Uncommon tumors of the salivary gland in fine needle aspiration biopsies. A surgeon's perspective.

Abstract

To determine the utilization of fine needle aspiration (FNA) biopsy in guiding the surgeon in the management of patients with parotid masses and to study the cytohistologic correlations of rare parotid tumors. FNA biopsies and parotidectomies performed by a head-and-neck surgeon over an approximate three-year period were analyzed. Cytologic features of rare salivary gland tumors were also studied and correlated with their histology. In an acinic cell carcinoma in a 15-year-old female whose smears were stained with Diff-Quik, novel negative images of crystals were found intracytoplasmically and extracellularly, corresponding to the crystallized, membrane-bound, exocrine, secretory substance ultrastructurally. A truly malignant mixed tumor from a 73-year-old female showed capsular invasion in the primary site that later metastasized to the lung with both epithelial and mesenchymal components. The tumor cells did not exhibit nuclear atypia except for fine cytoplasmic vacuoles in the Diff-Quik-stained smears. Basal cell adenoma, membranous (dermal analogue) type, from an 87-year-old female had an interesting geographic pattern on smears. Within three years, a total of 70 FNAs were performed. Of those cases, 46 had surgery. Preoperative FNAs of the salivary gland lesions were utilized by the surgeon in guiding treatment options for large, fixed masses as well as masses < 1 cm, in elderly and acquired immunodeficiency syndrome patients.