Spectrum Of Salivary Gland Lesions Research Articles

Cytopathological Spectrum of Salivary Gland Lesions According to Milan Reporting System: A Retrospective Study

Background: The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was developed in 2015 to standardize reporting of salivary gland cytology, promote better communication between clinicians and institutions, and ultimately improve patient outcomes care. The current study aims to determine the cytopathological spectrum of salivary gland lesions using the Milan System for reporting in a tertiary care hospital of northeast India. Methods: Clinical data and cytology smears of salivary gland lesions diagnosed from January 2016 to May 2021 were retrieved. All the cytology smears were reviewed again and reclassified to one of the six categories after applying strict criteria given by MSRSGC. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of FNAC to detect malignant lesions were calculated considering HPE as the gold standard. Results: A total of 57 salivary gland lesions were examined, 31 (54.38%) were males, and 26 (45.6%) were females with a median age of 34 years (range 6-70 years). Statistical analysis showed the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy as 75%, 100%, 100%, 95%, and 95.65%, respectively. MSRSGC Category IVa was the commonest with 29 cases of pleomorphic adenoma. Conclusion: The overall diagnostic accuracy of cytologic reporting of salivary gland lesions based on Milan nomenclature in our institution was 95.65%. Our findings reflect the positive contribution of the MSRSGC towards accurately identifying the malignant lesions and thus further helping the clinicians regarding the specific management decisions.

Clinicopathological Spectrum of Salivary Gland Lesions - A Retrospective Study from Tertiary Care Research Institute, Andhra Pradesh

Introduction: The salivary glands are subjected to various pathological conditions ranging from simple inflammation to most complex malignant lesions. Majority of these lesions can be diagnosed by simple histopathological examination. But, as these salivary gland lesions are not common, the incidence of these varies in different geographic locations. Aim: To study the spectrum of different salivary gland lesions and demographic data in a tertiary care hospital serving North East coastal area of Andhra Pradesh. Materials and Methods: This was a retrospective study conducted in Great Eastern Medical School and Hospital,Srikakulam, Andhra Pradesh, India. Total of 85 salivary gland lesions were analyzed for a period of 4 years (December 2015 to November 2019). From the records of Histopathology, Department of Pathology, data was retrieved. Typing of the salivary gland tumours were done using sections stained with Hematoxylin and Eosin (H&E). All the cases were analysed and divided according to the demographics and histological type. Descriptive statistics were used and data was tabulated in frequency and percentages. Results: A total of 85 salivary gland lesions were studied, of which 14 (16%) were non-neoplastic and 71 (84%) were neoplastic in nature. Among the neoplastic lesions, 56 (66%) were benign and 15 (18%) were malignant. There was slight male preponderance with a ratio of M:F=1.3:1. Majority of the tumours occurred in parotid gland (73), followed by submandibular gland (7) and minor salivary glands (5). All the tumours were classified and graded according to World Health Organization (WHO), while Brandwein Grading System was followed for mucoepidermoid carcinoma. Pleomorphic adenoma was the most frequent benign tumour and mucoepidermoid carcinoma was the most common malignant tumour. Conclusion: Though benign salivary gland tumours are more frequently encountered in the present study, malignant salivary gland tumours are not uncommon.

Cytomorphological Spectrum of Salivary Gland Lesions by Fine Needle Aspiration Cytology

Introduction: Salivary gland lesions encompass a baffling subset of lesions with overlapping morphologies on cytomorphology, due to their heterogenous histologies and rare enough to sometimes bewilder even the most knowledgeable cytopathologists. The technique of fine needle aspiration (FNA) cytology in the evaluation of salivary gland lesion is simple to perform, saves time, reliable, safe and inexpensive. FNA is highly accurate when used in proper clinical setting and supported by appropriate clinical and relevant diagnostic data. Rapidity of obtaining a pathological diagnosis allows more intelligent therapeutic approach. Materials and Methods: It was a prospective study carried out in the cytology section of pathology department for a period of two years using fine needle aspiration as a diagnostic tool as per standard protocol. The clinical and radiological data were obtained from the patient’s case papers and collaboration with the operating surgeon, the lesions were analysed on cytology. Haematoxylin & Eosin, Papanicolaou stain and Giemsa were used as standard stains. Results: A total of 66 cases of salivary gland lesions were aspirated for a period of two years. Majority of cases were in the age group of 21-30 years with 36 male patients (55%) and 30 female patients (45%). About 44(66.7%), 19(28.8%), 1(1.5%) and 2(3.0%) cases occurred in parotid gland, submandibular gland, sublingual gland and minor salivary gland respectively. There were 21(32%) cases of non-neoplastic lesions and 45(68%) cases of neoplastic lesions. Histopathological specimens were available in 11 out of 66 cases and showed correlation with cytological findings. Conclusion: Fine needle aspiration cytology of salivary gland lesions has high diagnostic accuracy, helps in appropriate therapeutic management and is useful as a diagnostic procedure because of the availability of earlier diagnosis in comparison with the histopathology. Keywords: Salivary gland lesions, fine needle aspiration cytology, neoplastic, non-neoplastic.

