Salivary Glands

Abstract

Fine needle aspiration (FNA) is a simple, safe, and inexpensive technique for investigation of salivary gland masses. This can be carried out as an outpatient procedure without the need for anesthesia and with minimal discomfort to the patient. The role of FNA is to establish salivary gland origin, distinguish nonneoplastic from neoplastic lesions, and offer a specific, or at least differential, diagnosis for neoplastic lesions. A specific diagnosis of a neoplasm is possible in most cases with reasonable accuracy in an adequately sampled lesion. Salivary gland neoplasms comprise a wide range of distinct morphological and clinical entities, and the cytologist should endeavor to offer a specific diagnosis. Since pleomorphic adenoma and Warthin tumor together constitute almost 80 % of all salivary gland neoplasms, this is possible in the majority of cases. Where the distinction between benign and malignant is not possible, cytology should provide a distinction between benign and low-grade versus high-grade lesions. This important distinction then can determine the radicality of the initial clinical intervention. Immunohistochemistry has a more limited role in the study of salivary gland neoplasms since most have epithelial and/or myoepithelial origin, yielding similar results. Furthermore, there is considerable morphological overlap. This is one of the most challenging areas in cytology where the study of morphology in conventionally prepared smears is the most rewarding.