Salivary glands
Fine needle aspiration

Topic Completed: 1 September 2012

Revised: 25 March 2019

Copyright: 2003-2019,, Inc.

PubMed Search: Fine needle aspiration salivary glands[TI]

Adriana Handra-Luca, M.D.
Page views in 2018: 141
Page views in 2019 to date: 227
Cite this page: Handra-Luca A Fine needle aspiration. website. Accessed October 22nd, 2019.
Definition / general
  • Rapid, reliable, safe
  • FNA > 90% sensitive but may induce necrotic and reparative changes in tumor, particularly oncocytic tumors
  • Induces numerous histologic changes, including hemorrhage, multinucleated giant cells and inflammation, granulation tissue and fibrosis, squamous cell metaplasia, infarction and necrosis, subepithelial stromal hyalinization (Arch Pathol Lab Med 2000;124:87)
  • Occasionally induces cholesterol clefts, pseudoxanthomatous reaction, pseudocapsular invasion, microcystic degeneration
  • Core biopsy not recommended as tumor may implant along needle tract
  • Recommended to initially classify as normal tissue / inflammation, pleomorphic adenoma, Warthin tumor, cyst, small cell epithelial lesion, large cell epithelial lesion (low grade or high grade), spindle cell lesion (low grade or high grade)
Diagnostic difficulties
  • Extensive squamous metaplasia may resemble squamous cell carcinoma or mucoepidermoid carcinoma (Mod Pathol 2002;15:342)
  • Basal cell adenoma may resemble adenoid cystic carcinoma (solid type)
  • Oncocytic proliferations may resemble acinic cell carcinoma
Microscopic (histologic) images

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Squamous metaplasia

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