Abstract：
Secretory carcinoma (SC) of the salivary gland is a rare entity with limited published literature on cytomorphology. The authors present the largest cohort to date of SC fine-needle aspiration (FNA) cases.
FNA cases of histologically confirmed SC were retrospectively retrieved from 12 academic institutions in the United States, Italy, Finland, and Brazil. The collated data included patient demographics, imaging findings, cytopathologic diagnoses according to the Milan System for Reporting Salivary Gland Cytopathology, cytomorphologic characteristics, and immunohistochemical/molecular profiles.
In total, 40 SCs were identified (male-to-female ratio, 14:26) in patients with a mean age of 52 years (age range, 13-80 years). Ultrasound imagining revealed a hypoechoic, ovoid, poorly defined, or lobulated mass. The most common primary site was the parotid gland (30 of 40 tumors). Regional lymph node metastasis (9 patients) and distant metastasis (4 patients; brain, liver, lungs, and mediastinum) were noted. Two patients died of disease. FNA smears were cellular and demonstrated mainly large, round cells with intracytoplasmic vacuoles or granules and round-to-oval nuclei with smooth nuclear contour, minimal irregularities, and prominent nucleoli arranged predominantly in clusters, papillary formations, and single cells. The background was variable and contained inflammatory cells, mucin, or proteinaceous material. The diagnoses were malignant (19 of 38 tumors; 50%), suspicious for malignancy (10 of 38 tumors; 26%), salivary gland neoplasm of uncertain malignant potential (7 of 38 tumors; 18%), and atypia of undetermined significance (2 of 38 tumors; 6%) according to the Milan System for Reporting Salivary Gland Cytopathology. Two malignant cases (2 of 40 tumors; 5%) were metastases. The neoplastic cells were immunoreactive for S100 (23 of 24 tumors), mammaglobin (18 of 18 tumors), GATA-3 (13 of 13 tumors), AE1/AE3 (7 of 7 tumors), and vimentin (6 of 6 tumors). ETV6-NTRK3 fusion was detected in 32 of 33 tumors by fluorescence in situ hybridization (n = 32) and next-generation sequencing (n = 1).
Familiarity with cytomorphologic features and the immunohistochemical/molecular profile of SC can enhance diagnostic accuracy.
FNA cases of histologically confirmed SC were retrospectively retrieved from 12 academic institutions in the United States, Italy, Finland, and Brazil. The collated data included patient demographics, imaging findings, cytopathologic diagnoses according to the Milan System for Reporting Salivary Gland Cytopathology, cytomorphologic characteristics, and immunohistochemical/molecular profiles.
In total, 40 SCs were identified (male-to-female ratio, 14:26) in patients with a mean age of 52 years (age range, 13-80 years). Ultrasound imagining revealed a hypoechoic, ovoid, poorly defined, or lobulated mass. The most common primary site was the parotid gland (30 of 40 tumors). Regional lymph node metastasis (9 patients) and distant metastasis (4 patients; brain, liver, lungs, and mediastinum) were noted. Two patients died of disease. FNA smears were cellular and demonstrated mainly large, round cells with intracytoplasmic vacuoles or granules and round-to-oval nuclei with smooth nuclear contour, minimal irregularities, and prominent nucleoli arranged predominantly in clusters, papillary formations, and single cells. The background was variable and contained inflammatory cells, mucin, or proteinaceous material. The diagnoses were malignant (19 of 38 tumors; 50%), suspicious for malignancy (10 of 38 tumors; 26%), salivary gland neoplasm of uncertain malignant potential (7 of 38 tumors; 18%), and atypia of undetermined significance (2 of 38 tumors; 6%) according to the Milan System for Reporting Salivary Gland Cytopathology. Two malignant cases (2 of 40 tumors; 5%) were metastases. The neoplastic cells were immunoreactive for S100 (23 of 24 tumors), mammaglobin (18 of 18 tumors), GATA-3 (13 of 13 tumors), AE1/AE3 (7 of 7 tumors), and vimentin (6 of 6 tumors). ETV6-NTRK3 fusion was detected in 32 of 33 tumors by fluorescence in situ hybridization (n = 32) and next-generation sequencing (n = 1).
