Salivary glands
Fine needle aspiration

Author: Adriana Handra-Luca, M.D. (see Authors page)

Revised: 21 March 2018, last major update September 2012

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Fine needle aspiration salivary glands[TI]

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Cite this page: Handra-Luca, A. Fine needle aspiration. website. Accessed January 23rd, 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