Salivary Gland Fine Needle Aspiration

  • He WangEmail author
  • Aatika Malik
  • Yun Gong
Part of the Atlas of Anatomic Pathology book series (AAP)


Salivary glands comprise three paired major glands—the parotid, submandibular, and sublingual—and numerous minor glands. Most salivary gland fine needle aspiration (FNA) targets parotid and submandibular glands. The masses or cystic lesions of salivary glands have a wide range of differential diagnoses, from inflammatory response to neoplasm to less common causes of infection [1]. The World Health Organization has included at least 37 morphologic types of primary salivary gland tumors, many of which show remarkable overlapping of morphologic features (Table 1.1) [2]. The application of needle aspiration to diagnose salivary gland lesions was documented by the 1930s [3, 4]. Over the past few decades, FNA has developed into a widely accepted diagnostic procedure and is often the first step in the evaluation of salivary gland lesions, with reported 79% accuracy, 74% sensitivity, and 88% specificity rates [5–7]. FNA has the potential to change the clinical approach in up to one third of patients [8]. The high accuracy of salivary gland FNA benefits from high frequencies of certain tumors with relatively unique cytologic features, including matrix component in the smears. The main purpose of this chapter is to highlight these characteristic findings. It cannot be overemphasized that these morphologic features must be interpreted in the appropriate clinical and radiologic settings, including lesion site and size, speed of growth, clinical symptoms, and the patient’s age, gender, and ethnicity. Like any cytologic samples, accurate salivary gland FNA diagnosis depends on adequate tissue sampling. Procedures including rapid on-site evaluation (ROSE) are critical to ensure sufficient diagnostic material.


Salivary gland Fine needle aspiration The Milan System for Reporting Salivary Gland Cytopathology Benign tumors Malignant tumors 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pathology and Laboratory MedicineRobert Wood Johnson Medical School of Rutgers UniversityNew BrunswickUSA
  2. 2.Department of Pathology and Laboratory MedicineTemple University Lewis Katz School of MedicinePhiladelphiaUSA
  3. 3.Department of Pathology and Laboratory MedicineThe University of Texas MD Anderson Cancer CenterHoustonUSA

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