Salivary Glands and Head and Neck

  • Elwira Bakuła-ZalewskaEmail author
  • Henryk A. Domanski
  • Gabrijela Kocjan


A large panorama of lesions is accessible to fine-needle aspiration cytology (FNAC). This chapter focuses on lesions of the salivary glands, as well as tumors of the tongue and oral and nasal cavities. Some unusual lesions of the neck will also be presented. Aspiration cytology of thyroid, parathyroid, and lymph nodes is dealt with in other chapters. When confronted with a mass lesion in the head and neck area, it is not always obvious which organ or structure is involved or where a tumor originates. The widespread distribution of minor salivary glands, for instance, implies that tumors originating from these glands may present in unexpected sites. Aspiration cytology therefore can play an important role in clarifying the basic question of tumor origin.


Milan system Salivary gland Cytology FNA Pleomorphic adenoma Adenoid cystic carcinoma Mucoepidermoid carcinoma Neck lesions Tongue Oral cavity 


  1. 1.
    Pynnonen MA, Gillespie MB, Roman B, Rosenfeld RM, Tunkel DE, Bontempo L, et al. Clinical practice guideline: evaluation of the neck mass in adults. Otolaryngol Head Neck Surg: Off J Am Acad Otolaryngol Head Neck Surg. 2017;157(2_suppl):S1–S30.CrossRefGoogle Scholar
  2. 2.
    Sood S, McGurk M, Vaz F. Management of salivary gland tumours: United Kingdom national multidisciplinary guidelines. J Laryngol Otol. 2016;130(S2):S142–S9.PubMedPubMedCentralCrossRefGoogle Scholar
  3. 3.
    Silva WP, Stramandinoli-Zanicotti RT, Schussel JL, Ramos GH, Ioshi SO, Accuracy SLM. Sensitivity and specificity of fine needle aspiration biopsy for salivary gland tumors: a retrospective study from 2006 to 2011. Asian Pac J Cancer Prev. 2016;17(11):4973–6.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Kim BY, Hyeon J, Ryu G, Choi N, Baek CH, Ko YH, et al. Diagnostic accuracy of fine needle aspiration cytology for high-grade salivary gland tumors. Ann Surg Oncol. 2013;20:2380–7.PubMedCrossRefPubMedCentralGoogle Scholar
  5. 5.
    Singh Nanda KD, Mehta A, Nanda J. Fine-needle aspiration cytology: a reliable tool in the diagnosis of salivary gland lesions. J Oral Pathol Med. 2012;41:106–12.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Nguansangiam S, Jesdapatarakul S, Dhanarak N, Sosrisakorn K. Accuracy of fine needle aspiration cytology of salivary gland lesions: routine diagnostic experience in Bangkok, Thailand. Asian Pac J Cancer Prev. 2012;13:1583–8.PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    Schmidt RL, Hall BJ, Wilson AR, Layfield LJ. A systematic review and meta-analysis of the diagnostic accuracy of fine-needle aspiration cytology for parotid gland lesions. Am J Clin Pathol. 2011;136:45–59.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Colella G, Cannavale R, Flamminio F, Foschini MP. Accuracy of fine-needle aspiration cytology of salivary gland lesions in the Netherlands cancer institute. Head Neck. 2004;26:418–24.CrossRefGoogle Scholar
  9. 9.
    Shetty A, Geethamani V. Role of fine-needle aspiration cytology in the diagnosis of major salivary gland tumors: a study with histological and clinical correlation. J Oral Maxillofac Pathol. 2016;20(2):224.PubMedPubMedCentralCrossRefGoogle Scholar
  10. 10.
    Feinstein AJ, Alonso J, Yang SE, St John M. Diagnostic accuracy of fine-needle aspiration for parotid and submandibular gland lesions. Otolaryngol Head Neck Surg: Off J Am Acad Otolaryngol Head Neck Surg. 2016;155(3):431–6.CrossRefGoogle Scholar
  11. 11.
    Gudmundsson JK, Ajan A, Abtahi J. The accuracy of fine-needle aspiration cytology for diagnosis of parotid gland masses: a clinicopathological study of 114 patients. J Appl Oral Sci. 2016;24(6):561–7.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Parfitt JR, McLachlin CM, Weir MM. Comparison of ThinPrep and conventional smears in salivary gland fine-needle aspiration biopsies. Cancer. 2007;111:123–9.PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Kechagias N, Ntomouchtsis A, Valeri R, Patrikidou A, Kitikidou K, Xirou P, et al. Fine-needle aspiration cytology of salivary gland tumours: a 10-year retrospective analysis. Oral Maxillofac Surg. 2012;16:35–40.PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Cho HW, Kim J, Choi J, Choi HS, Kim ES, Kim SH, et al. Sonographically guided fine-needle aspiration biopsy of major salivary gland masses: a review of 245 cases. AJR Am J Roentgenol. 2011;196:1160–3.PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Stramandinoli RT, Sassi LM, Pedruzzi PA, Ramos GH, Oliveira BV, Ogata DC, et al. Accuracy, sensitivity and specificity of fine needle aspiration biopsy in salivary gland tumours: a retrospective study. Med Oral Patol Oral Cir Bucal. 2010;15:e32–7.PubMedPubMedCentralGoogle Scholar
  16. 16.
    Zhang S, Bao R, Bagby J, Abreo F. Fine needle aspiration of salivary glands: 5-year experience from a single academic center. Acta Cytol. 2009;53:375–82.PubMedCrossRefPubMedCentralGoogle Scholar
  17. 17.
    Daneshbod Y, Daneshbod K, Khademi B. Diagnostic difficulties in the interpretation of fine needle aspirate samples in salivary lesions: diagnostic pitfalls revisited. Acta Cytol. 2009;53:53–70.PubMedCrossRefPubMedCentralGoogle Scholar
  18. 18.
