Ancillary studies on cell blocks from fine needle aspiration specimens of salivary gland lesions: A multi-institutional study.

Milan System for Reporting Cytology ancillary studies cell block fine-needle aspiration histochemistry stains immunohistochemistry in situ hybridization salivary gland

Journal

Diagnostic cytopathology
ISSN: 1097-0339
Titre abrégé: Diagn Cytopathol
Pays: United States
ID NLM: 8506895

Informations de publication

Date de publication:
May 2022
Historique:
revised: 03 01 2022
received: 27 04 2021
accepted: 21 01 2022
pubmed: 30 1 2022
medline: 6 4 2022
entrez: 29 1 2022
Statut: ppublish

Résumé

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. 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). 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). 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.

Sections du résumé

BACKGROUND 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 METHODS
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 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 CONCLUSIONS
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.

Identifiants

pubmed: 35092649
doi: 10.1002/dc.24939
pmc: PMC9303557
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

235-252

Informations de copyright

© 2022 The Authors. Diagnostic Cytopathology published by Wiley Periodicals LLC.

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Auteurs

Seena Tabibi (S)

Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Matthew Gabrielson (M)

Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Carla Saoud (C)

Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Katelynn Davis (K)

Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Sintawat Wangsiricharoen (S)

Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Ryan Lu (R)

Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Isabella Tondi Resta (I)

Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Kartik Viswanathan (K)

Department of Pathology, Emory University Hospital Midtown, Atlanta, Georgia, USA.

William C Faquin (WC)

Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.

Zubair Baloch (Z)

Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Zahra Maleki (Z)

Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

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