Faculty Collaboration Database

"Suspicious" salivary gland FNA: Risk of malignancy and interinstitutional variability. Cancer Cytopathol 2018 Feb;126(2):94-100

Date

10/21/2017

Pubmed ID

29053216

DOI

10.1002/cncy.21939

Scopus ID

2-s2.0-85031741878 (requires institutional sign-in at Scopus site)   33 Citations

Abstract

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 H

Author

James Adam Miller MD, MPH Assistant Professor in the Pathology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
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