    Rajwanshi A, Gupta K, Gupta N, Shukla R, Srinivasan R, Nijhawan R, et al. Fine-needle aspiration cytology of salivary glands: diagnostic pitfalls—revisited. Diagn Cytopathol. 2006;34:580–4.PubMedCrossRefPubMedCentralGoogle Scholar
  19. 19.
    Mairembam P, Jay A, Beale T, Morley S, Vaz F, Kalavrezos N, et al. Salivary gland FNA cytology: role as a triage tool and an approach to pitfalls in cytomorphology. Cytopathol: Off J Br Soc Clin Cytology. 2016;27(2):91–6.CrossRefGoogle Scholar
  20. 20.
    Kocjan G, Nayagam M, Harris M. Fine needle aspiration cytology of salivary gland lesions: advantages and pitfalls. Cytopathology. 1990;1:269–75.PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Chen KT. Diagnostic pitfalls in fine needle aspiration of cystic salivary gland lesions. Acta Cytol. 2007;51:675–6.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Siddiqui NH, Wu SJ. Fine-needle aspiration biopsy of cystic pleomorphic adenoma with adnexa-like differentiation mimicking mucoepidermoid carcinoma: a case report. Diagn Cytopathol. 2005;32:229–32.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Edwards PC, Wasserman P. Evaluation of cystic salivary gland lesions by fine needle aspiration: an analysis of 21 cases. Acta Cytol. 2005;49:489–94.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Firat P, Ersoz C, Uguz A, Onder S. Cystic lesions of the head and neck: cytohistological correlation in 63 cases. Cytopathology. 2007;18:184–90.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Allison DB, McCuiston AM, Kawamoto S, Eisele DW, Bishop JA, Maleki Z. Cystic major salivary gland lesions: utilizing fine needle aspiration to optimize the clinical management of a broad and diverse differential diagnosis. Diagn Cytopathol. 2017;45(9):800–7.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Handa U, Dhingra N, Chopra R, Mohan H. Pleomorphic adenoma: cytologic variations and potential diagnostic pitfalls. Diagn Cytopathol. 2009;37:11–5.PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Salehi S, Maleki Z. Diagnostic challenges and problem cases in salivary gland cytology: a 20-year experience. Cancer. 2018;126(2);101–11.PubMedCrossRefPubMedCentralGoogle Scholar
  28. 28.
    Ethunandan M, Witton R, Hoffman G, Spedding A, Brennan PA. Atypical features in pleomorphic adenoma—a clinicopathologic study and implications for management. Int J Oral Maxillofac Surg. 2006;35:608–12.PubMedCrossRefPubMedCentralGoogle Scholar
  29. 29.
    Batrani M, Kaushal M, Sen AK, Yadav R, Chaturvedi NK. Pleomorphic adenoma with squamous and appendageal metaplasia mimicking mucoepidermoid carcinoma on cytology. Cytojournal. 2009;6:5.CrossRefGoogle Scholar
  30. 30.
    Paker I, Yilmazer D, Arikok AT, Saylam G, Hucumenoglu S. Basal cell adenoma with extensive squamous metaplasia and cellular atypia: a case report with cytohistopathological correlation and review of the literature. Diagn Cytopathol. 2012;40:48–55.PubMedCrossRefPubMedCentralGoogle Scholar
  31. 31.
    Jurczyk M, Peevey JF, Vande Haar MA, Lin X. Pitfalls of fine-needle aspiration cytology of parotid membranous basal cell adenoma-a review of pitfalls in FNA cytology of salivary gland neoplasms with basaloid cell features. Diagn Cytopathol. 2015;43(5):432–7.PubMedCrossRefPubMedCentralGoogle Scholar
  32. 32.
    Rossi ED, Faquin WC, Baloch Z, Barkan GA, Foschini MP, Pusztaszeri M, et al. The Milan system for reporting salivary gland cytopathology: analysis and suggestions of initial survey. Cancer. 2017;125(10):757–66.Google Scholar
  33. 33.
    Griffith CC, Schmitt AC, Pantanowitz L, Monaco SE. A pattern-based risk-stratification scheme for salivary gland cytology: a multi-institutional, interobserver variability study to determine applicability. Cancer. 2017;125(10):776–85.PubMedCentralGoogle Scholar
  34. 34.
    Rohilla M, Singh P, Rajwanshi A, Gupta N, Srinivasan R, Dey P, et al. Three-year cytohistological correlation of salivary gland FNA cytology at a tertiary center with the application of the Milan system for risk stratification. Cancer. 2017;125(10):767–75.Google Scholar
  35. 35.
    Sharma G, Jung AS, Maceri DR, Rice DH, Martin SE, Grant EG. US-guided fine-needle aspiration of major salivary gland masses and adjacent lymph nodes: accuracy and impact on clinical decision making. Radiology. 2011;259:471–8.PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    Oeppen RS, Gibson D, Brennan PA. An update on the use of ultrasound imaging in oral and maxillofacial surgery. Br J Oral Maxillofac Surg. 2010;48:412–8.PubMedCrossRefPubMedCentralGoogle Scholar
  37. 37.
    Siewert B, Kruskal JB, Kelly D, Sosna J, Kane RA. Utility and safety of ultrasound-guided fine-needle aspiration of salivary gland masses including a cytologist’s review. J Ultrasound Med. 2004;23:777–83.PubMedCrossRefPubMedCentralGoogle Scholar
  38. 38.
    Breeze J, Poller DN, Gibson D, Tilley EA, Cooke L, Soar E, et al. Rapid on-site assessment of specimens by biomedical scientists improves the quality of head and neck fine needle aspiration cytology. Cytopathol: Off J Br Soc Clin Cytol. 2014;25(5):316–21.Google Scholar
  39. 39.