Histopathological spectrum of salivary gland lesions in rural India

Background: Salivary gland lesions are of a wide spectrum and affect all the major and minor salivary glands in varying proportions. This study, performed in a rural medical college in Maharashtra, India is intended to see the histopathologic spectrum of salivary gland lesions in the rural population and how it is related to the data from other parts of the country and of the world. 
 Materials and Methods: This is a retrospective study done in the Department of Pathology of a rural-based medical college, Indian Institute of Medical Science and Research, Warudi, Maharashtra, India for a period of 6 years, from January 2014 to January 2020. Age, sex, location of the lesion, gross and microscopic findings were noted.Results: A total of 71 lesions were received in the department of pathology during this period. Samples were received from age 11 years to 75 years. Female preponderance with a male: female ratio of 1:1.15 was seen. 57.7% (n=41) were benign, 15.5% (n=11) were malignant and the rest (n=19) were inflammatory in nature. A maximum number of lesions (50.7%) were detected in the Parotid gland. The most common lesion seen was Pleomorphic adenoma (36.62%, n=26) and the most common malignant lesion was Mucoepidermoid carcinoma.Conclusions: Present study showed benign and non-neoplastic lesions outnumbering the malignant lesions, with female predominance, and a low mean age for malignant lesions of 38.2years. Comparison with other studies within and outside India showed a similar pattern of distribution of salivary gland lesions in the rural population.

Fine needle aspiration cytology-based spectrum of salivary gland lesions at a teaching institute in north India

Introduction: Salivary gland swellings can occur because of inflammation, cyst or neoplastic process. Neoplasms of salivary glands are relatively rare comprising less than 2% of all human tumors. Prevalence of salivary of gland lesions differ from place to place. There are more than 30 morphologically different types of salivary gland neoplasms; majority of which can be diagnosed on fine needle aspiration cytology with expertise. Material and methods: This was a retrospective observational study spanning over 5 years carried out in the department of Pathology, Shaheed Hasan Khan Mewati Government Medical College, Nalhar. Hundred and forty-seven patients with salivary gland swelling were included in the study. Result: Benign salivary gland neoplasm was the most common lesion (54.42%) followed by inflammatory lesions (20.40%). Pleomorphic adenoma (90%) was the most common benign tumor affecting predominantly female patient and mostly involving the parotid gland. Mucoepidermoid carcinoma was the most common malignant tumor (36.85%) followed by poorly differentiated carcinoma (26.31%). Benign tumors were more common in females, whereas malignant tumors occurred more frequently in males. Conclusion: Fine needle aspiration cytology is fast, reliable and relatively accurate method to give tissue-based diagnosis of salivary gland swellings. It helps the clinician to plan the treatment modality for the patients in short time.

A Study on Cytological Spectrum of Salivary Gland Lesions with Emphasis on Diagnostic Pitfalls in Interpretation of Cystic Lesions

A Study on Cytological Spectrum of Salivary Gland Lesions with Emphasis on Diagnostic Pitfalls in Interpretation of Cystic Lesions

Clinico-Pathologic Study of Salivary Gland Disorders at a Sub-Urban Nigerian Tertiary Hospital: A 5 Year Retrospective Review

