Salivary Gland FNA: Anatomic, Clinical, and Technical Considerations

  • William C. Faquin
  • Celeste N. Powers
Part of the Essentials in Cytopathology Series book series (EICP, volume 5)

The major salivary glands consist of the parotid, the submandibular, and the sublingual glands. Under the control of the parasympathetic nervous system, the major salivary glands are responsible for the principal portion of saliva produced, which can be as much as 1.5 liters per day. The minor salivary glands of the oral cavity, pharynx, and upper airways contribute only a small percentage of the overall volume of saliva, but they are particularly important for supplying the mucus layer that protects the tissues of the oral cavity and upper respiratory tract.

Embryologically, the major salivary glands develop during the 6th to 8th weeks of gestation. The parotid gland arises first from ingrowth of the oral ectoderm into the surrounding mesenchyme. By the 7th week of development, the parotid gland moves in a dorsal and lateral direction to reside in the preauricular region, and by the 10th week, the facial nerve divides the surrounding parotid gland into anatomic superficial and deep compartments. A majority of parotid gland tumors develop within the superficial lobe, making FNA and clinical management relatively easy. Tumors originating within the deep lobe of the parotid gland usually present as pharyngeal swellings due to expansion into the parapharyngeal space. The parotid gland is unique among the salivary glands in that it incorporates lymphoid tissue during development, sometimes with entrapment of salivary gland epithelial cells. The latter are believed to be the source of lesions such as Warthin tumor and lymphoepithelial cysts. The minor salivary glands develop after the major glands and derive from the oral ectoderm and the nasopharyngeal endoderm.


Salivary Gland Parotid Gland Pleomorphic Adenoma Salivary Gland Tumor Minor Salivary Gland 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Allen SM, Boon AP, Brownridge DM, Chadwick CH, Buckley JG. Fine needle cytology of palpable head and neck lesions: a comparison of sampling methods with and without suction. Cytopathology 1999;10:97–106.PubMedCrossRefGoogle Scholar
  2. David O, Blaney S, Hearp M. Parotid gland fine-needle aspiration cytology: an approach to differential diagnosis. Diagn Cytopathol 2007;35:47–56.PubMedCrossRefGoogle Scholar
  3. Kontis TC, Johns ME. Anatomy and physiology of the salivary glands. In: Bailey BJ (ed): Head and neck surgery–Otolaryngology, 2nd ed. Philadelphia: Lippincott-Raven Publishers, 1998:531–539.Google Scholar
  4. Martinez-Madrigal F, Micheau C. Major salivary glands. In: Sternberg SS (ed), Histology for pathologists. New York: Raven Press, 1992:457–478.Google Scholar
  5. NCCLS. Fine needle aspiration biopsy (FNAB) techniques: approved guideline. NCCLS document GP20-A. NCCLS, 940 West Valley Road, Suite 1400, Wayne, PA, 1986 [].
  6. Powers CN and Frable WJ. Fine Needle Aspiration of the Head and Neck, Boston: Butterworth-Heinemann, 1996:1–21.Google Scholar
  7. Stewart B, Kruskal B, Kelly D, Sosna J, Kane RA. Utility and safety of ultrasound-guided fine-needle aspiration of salivary gland masses including a cytologist’s review. Ultrasound Med 2004;23:777–783.Google Scholar
  8. Wong DS, Li GK. The role of fine-needle aspiration cytology in the management of parotid tumors: a critical clinical appraisal. Head Neck 2000;22:469–473.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • William C. Faquin
    • 1
  • Celeste N. Powers
    • 2
  1. 1.Department of Pathology, Massachusetts General HospitalHarvard Medical SchoolBostonUSA
  2. 2.Department of Pathology, Medical College of Virginia HospitalsVirginia Commonwealth UniversityRichmondUSA

Personalised recommendations