Neoplastic Lesions Of Salivary Glands Research Articles

Significance of Nuclear Morphometry in Salivary Gland Neoplasms: A Cross-sectional Study

Introduction: Fine Needle Aspiration Cytology (FNAC) is one of the commonest and most efficient investigation done for salivary gland swellings, which is of much help in diagnosing inflammatory, benign and malignant lesions. The morphology of nucleus determines the behaviour of the cell/tissue as benign or malignant. Nuclear morphometry analysis is done by using various software. Aim: To determine the nuclear morphometry parameters in salivary gland neoplasm of FNAC smears by Image J software and to determine its association with the cytological diagnosis. Materials and Methods: This was a retrospective laboratory observational cross-sectional study done for four years (2018- 2021) at a tertiary healthcare centre, attached to Sri DevarajUrs Medical College, Kolar, Karnataka, India. All the FNAC smears of salivary gland neoplasms were considered and classified by cytomorphology as benign and malignant tumours. All smears were analysed using Image J software for nuclear morphometric parameters such as area of the nucleus, perimeter of the nucleus, feret diameter, minimum ferret and skewness. The nuclear morphometric findings of benign and malignant tumours were compared and statistical analysis was doneby using Student’s t-test, p-value of <0.05 was considered statistically significant. Results: A total of 52 cases were studied. The average age of presentation of benign and malignant salivary gland neoplasm was 38.7 and 49.4 years, respectively. Among, 30 (57.6%) benign neoplasms there were 23 (76.7%), pleomorphic adenoma was the commonest and among 22 (42.4%) malignant squamous cell carcinoma 16 (72.7%) deposits was the commonest. The nuclear morphometry analysis showed that the mean values of area (p-value ≤0.001), perimeter (p-value≤0.001), ferret diameter (p-value≤0.001) and minimum ferret (p-value=0.001) of malignant lesions were comparatively higher than benign and was statistically significant. Conclusion: Nuclear morphometry along with routine cytopathological evaluation will improve the accuracy of diagnosis of neoplastic lesions of salivary gland. This information can be used to plan better treatment and predict prognosis of the disease. Digital morphological analysis helps in obtaining quantitative values from qualitative data which can be utilised further for automation.

INTEGRATIVE REVIEW AND EPIDEMIOLOGICAL SURVEY OF SALIVARY GLAND LESIONS IN A UNIVERSITY HOSPITAL

<h3>Objectives</h3> Conduct an epidemiologic cases survey of salivary gland lesions seen in the pathology sector in a university hospital in the period from 2013 to 2019 and carry out an integrative review. <h3>Study Design</h3> This is a cross-sectional study, with a duration of 7 years. Through the analysis of clinical records of patients diagnosed with salivary gland lesions in the pathology sector, the following information was collected: sex, age, lesion site, and histopathologic diagnosis. <h3>Results</h3> One hundred forty-three salivary gland lesions were diagnosed; 60.1% were nonneoplastic salivary gland lesions (NNSGLs), and mucous extravasation phenomena represented 81.4% of NNSGLs. The neoplastic salivary gland lesions (NSGLs) represented 39.9% of all cases. Most of these injuries were benign neoplasms (88%), with an emphasis on pleomorphic adenoma (PA; 68%). Only 7 malignant salivary gland neoplasms were found. <h3>Conclusions</h3> NNSGL was more prevalent than NSGL, with an emphasis on the mucus leakage phenomenon, which most affected the lower lip salivary glands. Among NSGLs, benign neoplasms were the most common and PA was the most diagnosed, with the parotid gland being the most affected site.

