背景:通常对从细针抽吸(FNA)标本制备的细胞块进行辅助研究。对唾液腺(SG)FNA的细胞块的辅助研究应用研究有限。这项多机构研究评估了对细胞块进行的辅助研究在SG病变诊断中的作用。以及它们对临床管理的影响。
方法:在三个大型学术机构的电子病理学档案中搜索SGFNA,并对细胞块进行辅助研究。病人的人口统计,FNA网站,细胞学诊断,辅助研究,并记录手术随访情况。如果需要,根据米兰唾液腺细胞病理学报告系统(MSRSGC)对细胞学诊断进行了重新分类.
结果:确定了117例SGFNA病例,包括MSRSGCI类的3、10、11、6、23、4和60例,II,III,IVa,IVb,V,VI,分别进行手术随访,每个类别范围为27%至100%。辅助研究,包括组织化学,免疫细胞化学(IHC),原位杂交(ISH)在每个类别中60%-100%的病例中都是有益的。在可疑的恶性肿瘤(V)和恶性(VI)类别中,恶性肿瘤的风险均为100%。辅助研究改善了60%非肿瘤性病例的诊断(II,6/10),100%的良性肿瘤病例(IVa,6/6),和98.3%的恶性肿瘤(VI,59/60)。
结论:对具有足够材料的SGFNA细胞块进行明智和基于病例的辅助研究,可以通过进一步表征非典型/肿瘤细胞来提高诊断率。特别是在MSRSGC类别IVa-VI。
BACKGROUND: Ancillary studies are commonly performed on cell blocks prepared from fine-needle aspiration (FNA) specimens. There are limited studies in application of ancillary studies on cell blocks from salivary gland (SG) FNAs. This multi-institutional
study evaluates the role of ancillary studies performed on cell blocks in the diagnosis of SG lesions, and their impact on clinical management.
METHODS: The electronic pathology archives of three large academic institutions were searched for SG FNAs with ancillary studies performed on cell blocks. The patient demographics, FNA site, cytologic diagnosis, ancillary studies, and surgical follow-up were recorded. If needed, the cytologic diagnoses were reclassified as per the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC).
RESULTS: 117 SG FNA cases were identified including 3, 10, 11, 6, 23, 4, and 60 cases in MSRSGC categories I, II, III, IVa, IVb, V, VI, respectively with surgical follow-up available ranging from 27% to 100% within each category. Ancillary studies including histochemistry, immunocytochemistry (IHC), and in situ hybridization (ISH) were beneficial in 60%-100% of cases in each category. Risk of malignancy was 100% in both the suspicious for malignancy (V) and malignant (VI) categories. Ancillary studies improved diagnosis in 60% of non-neoplastic cases (II, 6/10), 100% of benign neoplasm cases (IVa, 6/6), and 98.3% of malignant cases (VI, 59/60).
CONCLUSIONS: Judicious and case-based ancillary studies performed on SG FNA cell blocks with sufficient material can improve the diagnostic yield by further characterization of the atypical/neoplastic cells, particularly in MSRSGC categories IVa-VI.