    Brennan PA, Herd MK, Howlett DC, Gibson D, Oeppen RS. Is ultrasound alone sufficient for imaging superficial lobe benign parotid tumours before surgery? Br J Oral Maxillofac Surg. 2012;50:333–7.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Douville NJ, Bradford CR. Comparison of ultrasound-guided core biopsy versus fine–needle aspiration biopsy in the evaluation of salivary gland lesions. Head Neck. 2012; [Epub ahead of print].CrossRefGoogle Scholar
  41. 41.
    Michelow P, Dezube BJ, Pantanowitz L. Fine needle aspiration of salivary gland masses in HIV-infected patients. Diagn Cytopathol. 2011;40:684–90.PubMedCrossRefPubMedCentralGoogle Scholar
  42. 42.
    Goff CJ, Allred C, Glade RS. Current management of congenital branchial cleft cysts, sinuses, and fistulae. Curr Opin Otolaryngol Head Neck Surg. 2012;20:533–9.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Papadogeorgakis N, Petsinis V, Parara E, Papaspyrou K, Goutzanis L, Alexandridis C. Branchial cleft cysts in adults. Diagnostic procedures and treatment in a series of 18 cases. Oral Maxillofac Surg. 2009;13:79–85.PubMedCrossRefPubMedCentralGoogle Scholar
  44. 44.
    Carlson ER. Diagnosis and management of salivary gland infections. Oral Maxillofac Surg Clin North Am. 2009;21:293–312.PubMedCrossRefPubMedCentralGoogle Scholar
  45. 45.
    Ferry JA, Deshpande V. IgG4-related disease in the head and neck. Semin Diagn Pathol. 2012;29:235–44.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Wallace ZS, Khosroshahi A, Jakobiec FA, Deshpande V, Hatton MP, Ritter J, et al. IgG4-related systemic disease as a cause of “idiopathic” orbital inflammation, including orbital myositis, and trigeminal nerve involvement. Surv Ophthalmol. 2012;57:26–33.PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Batsakis JG. Granulomatous sialadenitis. Ann Otol Rhinol Laryngol. 1991;100:166–9.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    Ma Q, Song H. Diagnosis and management of lymphoepithelial lesion of the parotid gland. Rheumatol Int. 2011;31:959–62.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    Agale SV, D’Costa GF, Hastak MS, Shedge RT. Primary non-Hodgkin’s lymphoma of the salivary gland: a spectrum of lymphoepithelial sialadenitis, low-grade B-cell lymphoma of mucosa-associated lymphoid tissue with transformation to high-grade lymphoma. Indian J Pathol Microbiol. 2010;53:364–7.PubMedCrossRefPubMedCentralGoogle Scholar
  50. 50.
    Ihrler S, Rath C, Zengel P, Kirchner T, Harrison JD, Weiler C. Pathogenesis of sialadenosis: possible role of functionally deficient myoepithelial cells. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110:218–23.PubMedCrossRefPubMedCentralGoogle Scholar
  51. 51.
    Gupta S, Sodhani P. Sialadenosis of parotid gland: a cytomorphologic and morphometric study of four cases. Anal Quant Cytol Histol. 1998;20:225–8.PubMedPubMedCentralGoogle Scholar
  52. 52.
    Ethunandan M, Vura G, Umar T, Anand R, Pratt CA, Macpherson DW, et al. Lipomatous lesions of the parotid gland. J Oral Maxillofac Surg. 2006;64:1583–6.PubMedCrossRefPubMedCentralGoogle Scholar
  53. 53.
    Fulciniti F, Losito NS, Ionna F, Longo F, Aversa C, Botti G, et al. Sclerosing polycystic adenosis of the parotid gland: report of one case diagnosed by fine-needle cytology with in situ malignant transformation. Diagn Cytopathol. 2010;38:368–73.PubMedPubMedCentralGoogle Scholar
  54. 54.
    Bharadwaj G, Nawroz I, O’Regan B. Sclerosing polycystic adenosis of the parotid gland. Br J Oral Maxillofac Surg. 2007;45:74–6.PubMedCrossRefPubMedCentralGoogle Scholar
  55. 55.
    Skálová A, Gnepp DR, Simpson RH, Lewis JE, Janssen D, Sima R. Clonal nature of sclerosing polycystic adenosis of salivary glands demonstrated by using the polymorphism of the human androgen receptor (HUMARA) locus as a marker. Am J Surg Pathol. 2006;30:939–44.PubMedCrossRefPubMedCentralGoogle Scholar
  56. 56.
    Carrillo JF, Ramírez R, Flores L, Ramirez-Ortega MC, Arrecillas MD, Ibarra M, et al. Diagnostic accuracy of fine needle aspiration biopsy in preoperative diagnosis of patients with parotid gland masses. J Surg Oncol. 2009;100:133–8.PubMedCrossRefPubMedCentralGoogle Scholar
  57. 57.
    Cohen EG, Patel SG, Lin O, Boyle JO, Kraus DH, Singh B, et al. Fine-needle aspiration biopsy of salivary gland lesions in a selected patient population. Arch Otolaryngol Head Neck Surg. 2004;130:773–8.PubMedCrossRefPubMedCentralGoogle Scholar
  58. 58.
    Brennan PA, Davies B, Poller D, Mead Z, Bayne D, Puxeddu R, et al. Fine needle aspiration cytology (FNAC) of salivary gland tumours: repeat aspiration provides further information in cases with an unclear initial cytological diagnosis. Br J Oral Maxillofac Surg. 2010;48:26–9.PubMedCrossRefPubMedCentralGoogle Scholar
  59. 59.
    Batsakis JG, Kraemer B, Sciubba JJ. The pathology of head and neck tumors: the myoepithelial cell and its participation in salivary gland neoplasia, part 17. Head Neck Surg. 1983;5:222–33.PubMedCrossRefPubMedCentralGoogle Scholar
  60. 60.
    Spiro RH. Salivary neoplasms: overview of a 35-year experience with 2,807 patients. Head Neck Surg. 1986;8:177–84.PubMedCrossRefPubMedCentralGoogle Scholar
  61. 61.
