The Utility of Liquid-Based Cytology in Salivary Gland Fine-Needle Aspirates: Experience of an Academic Institution

Abstract

Objective: To review the morphological features of salivary gland fine-needle aspirates (FNA) on ThinPrep® (TP) preparations. Emphasis is placed on the commonalities and specific differences between TP and conventional smear (CS) preparations. Study Design: The cytology and surgical pathology archives were searched for ‘salivary' or ‘parotid' at our institution from 2003 to 2013 for cases processed by TP and with a range of specified diagnoses and surgical follow-up. These cases were reviewed by the authors. A review of the known literature was also performed. Results: Morphological features and artifacts were noted for the most common salivary gland lesions. General features noted in the literature were identified, along with novel features identified on our review of cases. Emphasis was placed on cellular alterations, extracellular differences and architectural changes. Conclusions: The multitude of both benign and malignant lesions coupled with the unique artifacts encountered on TP makes salivary gland FNAs difficult for most practicing pathologists and cytopathologists. For this reason, many laboratories have been reluctant to implement TP preparations for these lesions. With knowledge of the specific artifacts and differences on TP compared to CS, TP can be used with confidence without a compromise in diagnostic accuracy for adequately cellular samples.

Diagnostic utility of fine‐needle aspiration cytology of lesions involving bone

“…Fine‐needle aspiration biopsy plays a key role in the diagnostic work‐up of a number of clinical lesions. In the thyroid and salivary gland, FNA is well‐accepted as a useful tool for the initial diagnosis of mass lesions . The evaluation of palpable lymphadenopathy often includes FNA for documentation of metastatic lesions and the evaluation for possible hematopoietic malignancies.…”

“…The utility of fine‐needle aspiration (FNA) in the diagnosis of superficial and deep‐seated mass lesions has been well established. Biopsy and characterization of mass lesions from a number of sites including thyroid, salivary gland, lung, and pancreas is well recognized as a reliable procedure of high sensitivity and specificity, which provides critical information for patient management . The utility of FNA and cytologic evaluation in the diagnosis of bone lesions has been addressed in a number of publications; however, some have questioned its accuracy, as evidenced by the skeptical tone of some publications regarding the subject that exist in the current literature .…”

The risk of malignancy according to Milan reporting system of salivary gland fine‐needle aspiration with Becton Dickinson SurePath liquid‐based processing

“…In the past 10 years, liquid‐based cytology (LBC) has been used increasingly in many laboratories for both gynecological and non‐gynecological specimens due to a number of advantages such as the need to examine fewer slides, well‐preserved nuclear details, and a clear background . Architecture, extracellular matrix material, and inflammatory component play an important role in the diagnosis of salivary gland lesions . In the literature, the sensitivity, specificity, and diagnostic accuracy of salivary gland FNA using a LBC technique have been demonstrated in a limited number of studies …”

“…Architecture, extracellular matrix material, and inflammatory component play an important role in the diagnosis of salivary gland lesions . In the literature, the sensitivity, specificity, and diagnostic accuracy of salivary gland FNA using a LBC technique have been demonstrated in a limited number of studies …”

Liquid-Based Cytology: A 25-Year Bridge between the Pap Smear and Molecular Cytopathology

“…As reported above, LBC may require different diagnostic criteria from those utilized on CS, as is the case with salivary gland tumors. In the article by Rarick et al [12], LBC diagnostic criteria for salivary gland tumors are exhaustively described. Once more, LBC advantages may be exploited when FNA is performed by noncytopathologists and liquid suspended cells may be alternatively used for LBC or cell blocks when rapid on-site evaluation is performed [10].…”