Frequency and pattern of salivary gland lesions at a tertiary care centre

Objective: To analyze the frequency and histo-morphological pattern of non-neoplastic and neoplastic salivary gland lesions at a tertiary care centre. Study Design: Retrospective descriptive cross-sectional study Place and Duration: Histopathology section, Dow Diagnostic Reference and Research Laboratory, Karachi from 1st February 2021 to 31st July, 2021. Methodology: Data of all salivary gland lesions were retrieved from institutional database. All tissue specimens of parotid, submandibular and sublingual salivary glands lesions as well as possible minor salivary glands swellings were included for histopathological analysis. Type of benign or neoplastic lesion along with salivary gland involved were assessed. Results: Out of a total of 739 samples, 28.0% were non-neoplastic whereas 72.0% were neoplastic lesions. Out of 207 non-neoplastic lesions, 55.1% were of inflammatory origin whereas 44.9% were mucoceles. Chronic sialadenitis (61.4%) was the most common non-neoplastic inflammatory lesion. Among mucoceles, those reported with no specification of type predominated (37.6%). Out of total 543 neoplastic lesions, 53.1% were benign whereas 19.3% were malignant. Pleomorphic adenoma (87.1%) was the commonest benign neoplastic lesion, followed by benign epidermal inclusion cysts (3.7%). Of the 127 malignant salivary gland tumors, mucoepidermoid carcinoma (39.4%) was the most common lesion, followed by adenoid cystic carcinoma (29.1%). Conclusion: Chronic sialadenitis was the most common non-neoplastic lesion whereas pleomorphic adenoma was the predominant benign lesion. Moreover, mucoepidermoid carcinoma was the most common malignant lesion followed by adenoid cystic carcinoma. Keywords: Salivary Glands, Neoplastic lesion, Non-neoplastic lesion, Frequency, Sialadenitis, Adenoma, Carcinoma

Tyrosine Crystals in Nasolabial Cyst - A Morphologic Curiosity Diagnosed at Cytology

Background: Tyrosine rich crystals (TC) are curious structures, rarely encountered at histopathology, more so at cytology. These crystals have been documented exceptionally in various non-neoplastic and neoplastic lesions of salivary gland, lacrimal gland and rarely in larynx. The finding of these crystals in nasolabial cyst has not been reported till date. Case: A 35-year-old female with a clinical and radiologic diagnosis of nasolabial cyst underwent fine needle aspiration cytology (FNAC). Tyrosine crystals in singles and in groups assuming ‘petaloid’ and ‘daisy head’ forms were noted along with few lymphocytes and histiocytes. Amylase crystals were also noted. Conclusion: Regardless of the precise cause, cytologic recognition of TC is important to avoid confusion. Identification of these crystals at FNAC is a matter of avid observation and encourages cytopathologist for meticulous examination of all fluids. The case also highlights that the occurrence of TC is not restricted to SG and the circumstances in which it occurs is diversified.

Histopathological study of non-neoplastic and neoplastic lesions of salivary gland

Histopathological study of non-neoplastic and neoplastic lesions of salivary gland - ACHR- Print ISSN No: - 2581-5725 Online ISSN No:- 2456-9267 Article DOI No:- 10.18231/2456-9267.2019.0013, IP Archives of Cytology and Histopathology Research-IP Arch Cytol Histopathol Res

Role of fine-needle aspiration cytology in the diagnosis of major salivary gland tumors: A study with histological and clinical correlation