    Passi D, Ram H, Dutta SR, Revansidha Malkunje L. Pleomorphic adenoma of soft palate: unusual occurrence of the major tumor in minor salivary gland-a case report and literature review. J Maxillofac Oral Surg. 2017;16(4):500–5.PubMedCrossRefPubMedCentralGoogle Scholar
  62. 62.
    Tsegga TM, Britt JD, Ellwanger AR. Pleomorphic adenoma of the accessory parotid gland: case report and reappraisal of intraoral extracapsular dissection for management. J Oral Maxillofac Surg: Off J Am Assoc Oral Maxillofac Surg. 2015;73(3):564–70.CrossRefGoogle Scholar
  63. 63.
    Chen L, Ray N, He H, Hoschar A. Cytopathologic analysis of stroma-poor salivary gland epithelial/myoepithelial neoplasms on fine needle aspiration. Acta Cytol. 2012;56:25–33.PubMedCrossRefPubMedCentralGoogle Scholar
  64. 64.
    Pusztaszeri M, Braunschweig R, Mihaescu A. Pleomorphic adenoma with predominant plasmocytoid myoepithelial cells: a diagnostic pitfall in aspiration cytology. Case report and review of the literature. Diagn Cytopathol. 2009;37:56–60.PubMedCrossRefPubMedCentralGoogle Scholar
  65. 65.
    Yang GC, Waisman J. Distinguishing adenoid cystic carcinoma from cylindromatous adenomas in salivary fine-needle aspirates: the cytologic clues and their ultrastructural basis. Diagn Cytopathol. 2006;34:284–8.PubMedCrossRefPubMedCentralGoogle Scholar
  66. 66.
    Kajor M, et al. Schwannomalike mixed tumor of the parotid gland: a case report. Acta Cytol. 2006;50:529–30.PubMedCrossRefPubMedCentralGoogle Scholar
  67. 67.
    Kajor M, Gierek T, Markowski J, Pajak J. Nodular fasciitis of parotid region: a pitfall in the diagnosis of pleomorphic adenomas on fine-needle aspiration cytology. Diagn Cytopathol. 2005;33:191–4.CrossRefGoogle Scholar
  68. 68.
    Das DK, Anim JT. Pleomorphic adenoma of salivary gland: to what extent does fine needle aspiration cytology reflect histopathological features? Cytopathology. 2005;16:65–70.PubMedCrossRefPubMedCentralGoogle Scholar
  69. 69.
    Ellis GL, Auclair PL. Tumors of the salivary glands. Silver Springs: ARP Press; 2008. p. 71–3.Google Scholar
  70. 70.
    Ahn S, Kim Y, Oh YL. Fine needle aspiration cytology of benign salivary gland tumors with myoepithelial cell participation: an institutional experience of 575 cases. Acta Cytol. 2013;57(6):567–74.PubMedCrossRefPubMedCentralGoogle Scholar
  71. 71.
    Bhat A, Rao M, Geethamani V, Shetty AC. Basal cell adenoma of the parotid gland: cytological diagnosis of an uncommon tumor. J Oral Maxillofac Pathol. 2015;19(1):106.PubMedPubMedCentralCrossRefGoogle Scholar
  72. 72.
    Hara H, Oyama T, Saku T. Fine needle aspiration cytology of basal cell adenoma of the salivary gland. Acta Cytol. 2007;51:685–91.PubMedCrossRefPubMedCentralGoogle Scholar
  73. 73.
    Hruban RH, Erozan YS, Zinreich SJ, Kashima HK. Fine-needle aspiration cytology of monomorphic adenomas. Am J Clin Pathol. 1988;90(1):46–51.PubMedCrossRefPubMedCentralGoogle Scholar
  74. 74.
    Nelson ZL, Newman L, Loukota RA, Williams DM. Bilateral multifocal canalicular adenomas of buccal minor salivary glands: a case report. Br J Oral Maxillofac Surg. 1995;33:299–301.PubMedCrossRefPubMedCentralGoogle Scholar
  75. 75.
    Philpott CM, Kendall C, Murty GE. Canalicular adenoma of the parotid gland. J Laryngol Otol. 2005;119:59–60.PubMedPubMedCentralGoogle Scholar
  76. 76.
    Peraza AJ, Wright J, Gomez R. Canalicular adenoma: A systematic review. J Craniomaxillofac Surg. 2017;45(10):1754–8.PubMedCrossRefPubMedCentralGoogle Scholar
  77. 77.
    Turk AT, Wenig BM. Pitfalls in the biopsy diagnosis of intraoral minor salivary gland neoplasms: diagnostic considerations and recommended approach. Adv Anat Pathol. 2014;21(1):1–11.PubMedCrossRefPubMedCentralGoogle Scholar
  78. 78.
    Pogodzinski MS, Sabri AN, Lewis JE, Olsen KD. Retrospective study and review of polymorphous low-grade adenocarcinoma. Laryngoscope. 2006;116:2145–9.PubMedCrossRefPubMedCentralGoogle Scholar
  79. 79.
    Saenz-Santamaria J, Catalina-Fernandez I. Polymorphous low grade adenocarcinoma of the salivary gland. Diagnosis by fine needle aspiration cytology. Acta Cytol. 2004;48:52–6.PubMedCrossRefPubMedCentralGoogle Scholar
  80. 80.
    Gibbons D, Saboorian MH, Vuitch F, Gokaslan ST, Ashfaq R. Fine-needle aspiration findings in patients with polymorphous low grade adenocarcinoma of the salivary glands. Cancer. 1999;87:31–6.PubMedCrossRefPubMedCentralGoogle Scholar
  81. 81.
    Batsakis JG, el-Naggar AK, Luna MA. Epithelial-myoepithelial carcinoma of salivary glands. Ann Otol Rhinol Laryngol. 1992;101:540–2.PubMedCrossRefPubMedCentralGoogle Scholar
  82. 82.
