Microscopic Examination

Abstract

The diagnostic complexity of salivary gland neoplasms is not to be underestimated. Although many cases are resolved at first microscopic glance, others require systematic evaluation to avoid diagnostic pitfalls. Salivary Gland Pathology A, B, C, Ds represent the author’s systematic approach to classifying neoplasms. The efficacy of this systematic approach has limitations—a common theme in surgical pathology—and there remains a subset of cases that are best handled by consultation and/or committee.

• Architecture—interface between neoplasm and adjacent parenchyma (e.g., encapsulated, circumscribed) often delineates benignity from malignancy.

• Biphasic—number of cell types/phases (monophasic, biphasic, triphasic, or more) often determines differential diagnostic considerations.

• Cytology—cytology of cells (e.g., clear, oncocytic) often determines differential diagnostic considerations.

• Differential—accurate classification often requires reconsideration of differential diagnostic considerations (Figs. 5.1, 5.2, 5.3, 5.4, 5.5, 5.6, 5.7, 5.8, 5.9, 5.10, 5.11, 5.12, 5.13, 5.14, 5.15, 5.16, 5.17, 5.18, 5.19, 5.20, 5.21, 5.22, 5.23, 5.24, 5.25, 5.25, 5.26, 5.27, 5.28, 5.29, 5.30, 5.31, 5.32, 5.33, 5.34 and 5.35).