Salivary Gland Cytology

This atlas provides a comprehensive outline of all but the very rarest salivary gland diseases, detailing the most common benign and malignant tumors with their radiological, cytopathological, and histological features. The differential diagnosis of each tumor is presented with essential tips on the use of fine needle aspiration (FNA) and making a correct diagnosis. Three separate chapters are dedicated to: introduction to salivary gland FNA with emphasis on the technique used to perform the aspiration; the surgical anatomy of these glands; and the various radiological characteristics of these lesions, including primarily CT scans and MRI studies.

Preface vii

Contributors ix

1 Introduction to Salivary Gland Lesions Cytology 1
Mousa A. Al-Abbadi, MD, FIAC

2 Surgery for Salivary Gland Lesions: A Surgeon’s Perspective 13
Ozlem E. Tulunay-Ugur, MD

3 Radiological Investigation of Salivary Gland Lesions 23
Imad Zak, MD

4 Infectious and Inflammatory Diseases of Salivary Glands 43
Wael N. Zakaria, MD, Isam A. Eltoum, MD, MBA, FIAC, Mousa A. Al-Abbadi, MD, FIAC

5 Pleomorphic Adenoma 57
Jining Feng, MD, PhD, Mousa A. Al-Abbadi, MD, FIAC

6 Warthin’s Tumor 69
Mousa A. Al-Abbadi, MD, FIAC

7 Mucoepidermoid Carcinoma 77
Ruba Halloush, MD

8 Carcinoma Ex Pleomorphic Adenoma 87
Husain A. Saleh, MD, FIAC, MBA

9 Acinic Cell Carcinoma 97
Eyas M. Hattab, MD, Harvey M. Cramer, MD

10 Basaloid Salivary Gland Tumor 109
Jerzy Klijanienko, MD, PhD, MIAC, Isam A. Eltoum, MD, MBA, FIAC

11 Adenoid Cystic Carcinoma 131
Husain A. Saleh, MD, FIAC, MBA

12 Oncocytoma 145
Jay K. Wasman, MD, Fadi W. Abdul-Karim, MD

13 Myoepithelioma and Related Lesions 157
Pamela Papas, MD, Momin T. Siddiqui, MD

14 Polymorphous Low-Grade Carcinoma 175
Jerzy Klijanienko, MD, PhD, MIAC, Mousa A. Al-Abbadi, MD, FIAC

15 Salivary Duct Carcinoma 181
Jerzy Klijanienko, MD, PhD, MIAC, Mousa A. Al-Abbadi, MD, FIAC

16 Salivary Gland Lymphomas 187
Mohammad Abuel-Haija, MD, Magdalena Czader, MD, PhD

17 Metastases and Rare Primary Neoplasms of Salivary Glands 215
Mousa A. Al-Abbadi, MD, FIAC

Index 243

Mousa A. Al-Abbadi, MD, FIAC, is Chief of the Pathology and Laboratory Medical Service at the James H. Quillen Veterans Affairs Med Center, and Professor of Pathology at East Tennessee State University? in Mountain Home, Tennessee. A cytopathologist and surgical pathologist since 1991, he has been teaching medical students and fellow physicians the art and science of fine needle aspiration since 1996. The first comprehensive, full-color salivary gland cytopathology atlas

It is well known that a very diverse group of diseases can arise from the salivary gland; as a result, surgical pathologists and cytopathologists consistently face numerous diagnostic challenges. Fine needle aspiration (FNA) of salivary gland lesions has been proven to be an exceptional diagnostic tool, with the combination of proper sampling, proper technique, and adequate clinical data providing enough information to effectively establish either a categorical or a specific diagnosis.

This atlas, the first to specifically address salivary gland cytopathology, provides a comprehensive outline of almost all salivary gland diseases, detailing the most common benign and malignant tumors along with their radiological, cytopathological, and histological features. Essential tips on the FNA technique itself are presented to help make a correct diagnosis.

After a brief introduction, the key cytologic diagnostic features are demonstrated, followed by a differential diagnosis and clues to make a definite interpretation. The summary of these two critical issues is shown in a simple table format; this is followed by a brief description of the histologic correlate with key illustrations. Featuring practical and immediately applicable information presented in full-color photographs, individual chapters are dedicated to:

• A clear explanation of salivary gland FNA with emphasis on the technique used to perform the aspiration

• The surgical anatomy of salivary glands, prepared by an ENT surgeon who outlines the importance of differential diagnosis and its effects on the surgical approach

• The various radiological characteristics of these lesions, including primarily computerized axial tomography (CT) scans and magnetic resonance imaging (MRI) studies, prepared by a head and neck neuroradiologist

• Rare entities

A rigorously consistent discussion format is applied to the discussion of each entity, for ease of use and application. Unique to this book, the radiological correlates point to real-life clinical scenarios in resolving diagnostic dilemmas. Also featured throughout are FNA technical hints, thoughtfully constructed tables, and bullet-point outlines.

Salivary Gland Cytology is essential reading for general pathologists, cytopathologists, oncologists, ENT specialists, head and neck radiologists, head and neck oncologic surgeons and oncologists, surgeons, family practitioners, and dentists. It is also ideal for use in pathology and cytopathology residency programs and cytotechnology schools.