    Klijanienko J, Vielh P. Fine-needle sampling of salivary gland lesions. VII. Cytology and histology correlation of five cases of epithelial-myoepithelial carcinoma. Diagn Cytopathol. 1998;19(6):405–9.PubMedCrossRefPubMedCentralGoogle Scholar
  83. 83.
    Firat P, Güler G, Sungur A, Akyol U. Fine-needle aspiration biopsy of epithelial-myoepithelial carcinoma. Diagn Cytopathol. 2001;24:224–5.PubMedCrossRefPubMedCentralGoogle Scholar
  84. 84.
    Yang GC, Soslow RA. Epithelial-myoepithelial carcinoma of the parotid. A case of ductal-predominant presentation with cytologic, histologic and ultrastructural correlations. Acta Cytol. 1999;43:1113–8.PubMedCrossRefPubMedCentralGoogle Scholar
  85. 85.
    Molnar SL, Zarka MA, De Las Casas LE. Going beyond “Basaloid neoplasm”: fine needle aspiration cytology of epithelial-myoepithelial carcinoma of the parotid gland. Diagn Cytopathol. 2016;44(5):422–5.PubMedCrossRefPubMedCentralGoogle Scholar
  86. 86.
    Aisagbonhi OA, Tulecke MA, Wilbur DC, Goldar-Najafi A, Iqbal S, Sadow PM, et al. Fine-needle aspiration of epithelial-myoepithelial carcinoma of the parotid gland with prominent adenoid cystic carcinoma-like cribriform features: avoiding a diagnostic pitfall. Am J Clin Pathol. 2016;146(6):741–6.PubMedCrossRefPubMedCentralGoogle Scholar
  87. 87.
    Al-Mamgani A, van Rooij P, Sewnaik A, Tans L, Hardillo JA, et al. Adenoid cystic carcinoma of parotid gland treated with surgery and radiotherapy: long-term outcomes, QoL assessment and review of the literature. Oral Oncol. 2012;48:278–83.PubMedCrossRefPubMedCentralGoogle Scholar
  88. 88.
    Tincani AJ, Del Negro A, Araújo PP, Akashi HK, Martins AS, Altemani AM, et al. Management of salivary gland adenoid cystic carcinoma: institutional experience of a case series. Sao Paulo Med J. 2006;124:26–30.PubMedCrossRefPubMedCentralGoogle Scholar
  89. 89.
    Klijanienko J, Vielh P. Fine-needle sampling of salivary gland lesions. III. Cytologic and histologic correlation of 75 cases of adenoid cystic carcinoma: review and experience at the Institut Curie with emphasis on cytologic pitfalls. Diagn Cytopathol. 1997;17(1):36–41.PubMedCrossRefPubMedCentralGoogle Scholar
  90. 90.
    Antony J, Gopalan V, Smith RA, Lam AK. Carcinoma ex pleomorphic adenoma: a comprehensive review of clinical, pathological and molecular data. Head Neck Pathol. 2012;6:1–9.PubMedCrossRefPubMedCentralGoogle Scholar
  91. 91.
    Magaki SD, Bhuta S, Abemayor E, Nabili V, Sepahdari AR, Lai CK. Carcinoma ex-pleomorphic adenoma of the parotid gland consisting of high-grade salivary duct carcinoma and keratinizing squamous cell carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;120(3):e169–73.PubMedCrossRefPubMedCentralGoogle Scholar
  92. 92.
    Wong CF, Lee HY, Yap WM, Chuah KL, Goh JP, Khoo ML. Fine needle aspiration cytology of oncocytic myoepithelial carcinoma ex pleomorphic adenoma. Acta Cytol. 2010;54:1051–6.PubMedPubMedCentralGoogle Scholar
  93. 93.
    Zbären P, Zbären S, Caversaccio MD, Stauffer E. Carcinoma ex pleomorphic adenoma: diagnostic difficulty and outcome. Otolaryngol Head Neck Surg. 2008;138:601–5.PubMedCrossRefPubMedCentralGoogle Scholar
  94. 94.
    Klijanienko J, El-Naggar AK, Servois V, Rodriguez J, Validire P, Vielh P. Mucoepidermoid carcinoma ex pleomorphic adenoma: nonspecific preoperative cytologic findings in six cases. Cancer. 1998;84(4):231–4.96.PubMedCrossRefPubMedCentralGoogle Scholar
  95. 95.
    Daneshbod Y, Negahban S, Khademi B, Daneshbod K. Epithelial myoepithelial carcinoma of the parotid gland with malignant ductal and myoepithelial components arising in a pleomorphic adenoma: a case report with cytologic, histologic and immunohistochemical correlation. Acta Cytol. 2007;51:807–13.PubMedCrossRefPubMedCentralGoogle Scholar
  96. 96.
    Parwani AV, Lujan G, Ali SZ. Myoepithelial carcinoma arising in a pleomorphic adenoma of the parotid gland: report of a case with cytopathologic findings. Acta Cytol. 2006;50:93–6.PubMedCrossRefPubMedCentralGoogle Scholar
  97. 97.
    Khademi B, Kazemi T, Bayat A, Bahranifard H, Daneshbod Y, Mohammadianpanah M. Salivary gland myoepithelial neoplasms: a clinical and cytopathologic study of 15 cases and review of the literature. Acta Cytol. 2010;54:1111–7.PubMedCrossRefPubMedCentralGoogle Scholar
  98. 98.
    Elsheikh TM, Bernacki EG. Fine needle aspiration cytology of cellular pleomorphic adenoma. Acta Cytol. 1996;40:1165–75.PubMedCrossRefPubMedCentralGoogle Scholar
  99. 99.
    Das DK, Haji BE, Ahmed MS, Hossain MN. Myoepithelioma of the parotid gland initially diagnosed by fine needle aspiration cytology and immunocytochemistry: a case report. Acta Cytol. 2005;49:65–70.PubMedCrossRefPubMedCentralGoogle Scholar
  100. 100.
