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Salivary glands


Fine needle aspiration

Reviewer: Adriana Handra-Luca, M.D. (see Reviewers page)
Revised: 26 January 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.


● 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’s 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


Classification table

Micro images

Squamous metaplasia

Various images

End of Salivary glands > Miscellaneous > Fine needle aspiration

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