TY - JOUR
T1 - Ancillary studies on cell blocks from fine needle aspiration specimens of salivary gland lesions
T2 - A multi-institutional study
AU - Tabibi, Seena
AU - Gabrielson, Matthew
AU - Saoud, Carla
AU - Davis, Katelynn
AU - Wangsiricharoen, Sintawat
AU - Lu, Ryan
AU - Tondi Resta, Isabella
AU - Viswanathan, Kartik
AU - Faquin, William C.
AU - Baloch, Zubair
AU - Maleki, Zahra
N1 - Publisher Copyright:
© 2022 The Authors. Diagnostic Cytopathology published by Wiley Periodicals LLC.
PY - 2022/5
Y1 - 2022/5
N2 - Background: Ancillary studies are commonly performed on cell blocks prepared from fine-needle aspiration (FNA) specimens. There are limited studies in application of ancillary studies on cell blocks from salivary gland (SG) FNAs. This multi-institutional study evaluates the role of ancillary studies performed on cell blocks in the diagnosis of SG lesions, and their impact on clinical management. Method: The electronic pathology archives of three large academic institutions were searched for SG FNAs with ancillary studies performed on cell blocks. The patient demographics, FNA site, cytologic diagnosis, ancillary studies, and surgical follow-up were recorded. If needed, the cytologic diagnoses were reclassified as per the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC). Results: 117 SG FNA cases were identified including 3, 10, 11, 6, 23, 4, and 60 cases in MSRSGC categories I, II, III, IVa, IVb, V, VI, respectively with surgical follow-up available ranging from 27% to 100% within each category. Ancillary studies including histochemistry, immunocytochemistry (IHC), and in situ hybridization (ISH) were beneficial in 60%–100% of cases in each category. Risk of malignancy was 100% in both the suspicious for malignancy (V) and malignant (VI) categories. Ancillary studies improved diagnosis in 60% of non-neoplastic cases (II, 6/10), 100% of benign neoplasm cases (IVa, 6/6), and 98.3% of malignant cases (VI, 59/60). Conclusion: Judicious and case-based ancillary studies performed on SG FNA cell blocks with sufficient material can improve the diagnostic yield by further characterization of the atypical/neoplastic cells, particularly in MSRSGC categories IVa-VI.
AB - Background: Ancillary studies are commonly performed on cell blocks prepared from fine-needle aspiration (FNA) specimens. There are limited studies in application of ancillary studies on cell blocks from salivary gland (SG) FNAs. This multi-institutional study evaluates the role of ancillary studies performed on cell blocks in the diagnosis of SG lesions, and their impact on clinical management. Method: The electronic pathology archives of three large academic institutions were searched for SG FNAs with ancillary studies performed on cell blocks. The patient demographics, FNA site, cytologic diagnosis, ancillary studies, and surgical follow-up were recorded. If needed, the cytologic diagnoses were reclassified as per the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC). Results: 117 SG FNA cases were identified including 3, 10, 11, 6, 23, 4, and 60 cases in MSRSGC categories I, II, III, IVa, IVb, V, VI, respectively with surgical follow-up available ranging from 27% to 100% within each category. Ancillary studies including histochemistry, immunocytochemistry (IHC), and in situ hybridization (ISH) were beneficial in 60%–100% of cases in each category. Risk of malignancy was 100% in both the suspicious for malignancy (V) and malignant (VI) categories. Ancillary studies improved diagnosis in 60% of non-neoplastic cases (II, 6/10), 100% of benign neoplasm cases (IVa, 6/6), and 98.3% of malignant cases (VI, 59/60). Conclusion: Judicious and case-based ancillary studies performed on SG FNA cell blocks with sufficient material can improve the diagnostic yield by further characterization of the atypical/neoplastic cells, particularly in MSRSGC categories IVa-VI.
KW - Milan System for Reporting Cytology
KW - ancillary studies
KW - cell block
KW - fine-needle aspiration
KW - histochemistry stains
KW - immunohistochemistry
KW - in situ hybridization
KW - salivary gland
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U2 - 10.1002/dc.24939
DO - 10.1002/dc.24939
M3 - Article
C2 - 35092649
AN - SCOPUS:85123871172
SN - 8755-1039
VL - 50
SP - 235
EP - 252
JO - Diagnostic cytopathology
JF - Diagnostic cytopathology
IS - 5
ER -