    Muller S, Barnes L. Basal cell adenocarcinoma of the salivary glands. Report of seven cases and review of the literature. Cancer. 1996;78:2471–7.PubMedCrossRefPubMedCentralGoogle Scholar
  101. 101.
    Pisharodi LR. Basal cell adenocarcinoma of the salivary gland. Diagnosis by fine-needle aspiration cytology. Am J Clin Pathol. 1995;103:603–8.PubMedCrossRefPubMedCentralGoogle Scholar
  102. 102.
    Moroz K, Ferreira C, Dhurandhar N. Fine needle aspiration of basal cell adenocarcinoma of the parotid gland. Report of a case with assessment of DNA ploidy in aspirates and tissue sections by image analysis. Acta Cytol. 1996;40:773–8.PubMedCrossRefPubMedCentralGoogle Scholar
  103. 103.
    Ikeda K, Watanabe M, Oshima T, Nakabayashi S, Kudo T, Sawai T, et al. A case of basal cell adenocarcinoma of the parotid gland. Tohoku J Exp Med. 1998;186:51–9.PubMedCrossRefPubMedCentralGoogle Scholar
  104. 104.
    Tawfik O, Tsue T, Pantazis C, Nuckols D, Younes S, Webb P. Salivary gland neoplasms with basaloid cell features: report of two cases diagnosed by fine-needle aspiration cytology. Diagn Cytopathol. 1999;21:46–50.PubMedCrossRefPubMedCentralGoogle Scholar
  105. 105.
    Tse GM, To EW, Yuen EH, Chen M. Basal cell adenocarcinoma of the salivary gland: report of a case with morphology on fine needle aspiration cytology. Acta Cytol. 2001;45:775–8.PubMedCrossRefPubMedCentralGoogle Scholar
  106. 106.
    Mardi K, Kaushal V, Asotra S. Basal cell adenocarcinoma of submandibular salivary gland-problems in cytologic diagnosis. J Cytol. 2011;28:203–6.PubMedPubMedCentralCrossRefGoogle Scholar
  107. 107.
    Ellis GL, Corio RL. Acinic cell adenocarcinoma. A clinicopathologic analysis of 294 cases. Cancer. 1983;52:542–9.PubMedCrossRefPubMedCentralGoogle Scholar
  108. 108.
    Palma O, Torri AM, de Cristofaro JA, Fiaccavento S. Fine needle aspiration cytology in two cases of well-differentiated acinic-cell carcinoma of the parotid gland. Discussion of diagnostic criteria. Acta Cytol. 1985;29:516–21.PubMedPubMedCentralGoogle Scholar
  109. 109.
    Klijanienko J, Vielh P. Fine-needle sample of salivary gland lesions. V: cytology of 22 cases of acinic cell carcinoma with histologic correlation. Diagn Cytopathol. 1997;17(5):347–52.PubMedCrossRefPubMedCentralGoogle Scholar
  110. 110.
    Prieto-Rodríguez M, Artés-Martínez MJ, Navarro-Hervás M, Camañas-Sanz A, Vera-Sempere FJ. Cytological characteristics of acinic cell carcinoma (ACC) diagnosed by fine-needle aspiration biopsy (FNAB). A study of four cases. Med Oral Patol Oral Cir Bucal. 2005;10:103–8.PubMedPubMedCentralGoogle Scholar
  111. 111.
    Nagel H, Laskawi R, Büter JJ, Schröder M, Chilla R, Droese M. Cytologic diagnosis of acinic-cell carcinoma of salivary glands. Diagn Cytopathol. 1997;16:402–12.PubMedCrossRefPubMedCentralGoogle Scholar
  112. 112.
    Johnykutty S, Miller CH, Hoda RS, Giampoli EJ. Fine-needle aspiration of dedifferentiated acinic cell carcinoma: report of a case with cyto-histological correlation. Diagn Cytopathol. 2009;37:763–8.PubMedCrossRefPubMedCentralGoogle Scholar
  113. 113.
    González-Peramato P, Jiménez-Heffernan JA, López-Ferrer P, Vicandi B, Viguer JM. Fine needle aspiration cytology of dedifferentiated acinic cell carcinoma of the parotid gland: a case report. Acta Cytol. 2006;50:105–8.PubMedCrossRefPubMedCentralGoogle Scholar
  114. 114.
    Luna MA. Salivary mucoepidermoid carcinoma: revisited. Adv Anat Pathol. 2006;13:293–307.PubMedCrossRefPubMedCentralGoogle Scholar
  115. 115.
    Wade TV, Livolsi VA, Montone KT, Baloch ZW. A cytohistologic correlation of mucoepidermoid carcinoma: emphasizing the rare oncocytic variant. Pathol Res Int. 2011;2011:135796.CrossRefGoogle Scholar
  116. 116.
    Klijanienko J, Vielh P. Fine-needle sampling of salivary gland lesions. IV. Review of 50 cases of mucoepidermoid carcinoma with histologic correlation. Diagn Cytopathol. 1997;17(2):92–8.PubMedCrossRefPubMedCentralGoogle Scholar
  117. 117.
    Brachtel EF, Pilch BZ, Khettry U, Zembowicz A, Faquin WC. Fine-needle aspiration biopsy of a cystic pleomorphic adenoma with extensive adnexa-like differentiation: differential diagnostic pitfall with mucoepidermoid carcinoma. Diagn Cytopathol. 2003;28:100–3.PubMedCrossRefPubMedCentralGoogle Scholar
  118. 118.
    Stanley MW. Selected problems in fine needle aspiration of head and neck masses. Mod Pathol. 2002;15:342–50.PubMedCrossRefPubMedCentralGoogle Scholar
  119. 119.
    Layfield LJ, Gopez EV. Cystic lesions of the salivary glands: cytologic features in fine-needle aspiration biopsies. Diagn Cytopathol. 2002;27:197–204.PubMedCrossRefPubMedCentralGoogle Scholar
  120. 120.
