Metastases to the parotid glands: An institutional experience

IF 1.2 4区医学 Q4 CELL BIOLOGY

Cytopathology Pub Date : 2024-05-16 DOI:10.1111/cyt.13387

Lea Calo, Tiziana Alboni, Carmine Bruno, Federica Policardo, Angela Feraco, Pietro Tralongo, Federica Vegni, Antonio Mulè, Francesca Brigato, Giorgia Rossi, Francesco Bussu, Liron Pantanowitz, Jacopo Galli, Esther Diana Rossi

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Abstract

Background

Metastatic lesions to the salivary gland are rare and mostly affect the parotids. Metastases represent 8% of all malignant lesions of the parotid gland. Around 80% originate from squamous cell carcinomas (SCC) of the head and neck region. Fine needle aspiration (FNA) plays a crucial role in distinguishing primary salivary gland lesions from metastases. Herein we describe our series of metastases to the parotid glands.

Materials and Methods

We analysed 630 parotid gland FNAs over a decade including conventional and liquid-based cytology specimens. Ancillary techniques such as immunocytochemistry (ICC) were conducted on cell blocks.

Results

Eighty (12.4%) cases were malignant lesions, of which 53 (63.75%) were metastases including 24% melanoma, 22.6% SCC, 19% renal carcinomas, 7.5% breast carcinomas, 11.3% lung, 9% intestinal and 1.8% testicular, malignant solitary fibrous tumour and Merkel cell carcinoma. The 53 cases, classified according to the Milan system for salivary cytopathology, belonged to 5 Suspicious for malignancy (SFM) and 48 malignant (M) categories. Forty had a known history of primary malignancy (75.4%), while 13 were suspicious to be a metastatic localisation (24.5%), distributed as 5SFM (2SCC and 3Melanoma) and 8 M. A combination of clinical history, cytomorphology and ICC identified 100% of them.

Conclusions

Fine needle aspiration plays a central role in the diagnostic workup of patients with metastatic lesions to their parotid glands, thereby defining the correct management. Diagnostic accuracy may be enhanced by applying ICC. Although melanoma and SCC are the most common histological types, several other malignancies may also metastasize to the parotid glands and should be kept into consideration.

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腮腺转移：机构经验。

背景：唾液腺转移性病变非常罕见，主要影响腮腺。转移瘤占腮腺所有恶性病变的 8%。其中约80%源自头颈部的鳞状细胞癌（SCC）。细针穿刺术（FNA）在区分原发性涎腺病变和转移瘤方面起着至关重要的作用。在此，我们对腮腺转移瘤进行了系列描述：我们分析了十年间 630 例腮腺 FNA，包括传统细胞学标本和液基细胞学标本。对细胞块进行了免疫细胞化学（ICC）等辅助技术处理：80例（12.4%）为恶性病变，其中53例（63.75%）为转移瘤，包括24%的黑色素瘤、22.6%的SCC、19%的肾癌、7.5%的乳腺癌、11.3%的肺癌、9%的肠癌和1.8%的睾丸癌、恶性单发纤维瘤和梅克尔细胞癌。根据米兰唾液细胞病理学系统对 53 例病例进行了分类，其中 5 例为可疑恶性（SFM），48 例为恶性（M）。其中 40 例有已知的原发性恶性肿瘤病史（75.4%），13 例可疑为转移灶（24.5%），分布为 5SFM （2SCC 和 3Melanoma）和 8 M。结合临床病史、细胞形态学和 ICC，100% 的患者都被确定为转移灶：结论：细针穿刺术在腮腺转移性病变患者的诊断工作中发挥着核心作用，从而确定了正确的治疗方法。应用 ICC 可以提高诊断的准确性。虽然黑色素瘤和鳞状细胞癌是最常见的组织学类型，但其他几种恶性肿瘤也可能转移到腮腺，因此也应考虑在内。

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来源期刊

Cytopathology 生物-病理学

CiteScore

2.30

自引率

15.40%

发文量

107

审稿时长

6-12 weeks

期刊介绍： The aim of Cytopathology is to publish articles relating to those aspects of cytology which will increase our knowledge and understanding of the aetiology, diagnosis and management of human disease. It contains original articles and critical reviews on all aspects of clinical cytology in its broadest sense, including: gynaecological and non-gynaecological cytology; fine needle aspiration and screening strategy. Cytopathology welcomes papers and articles on: ultrastructural, histochemical and immunocytochemical studies of the cell; quantitative cytology and DNA hybridization as applied to cytological material.