Schindler S, Nayar R, Dutra J, Bedrossian C W
Department of Pathology, Northwestern University Medical School, Chicago, IL, USA.
Semin Diagn Pathol. 2001 May;18(2):124-46.
The main goal of fine-needle aspiration (FNA) of salivary gland lesions is to assist the clinician in the management of patients who present with a mass lesion. Cytologic examination aims to determine, if a process is inflammatory and/or reactive, benign or malignant neoplasm and if possible renders a specific diagnosis. It has been argued that in the area of salivary gland tumors, surgical management relies less heavily on a specific preoperative diagnosis, because almost all neoplastic salivary gland lesions will undergo surgical excision. However, knowing beforehand if a lesion is malignant or benign, will aid in planning surgery and may prompt or postpone decisions for surgical intervention. The salivary glands are unique in their histologic complexity and morphological variability of tumors, which is reflected in the cytologic material. In addition to the overlapping morphologic patterns of salivary gland tumors, they also represent relatively rare lesions, thus making it more difficult to acquire diagnostic expertise in FNA. Other than approaching salivary gland tumors by a description of single entities in their benign and malignant categories, we favor a more practical approach to diagnosis based on the key morphologic features noted in FNAs. This article addresses differential diagnoses according to the predominant cytologic presentation with attention to the cell type and size, nature of the cytoplasm, and the smear background.
唾液腺病变细针穿刺抽吸（FNA）的主要目标是协助临床医生对出现肿块病变的患者进行管理。细胞学检查旨在确定病变过程是炎性和/或反应性的、良性还是恶性肿瘤，并尽可能做出明确诊断。有人认为，在唾液腺肿瘤领域，手术管理对术前明确诊断的依赖程度较低，因为几乎所有唾液腺肿瘤性病变都将接受手术切除。然而，事先了解病变是恶性还是良性，将有助于手术规划，并可能促使或推迟手术干预的决定。唾液腺在肿瘤的组织学复杂性和形态学变异性方面具有独特性，这在细胞学材料中有所体现。除了唾液腺肿瘤形态学模式的重叠外，它们还是相对罕见的病变，因此在FNA中获得诊断专业知识更加困难。除了通过描述良性和恶性类别中的单个实体来处理唾液腺肿瘤外，我们更倾向于基于FNA中观察到的关键形态学特征采用更实用的诊断方法。本文根据主要的细胞学表现进行鉴别诊断，重点关注细胞类型和大小、细胞质性质以及涂片背景。
