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What do we know about the cytological features of pure intraductal carcinomas of the salivary glands?
Author(s) -
Palicelli Andrea
Publication year - 2020
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12790
Subject(s) - atypia , medicine , nuclear atypia , grading (engineering) , malignancy , mucoepidermoid carcinoma , pathology , fine needle aspiration cytology , pathological , radiology , salivary gland , cytology , immunohistochemistry , civil engineering , engineering
Abstract Objective Intraductal carcinomas ( IDC s) are rare, poorly characterised salivary gland tumours. The cytological features of IDC s are even less known. In this paper, a systematic literature review of pure IDC s (without stromal invasion, not associated with other histotypes) of low‐grade ( LG ‐ IDC s) and high‐grade ( HG ‐ IDC s) was performed. Methods The bibliographic research included multiple databases (PubMed, Scopus, Web of Science). Mild‐moderate nuclear atypia favoured LG ‐ IDC s, severe atypia favoured HG ‐ IDC s. Results Preoperative fine‐needle aspiration cytology ( FNAC ) was performed in 13/94 published cases (14%): 10 parotid; two oral; one submandibular. All the cases were histologically LG ‐ IDC s, except two parotid IDC s. FNAC results included: negative for malignancy (three of 13 cases, 23%); tumour of uncertain malignant potential (seven of 13, 54%); malignancy (three of 13, 23%). The ductal component was identified in two cases; mucoepidermoid carcinoma was suggested in two additional cases. The grade was underestimated on FNAC evaluation in one HG ‐ IDC as focal high‐grade features were present on subsequent histological examination. The cases diagnosed as malignant tumours or describing intermediate atypia resulted in LG ‐ IDC s on subsequent histology. Occasional mitoses were described only in one HG ‐ IDC ; this feature may have not been considered in the remaining published cases. Conclusions FNAC and clinico‐pathological correlation are important aids for clinicians and pathologists. FNAC could assist surgery even if an accurate diagnosis is sometimes impossible. Discrepancy in grading the nuclear atypia between the FNAC material and the resected specimen can occur, sometimes being unavoidable. Further studies are needed to better characterise this rare tumour.