Cytopathological features of secretory carcinoma of salivary glands and ancillary techniques in its diagnostics: impact of new Milan system for reporting salivary gland cytopathology.

Authors:
Alena Skalova
Alena Skalova
Charles University in Prague
Czech Republic
Ivana Kholova
Ivana Kholova
Fimlab Laboratories

APMIS 2019 Jul 24;127(7):491-502. Epub 2019 May 24.

Department of Pathology, Fimlab Laboratories, Tampere, Finland.

Secretory carcinoma (SC) of salivary glands is a newly described low-grade malignancy characterized by the presence of ETV6 rearrangement. Only a few cases and very small series with cytomorphology were reported so far. Six cases of fine-needle aspirations (FNAs) from afterward histologically, immunohistochemically and genetically confirmed SCs were retrieved from the archives of the authors. Ancillary immunocytochemistry (ICC) and translocation detection were performed on cell blocks (CBs). All aspirates were sufficiently cellular and cells were arranged in more or less cohesive groups with only mild nuclear polymorphism. The cytoplasm was eosinophilic, granulated and vacuolated, especially in CBs. Secretory material within the microcystic spaces was periodic acid-Schiff (PAS) positive. Triple positivity of immunomarkers S-100 protein, mammaglobin and vimentin was present. The proliferation index was low. Ancillary techniques suggested the possibility of SC in a few cytology cases; nevertheless, the final diagnosis was based on histomorphology, immunohistochemistry and genetics. The SC of salivary glands is detectable pre-operatively using ICC and genetics. The presence of the diagnostic ETV6 rearrangement increases the accuracy of FNA to the maximum. According to the Milan system, cases genetically not confirmed should be categorized as Suspicious for Malignancy or Salivary Gland Neoplasm of Uncertain Malignant Potential (SUMP), both requiring surgery.

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http://dx.doi.org/10.1111/apm.12950DOI Listing
July 2019
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References

(Supplied by CrossRef)
Mammary analogue secretory carcinoma of salivary glands, containing the ETV6‐NTRK3 fusion gene: a hitherto undescribed salivary gland tumor entity
Skalova A et al.
Am J Surg Pathol 2010

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