Familiarity with cytomorphologic features and the immunohistochemical/molecular profile of SC can enhance diagnostic accuracy.
摘要：
唾液腺分泌性癌（SC）是一种罕见的实体，有关细胞形态学的公开文献有限。作者介绍了迄今为止最大的SC细针穿刺（FNA）病例队列。
从美国12个学术机构回顾性地检索到经组织学证实的SC的FNA病例。意大利,芬兰,和巴西。整理的数据包括患者的人口统计，影像学发现，根据米兰唾液腺细胞病理学报告系统进行的细胞病理学诊断，细胞形态学特征，和免疫组织化学/分子谱。
总共，鉴定了40个SCs(男女比例，14：26）在平均年龄为52岁的患者中（年龄范围，13-80岁）。超声成像显示低回声，卵形,定义不清,或分叶状肿块。最常见的原发部位是腮腺（40个肿瘤中有30个）。区域淋巴结转移（9例）和远处转移（4例；脑，肝脏,肺,和纵隔）被注意到。两名患者死于疾病。FNA涂片是细胞的，主要表现为大，具有胞浆内液泡或颗粒的圆形细胞和具有光滑核轮廓的圆形至椭圆形核，最小的不规则性，突出的核仁主要成簇排列，乳头状结构，和单细胞。背景是可变的，含有炎症细胞，粘蛋白,或蛋白质材料。诊断为恶性（38个肿瘤中有19个；50％），可疑恶性肿瘤（38个肿瘤中有10个；26%），不确定恶性潜能的涎腺肿瘤（38个肿瘤中的7个；18%），根据米兰唾液腺细胞病理学报告系统，不确定的非典型性（38个肿瘤中有2个；6％）。2例恶性肿瘤（40例肿瘤中有2例；5％）是转移。肿瘤细胞对S100具有免疫反应性（24个肿瘤中有23个），乳腺球蛋白（18个肿瘤中的18个），GATA-3（13个肿瘤中的13个），AE1/AE3（7个肿瘤中的7个），和波形蛋白（6个肿瘤中的6个）。通过荧光原位杂交（n=32）和下一代测序（n=1）在33个肿瘤中的32个中检测到ETV6-NTRK3融合。
熟悉细胞形态学特征和SC的免疫组织化学/分子谱可以提高诊断准确性。
从美国12个学术机构回顾性地检索到经组织学证实的SC的FNA病例。意大利,芬兰,和巴西。整理的数据包括患者的人口统计，影像学发现，根据米兰唾液腺细胞病理学报告系统进行的细胞病理学诊断，细胞形态学特征，和免疫组织化学/分子谱。
总共，鉴定了40个SCs(男女比例，14：26）在平均年龄为52岁的患者中（年龄范围，13-80岁）。超声成像显示低回声，卵形,定义不清,或分叶状肿块。最常见的原发部位是腮腺（40个肿瘤中有30个）。区域淋巴结转移（9例）和远处转移（4例；脑，肝脏,肺,和纵隔）被注意到。两名患者死于疾病。FNA涂片是细胞的，主要表现为大，具有胞浆内液泡或颗粒的圆形细胞和具有光滑核轮廓的圆形至椭圆形核，最小的不规则性，突出的核仁主要成簇排列，乳头状结构，和单细胞。背景是可变的，含有炎症细胞，粘蛋白,或蛋白质材料。诊断为恶性（38个肿瘤中有19个；50％），可疑恶性肿瘤（38个肿瘤中有10个；26%），不确定恶性潜能的涎腺肿瘤（38个肿瘤中的7个；18%），根据米兰唾液腺细胞病理学报告系统，不确定的非典型性（38个肿瘤中有2个；6％）。2例恶性肿瘤（40例肿瘤中有2例；5％）是转移。肿瘤细胞对S100具有免疫反应性（24个肿瘤中有23个），乳腺球蛋白（18个肿瘤中的18个），GATA-3（13个肿瘤中的13个），AE1/AE3（7个肿瘤中的7个），和波形蛋白（6个肿瘤中的6个）。通过荧光原位杂交（n=32）和下一代测序（n=1）在33个肿瘤中的32个中检测到ETV6-NTRK3融合。
熟悉细胞形态学特征和SC的免疫组织化学/分子谱可以提高诊断准确性。