    Ballo MS, Shin HJ, Sneige N. Sources of diagnostic error in the fine-needle aspiration diagnosis of Warthin’s tumor and clues to a correct diagnosis. Diagn Cytopathol. 1997;17:230–4.PubMedCrossRefPubMedCentralGoogle Scholar
  121. 121.
    Mooney EE, Dodd LG, Layfield LJ. Squamous cells in fine-needle aspiration biopsies of salivary gland lesions: potential pitfalls in cytologic diagnosis. Diagn Cytopathol. 1996;15:447–52.PubMedCrossRefPubMedCentralGoogle Scholar
  122. 122.
    Oza N, Sanghvi K, Shet T, Patil A, Menon S, Ramadwar M, et al. Mammary analogue secretory carcinoma of parotid: is preoperative cytological diagnosis possible? Diagnostic Cytopathol. 2016;44(6):519–25.CrossRefGoogle Scholar
  123. 123.
    Hsieh MS, Chou YH, Yeh SJ, Chang YL. Papillary-cystic pattern is characteristic in mammary analogue secretory carcinomas but is rarely observed in acinic cell carcinomas of the salivary gland. Virchows Archiv: An International Journal of Pathology. 2015;467(2):145–53.CrossRefGoogle Scholar
  124. 124.
    Takeda M, Kasai T, Morita K, Takeuchi M, Nishikawa T, Yamashita A, et al. Cytopathological features of mammary analogue secretory carcinoma--review of literature. Diagnostic Cytopathol. 2015;43(2):131–7.CrossRefGoogle Scholar
  125. 125.
    Veder LL, Kerrebijn JD, Smedts FM, den Bakker MA. Diagnostic accuracy of fine-needle aspiration cytology in Warthin tumors. Head Neck. 2010;32:1635–40.PubMedCrossRefPubMedCentralGoogle Scholar
  126. 126.
    Verma K, Kapila K. Salivary gland tumors with a prominent oncocytic component. Cytologic findings and differential diagnosis of oncocytomas and Warthin’s tumor on fine needle aspirates. Acta Cytol. 2003;47:221–6.PubMedCrossRefPubMedCentralGoogle Scholar
  127. 127.
    Eneroth CM, Zajicek J. Aspiration biopsy of salivary gland tumors. II. Morphologic studies on smears and histologic sections from oncocytic tumors (45 cases of papillary cystadenoma lymphomatosum and 4 cases of oncocytoma). Acta Cytol. 1965;9:355–61.PubMedPubMedCentralGoogle Scholar
  128. 128.
    Rooper LM, Onenerk M, Siddiqui MT, Faquin WC, Bishop JA, Ali SZ. Nodular oncocytic hyperplasia: can cytomorphology allow for the preoperative diagnosis of a nonneoplastic salivary disease? Cancer. 2017;125(8):627–34.Google Scholar
  129. 129.
    Chakrabarti I, Basu A, Ghosh N. Oncocytic lesion of parotid gland: a dilemma for cytopathologists. J Cytol/Indian Acad Cytologists. 2012;29(1):80–2.CrossRefGoogle Scholar
  130. 130.
    Rajesh NG, Prayaga AK, Sundaram C. Salivary duct carcinoma: correlation of morphologic features by fine needle aspiration cytology and histopathology. Indian J Pathol Microbiol. 2011;54:37–41.PubMedCrossRefPubMedCentralGoogle Scholar
  131. 131.
    Kinnera VS, Mandyam KR, Chowhan AK, Nandyala R, Bobbidi VP, Vutukuru VR. Salivary duct carcinoma of parotid gland. J Oral Maxillofac Pathol. 2009;13:85–8.PubMedPubMedCentralCrossRefGoogle Scholar
  132. 132.
    Klijanienko J, Vielh P. Cytologic characteristics and histomorphologic correlations of 21 salivary duct carcinomas. Diagn Cytopathol. 1998;19(5):333–7.PubMedCrossRefPubMedCentralGoogle Scholar
  133. 133.
    Afzelius LE, Cameron WR, Svensson C. Salivary duct carcinoma—a clinicopathologic study of 12 cases. Head Neck Surg. 1987;9:151–6.PubMedCrossRefPubMedCentralGoogle Scholar
  134. 134.
    Laco J, Podhola M, Dolezalova H. Low-grade cribriform cystadenocarcinoma of the parotid gland: a neoplasm with favorable prognosis, distinct from salivary duct carcinoma. Int J Surg Pathol. 2010;18:369–73.PubMedCrossRefPubMedCentralGoogle Scholar
  135. 135.
    Nakazawa T, Kondo T, Yuminomochi T, Nakazawa K, Ishii Y, Mochizuki K, et al. Fine-needle aspiration biopsy of low-grade cribriform cystadenocarcinoma of the salivary gland. Diagn Cytopathol. 2011;39(3):218–22.PubMedPubMedCentralGoogle Scholar
  136. 136.
    Stanley MW, Bardales RH, Farmer CE, Frierson HF Jr, Suhrland M, Powers CN, et al. Primary and metastatic high-grade carcinomas of the salivary glands: a cytologic-histologic correlation study of twenty cases. Diagn Cytopathol. 1995;13:37–43.PubMedCrossRefPubMedCentralGoogle Scholar
  137. 137.
    Pettinato G, Insabato L, De Chiara A, Manco A, Petrella G. High-grade mucoepidermoid carcinoma of the breast. Fine needle aspiration cytology and clinicopathologic study of a case. Acta Cytol. 1989;33:195–200.PubMedPubMedCentralGoogle Scholar
  138. 138.
    Klijanienko J, Lagace R, Servois V, Lussier C, El-Naggar AK, Vielh P. Fine-needle sampling of primary neuroendocrine carcinomas of salivary glands: cytohistological correlations and clinical analysis. Diagn Cytopathol. 2001;24(3):163–6.PubMedCrossRefPubMedCentralGoogle Scholar
  139. 139.
