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“Suspicious” salivary gland FNA: Risk of malignancy and interinstitutional variability
Author(s) -
Maleki Zahra,
Miller James Adam,
Arab Seyedeh Elham,
Fadda Guido,
Bo Ping,
Wise Olga,
Rossi Esther Diana,
Jhala Nirag,
Ashish Chandra,
Ali Syed Z.,
Wang He
Publication year - 2018
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.29
H-Index - 57
eISSN - 1934-6638
pISSN - 1934-662X
DOI - 10.1002/cncy.21939
Subject(s) - malignancy , medicine , salivary gland , fine needle aspiration , cytopathology , cytology , pathology , cancer , salivary gland cancer , radiology , biopsy
BACKGROUND Fine‐needle aspiration (FNA) cytology is well accepted as a safe, reliable, minimally invasive, and cost‐effective method for the diagnosis of salivary gland lesions. Salivary gland neoplasms are often difficult to diagnose because of morphologic heterogeneity and a variety of epithelial metaplastic changes. Hence, a number of salivary gland FNA specimens yield indeterminate results. For indeterminate FNA specimens, the suspicious‐for‐malignancy (SFM) category is used when a specific neoplasm falls short in quantity or quality for the criteria for malignancy. Therefore, the findings are not sufficient for a conclusive diagnosis of malignancy. METHODS This study was designed to evaluate the risk of malignancy (ROM) for the SFM group at 5 tertiary medical centers worldwide with the aforementioned criteria. Among 12,606 salivary gland FNA cases between 1997 and 2014, 276 (2.2%) were reported to be SFN. Specifically, 114 suspicious cases (41%) had histological follow‐up. RESULTS Histological follow‐up of the 114 suspicious cases showed 95 malignant tumors indicating a risk of malignancy (ROM) of 83.3%. The ROM varied between 74% and 88% for the 5 participating institutions, and a Fisher's exact test with significance set to p<.05 showed no significant difference in ROM among the institutions (p = .78). CONCLUSIONS Overall, 83.3% of SFM salivary gland FNA specimens turned out to be malignant; there was no significant interinstitutional variability in the ROMs. The SFM category for salivary gland FNA is very homogeneous, and the ROMs are quite similar worldwide. Cancer Cytopathol 2018;126:94‐100. © 2017 American Cancer Society .