Background: The spectrum of salivary gland lesions is wide and the relative incidence of neoplastic and non-neoplastic lesions is variable in different studies. Despite the relatively common nature of salivary gland disorders, there is dearth of literature on these lesions, especially in sub-Saharan Africa. We therefore embarked on this study to analyze the differential diagnosis of salivary gland lesions seen and managed at our institution. Methods: A retrospective review of salivary gland disorders that presented at our facility from January 2012 to December 2016 was done. Information on patients’ demographic details, type and location of salivary gland lesion, histologic diagnosis and treatment were retrieved and analyzed with SPSS version 20. Result: A total of 65 patients were treated for salivary gland lesions of various types during the study period. The age of the patients ranged from 3 months to 68 years [mean 33.8 ± 12.3]. Neoplastic lesions [n = 39, 60.0%] were the commonest followed by sialolithiasis [n = 14, 21.5%] while mucous retention/extravasation cysts accounted for 13.9% of the cases. Pleomorphic adenoma was the predominant tumor in this series [87.2%] and the commonest site was the parotid gland [58.8%]. On the contrary submandibular gland appeared to be the commonest site for sialolithiasis [57.1%]. The majority of mucous retention/extravasation cysts occurred in the sublingual gland [55.5%]. Conclusion: Neoplastic lesions remain the commonest salivary gland disorder and pleomorphic adenoma was the most prevalent. Sialolithiasis and mucous cysts are salivary gland lesions with equally wide disease spectrum.

Histopathological study of Salivary gland lesions

Introduction: There is a wide spectrum of salivary gland lesions with morphologically and clinically diversity which is a difficult task for histopathological interpretation. There are three major salivary glands-parotid, submandibular, and sublingual as well as minor salivary glands distributed throughout the mucosa of the oral cavity. Neoplastic and non-neoplastic disease may develop within any of these. Aims: (1) To study the histopathological features of salivary gland lesions, (2) To study the prevalence of salivary gland lesions in tertiary care hospital, (3) To evaluate the incidence, age at the occurrence, and sex ratio among the patients with salivary gland lesions, (4) To compare the result of our study with other studies. Material and Method: Retrospective study was done from January 2016 to June 2018. The study was done on 55 specimens from patients with salivary gland lesions which are referred to the Department of Pathology from Department of ENT and Surgery, P.D.U. Medical college, Rajkot. Salivary gland specimens were immediately fixed in 10% formalin and processed by paraffin embedding. Sections were stained by hematoxylin and eosin stain. Finally, microscopic examination was done to diagnose Result: In present study, out of 55 cases, 05 cases (9.1%) were inflammatory, 41 cases (74.5%) were benign and 09 cases (16.4%) were malignant. Most common benign tumor of salivary gland was pleomorphic adenoma followed by Warthin’s tumor. Most common malignant tumor of salivary gland was mucoepidermoid carcinoma. Conclusion: Histopathological study of salivary gland lesions is the most important method in establishing the final diagnosis and subtyping. Salivary gland tumors are relatively less common and they exhibit a wide variety of microscopic appearances even within one particular lesions.

Cytological Spectrum of Salivary Gland Lesions in a Tertiary Care Hospital

Cytological Spectrum of Salivary Gland Lesions in a Tertiary Care Hospital

Spectrum of Salivary Gland Lesions in Western Odisha with the Diagnostic Value of F.N.A.C. Correlating with Histomorphology

Spectrum of Salivary Gland Lesions in Western Odisha with the Diagnostic Value of F.N.A.C. Correlating with Histomorphology

Cytological spectrum of salivary gland lesions and their correlation with epidemiological parameters.

Background:The role fine-needle aspiration (FNA) in the diagnosis of salivary gland lesions has evolved over the years. Although clinical and radiological parameters help to narrow the differential diagnosis the tissue diagnosis still remains the gold standard.Materials and Methods:This study is from January 2013 to December 2015 in our Department of Pathology where 170 salivary gland lesions were aspirated. The aim of the present study was to analyze adequacy rate in relation to the size of lesion and to evaluate varied cytological spectrum of salivary gland lesions with emphasis on differential diagnosis and to correlate cytological diagnosis with age, gender and anatomical site.Results:The 170 cytological smears were categorized into two groups: Group 1 adequate aspirations (88.2%), Group 2 inadequate aspirations (11.7%). The adequate aspirations were subdivided as neoplastic (53.33%) and nonneoplastic (46.66%). The distribution of the various neoplastic lesions (80; 53.33%) were 66 (82.5%) benign, 12 (15%) were malignant and 2 (2.5%) were suspicious of malignancy. Among benign neoplasms, the pleomorphic adenoma (62; 93.3%) was the most frequent followed by Warthins tumor (4; 6%). The most common malignant neoplasms were adenoid cystic carcinoma (6; 50%), followed by mucoepidermoid carcinoma (4; 33.3%), malignant lymphoma (1; 8.3%) and metastatic carcinomatous deposits (1; 8.3%). In two cases, cytological picture indicated suspicion for malignancy however specific tumor typing could not be done. The neoplasms occurred more frequently in the parotid gland (65%), followed by submandibular gland (21.3%) and minor salivary glands (13.8%). The nonneoplastic lesions (70) included 68.6% cases of chronic sialadenitis, 17.1% cases were reported as mucocele, 11.4% cases of acute sialadenitis 2.9% cases as tubercular granulomas.Conclusion:FNA cytology provides useful information on the management of salivary gland lesions and prevents unnecessary surgery in cases of nonneoplastic lesions and identification of malignancy helps the surgeon in deciding type and extent of surgery.

