Review of fine-needle aspiration cytology of salivary gland neoplasms, with emphasis on differential diagnosis.

The widespread use of fine-needle aspiration (FNA) biopsy of salivary gland lesions in many centers is testimony to its usefulness and acceptance as a diagnostic technique. Many pertinent questions concerning a mass arising in the salivary gland can be answered by evaluation of FNA cytologic material, and these include whether the mass is truly of salivary gland origin, whether the lesion is inflammatory or neoplastic, and if neoplastic, whether benign or malignant. On diagnosis of a neoplastic salivary gland lesion, the next important issue is to correctly classify the tumor, particularly if malignant. Specific cytologic diagnoses can be achieved in the majority of cases, thus enabling the clinician and patient to make appropriate informed decisions. The cytologic evaluation of salivary gland tumors, however, is limited by the wide range and heterogeneous nature of benign and malignant tumors arising in this area, many of which share similar or show overlapping cytologic features, making the diagnosis of rare tumors problematic. In this review, the cytologic features of the major salivary gland neoplasms, the differential diagnoses, and the salient points that, if examined carefully, help achieve a specific diagnosis are discussed.