"Suspicious" salivary gland FNA: Risk of malignancy and interinstitutional variability. Cancer Cytopathol 2018 Feb;126(2):94-100
Date
10/21/2017Pubmed ID
29053216DOI
10.1002/cncy.21939Scopus ID
2-s2.0-85031741878 (requires institutional sign-in at Scopus site) 33 CitationsAbstract
BACKGROUND: Fine-needle aspiration (FNA) cytology is well accepted as a safe, reliable, minimally invasive, and cost-effective method for the diagnosis of salivary gland lesions. Salivary gland neoplasms are often difficult to diagnose because of morphologic heterogeneity and a variety of epithelial metaplastic changes. Hence, a number of salivary gland FNA specimens yield indeterminate results. For indeterminate FNA specimens, the suspicious-for-malignancy (SFM) category is used when a specific neoplasm falls short in quantity or quality for the criteria for malignancy. Therefore, the findings are not sufficient for a conclusive diagnosis of malignancy.
METHODS: This study was designed to evaluate the risk of malignancy (ROM) for the SFM group at 5 tertiary medical centers worldwide with the aforementioned criteria. Among 12,606 salivary gland FNA cases between 1997 and 2014, 276 (2.2%) were reported to be SFN. Specifically, 114 suspicious cases (41%) had histological follow-up.
RESULTS: Histological follow-up of the 114 suspicious cases showed 95 malignant tumors indicating a risk of malignancy (ROM) of 83.3%. The ROM varied between 74% and 88% for the 5 participating institutions, and a Fisher's exact test with significance set to p<.05 showed no significant difference in ROM among the institutions (p = .78).
CONCLUSIONS: Overall, 83.3% of SFM salivary gland FNA specimens turned out to be malignant; there was no significant interinstitutional variability in the ROMs. The SFM category for salivary gland FNA is very homogeneous, and the ROMs are quite similar worldwide. Cancer Cytopathol 2018;126:94-100. © 2017 American Cancer Society.
Author List
Maleki Z, Miller JA, Arab SE, Fadda G, Bo P, Wise O, Rossi ED, Jhala N, Ashish C, Ali SZ, Wang HAuthor
James Adam Miller MD, MPH Assistant Professor in the Pathology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Biopsy, Fine-Needle
Child
Child, Preschool
China
Europe
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Male
Middle Aged
Observer Variation
Prevalence
Risk Assessment
Salivary Gland Neoplasms
Salivary Glands
United States
Young Adult