Introduction:Neoplastic lesions of salivary glands present an interesting subject because of their histologic diversification. Complex features exhibited by them have aroused considerable speculations concerning their histogenesis and continues to hold the interest of clinicians and pathologists. Major salivary glands are superficial and have easy accessibility for fine-needle aspiration cytology (FNAC). These glands are generally not subjected to incisional or core needle biopsy, because of the possible risks of fistula formation and tumor seedling. FNAC diagnosis of major salivary gland neoplasms aids in proper planning of required surgery and avoidance of the same in cases of non-neoplastic lesions.Materials and Methods:Cytological features of major salivary gland tumors diagnosed on FNAC were studied over a period of one and a half years. Cytological and architectural patterns in smears were compared with histopathological features in cases where the specimens were available with a note on the age, sex and presenting complaints. Statistical Analysis: Analysis of variance (ANOVA) was used to find the significance of study parameters. Chi-square/Fisher Exact was used to find the significance of study parameters on categorical scale between two or more groups. P value of <0.05 was considered to be significant.Results:A total of 114 salivary gland FNACs were done, 75 patients were clinically suspected to be neoplasms. The peak incidence was in the third to fourth decade of life with a female preponderance. Parotid was the most commonly affected gland (80%) with pleomorphic adenoma and mucoepidermoid carcinoma (10.7%) being the most common benign and malignant tumors respectively. The diagnostic accuracy of FNAC was 97.6%. Warthins tumor was misdiagnosed and was associated with a strong smoking history.Conclusion:Salivary gland neoplasms constitute a small but significant percentage of head and neck tumors. FNAC is inexpensive, quick, and aids in the preoperative diagnosis and planning of surgery.

Oncocytoma of the parotid gland: Dilemma for the cytopathologist

Oncocytoma is a rare benign tumor of the salivary glands usually seen in elderly patients in the sixth to eighth decade. Microscopically, the hallmark of this lesion is the presence of oncocytes that comprise the entire tumor. These are large polygonal cells which have abundant eosinophilic granular cytoplasm, and from central to eccentric round nucleus. Several reactive as well as neoplastic lesions of salivary glands often have concurrent oncocytic changes. On fine-needle aspiration cytology, all of them have overlapping morphological features, thus making the diagnosis difficult by cytology alone. We report a case of oncocytoma of the right parotid gland in a 32-year-old Indian male. Although the tumor was initially suspected on cytology, confirmation was possible only after histopathological examination. The main purpose of this case report is to discuss the cytological differential diagnosis of oncocytic lesions of salivary glands and simultaneously emphasize the importance of histopathology for arriving at conclusive diagnosis in such cases.

Neoplastic Salivary Gland Lesions: Analysis of 135 Cases from Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

Neoplastic Salivary Gland Lesions: Analysis of 135 Cases from Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

Crystalloids in Submandibular Sialadenitis

Fine needle aspiration cytology of the salivary glands plays an important role in the diagnosis of neoplastic and non neoplastic lesions of salivary gland. Crystalloids in salivary gland lesions are a rare occurrence. A case of submandibular sialomegaly in an elderly patient with a clinical suspicion of metastasis was subjected to FNAC which showed crystalloids morphologically resembling amylase occurring in a background of sialadenitis. These crystals are non birefrigent, eosinophilic structures with a variety of geometric shapes including needles, rods, rectangular structures that do not stain with mucin stains. Other important crystalloids which can be observed in neoplastic and non-neoplastic salivary gland lesions are tyrosine-rich crystalloids, collagenous crystalloids, and oxalate crystals. These can be distinguished both morphologically and on the basis of several staining techniques in addition to biochemical studies. FNAC plays a major role in the diagnosis of these lesions and helps in avoiding unnecessary surgery.

Amylase crystalloids on fine-needle aspiration of the salivary gland

Amylase crystalloids is one of the several types of crystalline structures that can be seen in non-neoplastic and neoplastic salivary gland lesions. Here, a 60-year-old woman with an infraauricular mass existing for two years is presented. On ultrasound a cystic mass, 1 cm in diameter was detected in the tail of right parotid gland. Clear and mucoid fluid was obtained from the mass by fine-needle aspiration. Smears showed numerous rhomboid, rectangular or rod-shaped, non-birefringent crystalloid structures and a few acinar cell groups in a mucoid background rich in polymorphonuclear leucocytes and lymphoctes. It was reported as cystic sialadenitis with amylase crystalloids. In the four-month follow-up, there was no recurrence of the mass. Since encountered only in benign salivary gland lesions in the literature as in our case, observation of amylase crystalloids on fine-needle aspiration smears indicates a benign lesion and avoids unnecessary surgery.