He Wang1, Aatika Malik1, Zahra Maleki2, Esther Diana Rossi3, Bo Ping4, Ashish Chandra5, Syed Z Ali2, Guido Fadda3, Jindong Wang1, Seyedeh Elham Arab1, Huaqing Zhao1, Nirag Jhala1. 1. Department of Laboratory Medicine and Pathology, Temple University Hospital, Pennsylvania. 2. Department of Pathology, The Johns Hopkins Hospital, Maryland. 3. The Department of Anatomic Pathology and Histology, the Catholic University of Rome, Rome, Italy. 4. Department of Pathology, Fudan University Cancer Hospital, Shanghai, People's Republic of China. 5. Department of Cellular Pathology, Guy's & St Thomas's Hospital NHSfT, London, United Kingdom.
Abstract
BACKGROUND: Fine needle aspiration (FNA) is widely used in the diagnosis of salivary gland lesions. Salivary gland FNAs are often difficult to diagnose because of morphologic heterogeneity, a small but significant number of the FNAs yield "atypical" diagnosis. However, systematic evaluation of the risk of malignancy (ROM) of the atypical diagnoses across institutions and the variability of ROM among institutions are still lacking. METHODS: Salivary gland FNAs from five tertiary medical centers of United States, Europe and China were reviewed. Cases with "atypical" diagnosis and histological follow-up were included in this study. The diagnostic category of "atypical" was adopted from Milan System for Reporting Salivary Gland Cytopathology (MSRSGC, personal communication). RESULTS: Among the 12,606 salivary gland FNAs, 504 (4.0%) cases were reported as "atypical", with 154 cases (30.6%) having histological follow-ups. Histological follow-ups revealed 94 malignant tumors (61.0%, 57 lymphomas, 33 carcinomas, 2 sarcomas, 1 metastatic melanoma, 1 metastatic neuroblastoma), 33 benign tumors (21.4%), and 25 benign lesions (16.2%). ROM in the subset of "atypical" cases with histological follow-up from different institutions vary from 73.08% to 0.00%, the Pearson chi2 = 24.38 and P < .001. CONCLUSIONS: More than half of the subset of "atypical" salivary gland FNAs with histological resection turned out to be malignant tumors; another one-fourth were benign neoplasms. Further, the highly variable ROMs of the "atypical" category amongst different institutions likely reflect the variable practices at each individual institution.
BACKGROUND: Fine needle aspiration (FNA) is widely used in the diagnosis of salivary gland lesions. Salivary gland FNAs are often difficult to diagnose because of morphologic heterogeneity, a small but significant number of the FNAs yield "atypical" diagnosis. However, systematic evaluation of the risk of malignancy (ROM) of the atypical diagnoses across institutions and the variability of ROM among institutions are still lacking. METHODS: Salivary gland FNAs from five tertiary medical centers of United States, Europe and China were reviewed. Cases with "atypical" diagnosis and histological follow-up were included in this study. The diagnostic category of "atypical" was adopted from Milan System for Reporting Salivary Gland Cytopathology (MSRSGC, personal communication). RESULTS: Among the 12,606 salivary gland FNAs, 504 (4.0%) cases were reported as "atypical", with 154 cases (30.6%) having histological follow-ups. Histological follow-ups revealed 94 malignant tumors (61.0%, 57 lymphomas, 33 carcinomas, 2 sarcomas, 1 metastatic melanoma, 1 metastatic neuroblastoma), 33 benign tumors (21.4%), and 25 benign lesions (16.2%). ROM in the subset of "atypical" cases with histological follow-up from different institutions vary from 73.08% to 0.00%, the Pearson chi2 = 24.38 and P < .001. CONCLUSIONS: More than half of the subset of "atypical" salivary gland FNAs with histological resection turned out to be malignant tumors; another one-fourth were benign neoplasms. Further, the highly variable ROMs of the "atypical" category amongst different institutions likely reflect the variable practices at each individual institution.
Authors: Eric Barbarite; Sidharth V Puram; Adeeb Derakhshan; Esther D Rossi; William C Faquin; Mark A Varvares Journal: Laryngoscope Date: 2019-03-08 Impact factor: 3.325
Authors: Zahra Maleki; Zubair Baloch; Ryan Lu; Khurram Shafique; Sharon J Song; Kartik Viswanathan; Rema A Rao; Holly Lefler; Aisha Fatima; Austin Wiles; Vickie Y Jo; He Wang; Guido Fadda; Celeste N Powers; Syed Z Ali; Liron Pantanowitz; Momin T Siddiqui; Ritu Nayar; Jerzy Klijanienko; Guliz A Barkan; Jeffrey F Krane; Esther D Rossi; Fabiano Callegari; Ivana Kholová; Massimo Bongiovanni; William C Faquin; Marc P Pusztaszeri Journal: Cancer Cytopathol Date: 2019-05-03 Impact factor: 5.284
Authors: Daniel N Johnson; Mine Onenerk; Jeffrey F Krane; Esther Diana Rossi; Zubair Baloch; Güliz Barkan; Massimo Bongiovanni; Fabiano Callegari; Sule Canberk; Glen Dixon; Andrew Field; Christopher C Griffith; Nirag Jhala; Sara Jiang; Daniel Kurtycz; Lester Layfield; Oscar Lin; Zahra Maleki; Miguel Perez-Machado; Marc Pusztaszeri; Philippe Vielh; He Wang; Matthew A Zarka; William C Faquin Journal: Cancer Cytopathol Date: 2020-04-08 Impact factor: 5.284