Spectrum of Salivary Gland Lesions with Associated Cytological and Histopathological Correlation

Spectrum of Salivary Gland Lesions with Associated Cytological and Histopathological Correlation

Diagnostic role of fine needle aspiration cytology (FNAC) in the evaluation of salivary gland swelling: an institutional experience.

BackgroundFine needle aspiration cytology (FNAC) is a cytodiagnostic method based on morphologic findings of individual and small group of cells aspirated using a fine needle. The aim of the present study is to evaluate the spectrum of salivary gland lesions in our setting and to assess the diagnostic accuracy of FNAC for salivary gland lesions.MethodsThe study involved 187 cases of parotid and submandibular swellings of patients who underwent FNAC at our institution. Thirty one (31) patients with a FNAC diagnosis of neoplastic lesion subsequently underwent excision biopsies. The results of FNAC and final histology were compared and accuracy of FNAC was determined.ResultsMean age of patients was 42 (±21) years and male to female ratio was 1:1. Chronic sialadenitis was the most common non-neoplastic lesion (33.8%) followed by acute and chronic sialadenitis (29.7%) and chronic granulomatous inflammation (27.0%). Pleomorphic adenoma was the most common benign neoplasm and non-Hodgkin’s lymphoma was the most common malignant lesion (38.9%) followed by acinic cell (27.8%) and adenoid cystic carcinoma (16.7%). Total 31 patients subsequently underwent surgical excision, out of which 21 were benign and 9 were malignant, 20 cases (64.5%) were of pleomorphic adenoma, 3 cases (9.6%) of acinic cell carcinoma, 2 cases (6.4%) each of warthin tumor, adenoid cystic carcinoma and non-hodgkin lymphoma and 1 case (3.2%) each of mucoepidermoid carcinoma and mucinous adenocarcinoma. The overall accuracy of FNAC in our study was found to be 83.8% with 77.7% sensitivity and 86.3%, specificity. The revised sensitivity and specificity after adjusting verification bias were 68.5% and 91% respectively. False negative diagnosis was rendered in mucoepidermoid carcinoma and acinic cell carcinoma whereas false positive diagnosis was given in cases of pleomorphic adenoma.ConclusionWe found a good concordance between FNAC and histology, however pleomorphic adenoma may impart a diagnostic challenge when inadequately aspirated and therefore we advice either immunohistochemical studies (if cell block material is available) or repeat aspiration in difficult cases.

Non-neoplastic salivary gland lesions: a 15-year study

The spectrum of salivary gland lesions is wide and the relative incidence of neoplastic versus non-neoplastic lesions is variable in different studies. A series of non-neoplastic salivary gland lesions is reviewed to analyze their spectrum and their relative frequency. This is a retrospective study of salivary gland excisions and biopsies received in our department from January 1994 to December 2008. Routine hematoxylin and eosin-stained sections of all the salivary gland excisions and biopsies received were analyzed. Of the 393 salivary gland excisions and biopsies received, 216 cases were reported as non-neoplastic (55%) and formed our study group; 177 (45%) were neoplastic. Non-neoplastic lesions were more frequent in major salivary glands (65.7%) and submandibular gland was the most commonly involved (66.2%). Lip was the most frequent site (81.7%) for minor salivary gland lesions. Inflammation was the predominant pathological finding (49.5%), of which non-specific chronic sialadenitis constituted the majority (86.9%). Sialolithiasis was present in 22 cases (20.6%); all of these cases were of non-specific chronic sialadenitis. Cysts were second in frequency (36.6%), of which mucocele was the most common (54.5%). There were 5.6% cases of benign lympho-epithelial lesions, while normal salivary gland tissue was seen in 6.5% cases. Non-neoplastic salivary gland diseases are more common than neoplastic diseases and have a wide disease spectrum.