title: FNA biopsy of secondary nonlymphomatous malignancies in salivary glands: A multi-institutional study of 184 cases.
abstract: BACKGROUND
  Secondary malignancies of salivary glands (SMSGs) are among the most common malignant neoplasms to involve the salivary glands. Fine-needle aspiration biopsy (FNAB) of SMSG can present diagnostic challenges. The current report presents the largest such FNAB series to date.
  
  
  METHODS
  A search of the pathology database from 6 academic institutions identified 184 FNAB cases of nonlymphomatous SMSG.
  
  
  RESULTS
  Of the 184 cases, 171 were of the parotid glands, and 13 were of the submandibular glands; 130 patients were men, and 54 were women, and the mean patient age at diagnosis was 68 years. Metastatic squamous cell carcinoma (SCC) from all sites (n = 87) and melanoma (n = 67) constituted the majority of SMSGs. Less frequent SMSGs were comprised of metastatic carcinomas from distant organs (n = 16), including sites in the breast, lung, kidney, thyroid, pancreatobiliary, prostate, and bladder. Other uncommon SMSGs, including nasopharyngeal carcinoma (n = 3), sarcoma (n = 4), other metastatic skin-derived carcinomas (n = 6), and metastatic chordoma (n = 1), also were observed. Ancillary tests were performed on 37 FNAB specimens (20.1%) to aid the evaluation. One hundred forty-seven specimens (79.9%) had a definitive diagnosis with accurate tumor subtyping, 21 (11.4%) had a definitive malignant diagnosis but without specifying subtype, 9 (4.9%) had an indeterminate diagnosis, and 7 (3.8%) had a false-negative diagnosis.
  
  
  CONCLUSIONS
  SMSGs originate predominately from the head and neck and are more common in older men. Overall, the FNAB diagnosis of SMSG is accurate, but diagnostic challenges can be encountered, especially in SCC types of SMSG. Ancillary studies are needed for the definitive diagnosis of challenging cases. Cancer Cytopathol 2017;125:91-103. © 2016 American Cancer Society.
authors.affiliation: Department of Pathology and Laboratory Medicine, Temple University Hospital, Philadelphia, Pennsylvania.
authors.forename: He
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Harvard University, Boston, Massachusetts.
authors.forename: Raza S
authors.initials: RS
authors.lastname: Hoda
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Harvard University, Boston, Massachusetts.
authors.forename: William
authors.initials: W
authors.lastname: Faquin
authors.affiliation: Department of Anatomic Pathology and Histology, the Catholic University of Rome, Rome, Italy.
authors.forename: Esther Diana
authors.initials: ED
authors.lastname: Rossi
authors.affiliation: Department of Pathology and Laboratory Medicine, Temple University Hospital, Philadelphia, Pennsylvania.
authors.forename: Nihar
authors.initials: N
authors.lastname: Hotchandani
authors.affiliation: Department of Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Tianlin
authors.initials: T
authors.lastname: Sun
authors.affiliation: Department of Pathology, Geneva University Hospital, Geneva, Switzerland.
authors.forename: Marc
authors.initials: M
authors.lastname: Pusztaszeri
authors.affiliation: Department of Anatomic Pathology and Histology, the Catholic University of Rome, Rome, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Bizzarro
authors.affiliation: Institute of Pathology, University Hospital, Lausanne, Switzerland.
authors.forename: Massimo
authors.initials: M
authors.lastname: Bongiovanni
authors.affiliation: Department of Pathology and Laboratory Medicine, Temple University Hospital, Philadelphia, Pennsylvania.
authors.forename: Viren
authors.initials: V
authors.lastname: Patel
authors.affiliation: Department of Pathology and Laboratory Medicine, Temple University Hospital, Philadelphia, Pennsylvania.
authors.forename: Nirag
authors.initials: N
authors.lastname: Jhala
authors.affiliation: Department of Anatomic Pathology and Histology, the Catholic University of Rome, Rome, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Fadda
authors.affiliation: Department of Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Yun
authors.initials: Y
authors.lastname: Gong
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010306:Parotid Gland / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D012468:Salivary Gland Neoplasms / Q000175:diagnosis / Q000473:pathology*; D013363:Submandibular Gland / Q000473:pathology; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary
keywords: ancillary test; fine-needle aspiration biopsy; metastasis; multi-institutional; salivary gland