Glial Fibrillary Acidic Protein and CD57 Immunolocalization in Cell Block Preparations Is a Useful Adjunct in the Diagnosis of Pleomorphic Adenoma

2007 ◽  
Vol 131 (9) ◽  
pp. 1373-1377 ◽  
Author(s):  
Sejal S. Shah ◽  
Vishal S. Chandan ◽  
David C. Wilbur ◽  
Kamal K. Khurana

Abstract Context.—The cytologic distinction between pleomorphic adenoma (PA) and adenoid cystic carcinoma (ACC) can be diagnostically challenging in aspirate smears. Hence a cytologic diagnosis of “atypical cytology” with a differential diagnosis including PA and ACC is occasionally rendered in a subset of salivary gland fine-needle aspirations. Objective.—To evaluate the role of glial fibrillary acidic protein (GFAP) and CD57 expression in cell block material obtained during fine-needle aspiration procedure in differentiating PA from ACC. Design.—We performed GFAP and CD57 immunostains on formalin-fixed, paraffin-embedded cell block sections of 26 salivary gland fine-needle aspiration cases with the following cytologic diagnoses: (1) PA (10 cases); (2) atypical cytology, cannot exclude ACC (8 cases); and (3) ACC (8 cases). Results.—All 10 (100%) cases with cytologic diagnoses of PA were positive for GFAP, and 8 (80%) of 10 cases were positive for CD57; tissue follow-up confirmed the diagnosis of PA in all cases. All 8 (100%) cases with cytologic diagnosis of ACC were negative for both GFAP and CD57; tissue follow-up confirmed the diagnoses of ACC in all cases. Of the 8 cases with diagnoses of atypical cytology, 4 (50%) were negative and 4 (50%) were positive for both GFAP and CD57. Subsequent tissue follow-up in these cases revealed 4 cases of ACC (all negative for GFAP and CD57) and 4 cases of PA (all positive for GFAP and CD57). Conclusions.—Our results show that positive staining for GFAP and CD57 serves as a useful adjunct for the diagnosis of PA and helps to reduce the uncertainty in challenging cases.

2018 ◽  
Vol 7 (1) ◽  
pp. 54-58
Author(s):  
Marcin Jarosław Kubiak ◽  
Dariusz Kaczmarczyk ◽  
Aleksandra Oleśna ◽  
Alina Morawiec-Sztandera

Objectives: Salivary gland tumors account for only 3% of head and neck tumors. Their character is mostly benign, although tumors of the submandibular gland are more often malignant. The purpose of this article was to evaluate the structure of patients operated due to submandibular gland tumor and to study the correlation between fine-needle aspiration cytology and postoperative histopathological examination. Methodology: We retrospectively analyzed the medical records of all patients with submandibular gland tumors. The collected data included the demographic structure, results of preoperative fine-needle aspiration cytology and postoperative histopathologic examination. Results: We analyzed 58 patients – 35 women and 23 men with a mean age of 56.6 years. The character of the lesion was benign in 45 cases and malignant in 13. The most frequent benign tumors were pleomorphic adenoma, inflammatory tumor and Warthin’s tumor, whereas most common malignancies were carcinoma planoepitheliale and lymphoma . There were four recurrences. Moreover, we compared results of preoperative fine-needle aspiration cytology and histopathological findings. The accuracy of this examination was almost 83%; 56% of incorrect results involved nondetection of malignancies. The sensitivity and specificity in the diagnosis of those tumors were 58.3% and 97.5%, respectively. Conclusions: The most common types of submandibular gland are pleomorphic adenoma and carcinoma planoepitheliale and lymphoma amongst malignancies. Fine-needle aspiration cytology is accurate in the preoperative diagnosis, mistakes are mostly caused by underdiagnosis of malignant tumors.


2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Fang-Ming Deng ◽  
Jack Hsu ◽  
Kamal K. Khurana

Fine Needle aspiration (FNA) studies of oropharyngeal lesions are few and limited. We retrospectively reviewed cytologic diagnosis and cytohistologic correlation of 28 cases of FNAs of oropharyngeal lesions. Cytologically, 11 cases were diagnosed as malignant/suspicious and 17 cases as benign. Ten of these cases diagnosed as malignant/suspicious correlated with the subsequent histological diagnosis or were compatible with previous histological diagnoses. One case categorized as suspicious for malignancy revealed pleomorphic adenoma with extensive squamous metaplasia. Of the 17 cases diagnosed as benign by cytology, 11 correlated with the subsequent histological diagnosis. The remaining 6 cytologically benign cases were considered clinically benign, and there was no histological followup. Clinical followup on these 6 patients did not reveal any evidence of disease. The sensitivity, specificity, and accuracy of malignant diagnosis were 100%, 95%, and 97%. FNA biopsy may be used as the first line of investigation in evaluation of oropharyngeal lesions.


1999 ◽  
Vol 123 (5) ◽  
pp. 421-425
Author(s):  
Kamal K. Khurana ◽  
Ibrahim Ramzy ◽  
Luan D. Truong

Abstract Objective.—Mutations of the p53 tumor suppressor gene, with consequent nuclear p53 protein accumulation, are among the most common genetic abnormalities in human cancers. The purpose of this study was to determine the utility of p53 immunostaining as an adjunct to the diagnosis of malignancy in fine-needle aspirations of squamous lesions of the neck. Materials and Methods.—Using a monoclonal antibody to the p53 protein and a standard avidin-biotin complex technique, immunostaining was performed on paraffin-embedded cell blocks of 20 cases with the following cytologic diagnoses: (1) metastatic squamous cell carcinoma (SCC) (7 cases); (2) atypical squamous cells, SCC cannot be excluded (7 cases); and (3) cytologic findings consistent with branchial cleft cyst (6 cases). Tissue or clinical follow-up was available in all cases. Results.—Five (71%) of 7 cases with an unequivocal cytologic diagnosis of metastatic SCC were positive for p53 protein. Tissue follow-up confirmed metastatic SCC in all of these 7 cases. Of the 7 cases with cytologic diagnosis of atypical squamous cells, 2 were negative and 5 (71%) were positive for p53 protein. Subsequent excisional biopsies in these cases revealed metastatic SCC (6 cases) and branchial cleft cyst (1 case). The squamous cells in all 5 cases with cytologic findings consistent with branchial cleft cyst were negative for p53 protein; tissue follow-up confirmed the diagnoses of branchial cleft cyst in 4 cases. In the remaining 2 cases excision was not performed, as the cystic lesion was completely decompressed and, clinically, no recurrences were identified at 14 and 8 months of follow-up. Conclusions.—Our findings suggest that p53 immunostaining is helpful in differentiating benign and malignant squamous lesions. While negative staining for p53 does not exclude malignancy, positive immunostaining may aid in accurate fine-needle aspiration diagnosis of malignancy in cytomorphologically equivocal squamous lesions of the neck.


2020 ◽  
Vol 4 (12) ◽  
pp. 01-02
Author(s):  
Anju Khairwa

Pleomorphic adenoma (PA) is benign tumor of salivary gland. Pleomorphic adenoma contains both epithelial and myoepithelial elements and it arises from myoepithelial cells of salivary gland. The index study to describe rare case of pleomorphic adenoma of soft palate diagnosed by FNAC (fine needle aspiration cytology).


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