    Klijanienko J, Vielh P. Fine-needle sampling of salivary gland lesions. VI. Cytological review of 44 cases of primary salivary squamous-cell carcinoma with histological correlation. Diagn Cytopathol. 1998;18(3):174–8.PubMedCrossRefPubMedCentralGoogle Scholar
  140. 140.
    Bjørndal K, Krogdahl A, Therkildsen MH, Overgaard J, Johansen J, Kristensen CA, et al. Salivary gland carcinoma in Denmark 1990–2005: outcome and prognostic factors. Results of the Danish Head and Neck Cancer Group (DAHANCA). Oral Oncol. 2012;48:179–85.PubMedCrossRefPubMedCentralGoogle Scholar
  141. 141.
    Lussier C, Klijanienko J, Vielh P. Fine-needle aspiration of metastatic nonlymphomatous tumors to the major salivary glands: a clinicopathologic study of 40 cases cytologically diagnosed and histologically correlated. Cancer. 2000;90(6):350–6.PubMedCrossRefPubMedCentralGoogle Scholar
  142. 142.
    Gupta N, Banik T, Rajwanshi A, Radotra BD, Panda N, Dey P, et al. Fine needle aspiration cytology of oral and oropharyngeal lesions with an emphasis on the diagnostic utility and pitfalls. J Cancer Res Ther. 2012;8:626–9.PubMedCrossRefPubMedCentralGoogle Scholar
  143. 143.
    Shah SB, Singer MI, Liberman E, Ljung BM. Transmucosal fine-needle aspiration diagnosis of intraoral and intrapharyngeal lesions. Laryngoscope. 1999;109:1232–7.PubMedCrossRefPubMedCentralGoogle Scholar
  144. 144.
    Daskalopoulou D, Rapidis AD, Maounis N, Markidou S. Fine-needle aspiration cytology in tumors and tumor-like conditions of the oral and maxillofacial region: diagnostic reliability and limitations. Cancer. 1997;81:238–52.PubMedCrossRefPubMedCentralGoogle Scholar
  145. 145.
    Scher RL, Oostingh PE, Levine PA, Cantrell RW, Feldman PS. Role of fine needle aspiration in the diagnosis of lesions of the oral cavity, oropharynx, and nasopharynx. Cancer. 1988;62:2602–6.PubMedCrossRefPubMedCentralGoogle Scholar
  146. 146.
    Bardales RH, Baker SJ, Mukunyadzi P. Fine-needle aspiration cytology findings in 214 cases of nonparotid lesions of the head. Diagn Cytopathol. 2000;22:211–7.PubMedCrossRefPubMedCentralGoogle Scholar
  147. 147.
    Domanski HA, Akerman M. Fine-needle aspiration cytology of tongue swellings: a study of 75 cases. Diagn Cytopathol. 1998;18:387–92.PubMedCrossRefPubMedCentralGoogle Scholar
  148. 148.
    Persson PG, Domanski HA. Fine needle aspiration cytology of uterine leiomyosarcoma metastatic to the tongue. Acta Cytol. 1998;42:1066–7.PubMedPubMedCentralGoogle Scholar
  149. 149.
    Schmid S, Tinguely M, Cione P, Moch H, Bode B. Flow cytometry as an accurate tool to complement fine needle aspiration cytology in the diagnosis of low grade malignant lymphomas. Cytopathology. 2011;22:397–406.PubMedCrossRefPubMedCentralGoogle Scholar
  150. 150.
    Dictor M, Skogvall I, Warenholt J, Rambech E. Multiplex polymerase chain reaction on FTA cards vs. flow cytometry for B-lymphocyte clonality. Clin Chem Lab Med. 2007;45:339–45.PubMedCrossRefPubMedCentralGoogle Scholar
  151. 151.
    Jereczek-Fossa BA, Jassem J, Orecchia R. Cervical lymph node metastases of squamous cell carcinoma from an unknown primary. Cancer Treat Rev. 2004;30:153–64.PubMedCrossRefPubMedCentralGoogle Scholar
  152. 152.
    Goldenberg D, Sciubba J, Koch WM. Cystic metastasis from head and neck squamous cell cancer: a distinct disease variant? Head Neck. 2006;28:633–8.PubMedCrossRefPubMedCentralGoogle Scholar
  153. 153.
    Rosa M, Sahoo S. Bilateral carotid body tumor: the role of fine-needle aspiration biopsy in the preoperative diagnosis. Diagn Cytopathol. 2008;36:178–80.PubMedCrossRefPubMedCentralGoogle Scholar
  154. 154.
    Masilamani S, Duvuru P, Sundaram S. Fine needle aspiration cytology diagnosis of a case of carotid body tumour. Singap Med J. 2012;53:e35–7.Google Scholar
  155. 155.
    Monabati A, Hodjati H, Kumar PV. Cytologic findings in carotid body tumors. Acta Cytol. 2002;46:1101–4.PubMedCrossRefPubMedCentralGoogle Scholar
  156. 156.
    Rana RS, Dey P, Das A. Fine needle aspiration (FNA) cytology of extra-adrenal paragangliomas. Cytopathology. 1997;8:108–13.PubMedCrossRefPubMedCentralGoogle Scholar
  157. 157.
    Brewin J, Hill M, Ellis H. The prevalence of cervical ribs in a London population. Clin Anat. 2009;22:331–6.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Elwira Bakuła-Zalewska
    • 1
    Email author
  • Henryk A. Domanski
    • 2
  • Gabrijela Kocjan
    • 3
  1. 1.Department of PathologyThe Maria Sklodowska-Curie Memorial Cancer Centre and Institute of OncologyWarsawPoland
  2. 2.Department of PathologySkåne University HospitalLundSweden
  3. 3.Department of Cellular PathologyUniversity College LondonLondonUK

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