspiration cytology is an important diagnostic tool in salivary gland cytopathology. However, cytology of salivary gland neoplasms shows diversity with morphological overlap, heterogeneity and subjective variability, posing diagnostic challenge. Nuclear cytomorphometric image analysis turns the subjective criteria into quantitative parameters, which may aid not only in differentiating between benign and malignant tumours but also can aid in categorising challenging cases with morphological overlap. Methods: A retrospective analysis of Papanicolaou stained fine needle aspirate smears from 50 patients with salivary gland neoplasms, with available follow-up histopathology, was performed. The aspirates were categorised in to three neoplastic categories of Milan system for reporting salivary gland cytology (MSRSGC) that is benign neoplasm, salivary gland neoplasm with uncertain malignant potential, and malignant. The smears were subjected to cytomorphometric image analysis using Image Pro Software (version 10). Each nucleus was analysed for 13 parameters including aspect ratio, intensity, diameter, perimeter, roundness, area, Feret diameter, circularity, radii, Fournier description and chromatin texture characteristics such as margination, heterogeneity and clumpiness. The data obtained was compared through relevant statistical methods. Results: The comparative morphometric data obtained for parameters using ANOVA, for the three categories showed statistically significant P values (<0.001). The post hoc test (Games-Howel) test also showed significant P values (<.001). Conclusion: Cytomorphometric image analysis is an important tool in diagnosis of salivary gland neoplasms and can improve the diagnostic accuracy for better treatment and improved prognosis. However, more studies with larger sample size may be needed in future for further affirming its role.

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Salivary Gland Tumors: A Diagnostic Dilemma!

Cited by 17 publications

References 18 publications

Adenoid cystic carcinoma of the sublingual gland: A case report

Adenoid cystic carcinoma of the sublingual gland: A case report

Carcinoma ex pleomorphic adenoma: A diagnostic challenge on cytology

Role of nuclear morphometry in diagnosis of salivary gland neoplasms

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