22
Salivary Glands and Rare Head and Neck Lesions
Fig. 22.31 Adenocarcinoma not otherwise specified. An irregular tumor
cell fragment hyperchromatic irregular tumor cells of adenocarcinoma type
(May-Grunwald-Giemsa x MP).
Diagnostic accuracy
Cytologic diagnosis of salivary gland tumors requires a great
deal of experience, partly because of the great diversity of tumor
types and because of the complexity of cytologic patterns of
individual tumors.11
The literature in this field has expanded
considerably, providing excellent guides to improved diagnostic
accuracy.68-71 This is illustrated by the results presented in
Table 27.1. In the early work of Eneroth and associates,3 a low
sensitivity was recorded. This is to a large extent explained
by the underdiagnosis of adenoid cystic and acinic cell carci-
nomas. At that time, the cytologic criteria for these tumors were
poorly defined. Later studies benefited from the pioneer work
of Zajicek and his colleagues,42 and the figures for sensitivity
increased considerably to vary between 87.5 and 98% (see
Table 27.1).
The accuracy of benign diagnoses was high in all studies,
varying between 96.2 and 99.4%.
A
C
Fig. 22.32 Metastatic tumors. (A) Blastic cells of hematogenous origin in an aspirate from an infiltrate in the parotid gland (May-Grünwald-Giemsa x HP).
The patient had a treated AML. (B) Metastasis from a papillary thyroid carcinoma in a Warthin's tumor (May-Grünwald-Giemsa x MP). (C) Metastasis from a
poorly differentiated epipharyngeal carcinoma to the parotid gland (May-Grünwald-Giemsa x HP).
623
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