Skip to content
DraconiticResearch
Search Sources API
201,818 studies31 sourcesUpdated 33 min ago
Peer-reviewedCC BY 4.0Diagnostic Cytopathology

Fine‐Needle Aspiration of Salivary Gland Tumors With Low‐Grade Oncocytic Features: Focusing on Oncocytoma Versus Oncocytic Mucoepidermoid Carcinoma

  • Lois Araneta1,2,3
  • Ying‐Ju Kuo3,4
  • Jen‐Fan Hang3,4
4 affiliations
  1. 1Rizal Medical Center Pasig City Metro Manila Philippines
  2. 2Chinese General Hospital College of Medicine Manila Philippines
  3. 3Department of Pathology and Laboratory Medicine Taipei Veterans General Hospital Taipei Taiwan
  4. 4Department of Pathology, School of Medicine National Yang Ming Chiao Tung University Taipei Taiwan
Read full textPDFDOICite

Abstract

Background: Salivary gland fine‐needle aspirates (FNAs) with low‐grade oncocytic features are diagnostically challenging due to the substantial morphologic overlap between benign oncocytic tumors and their malignant mimickers. This study evaluates the diagnostic discriminators, performance, and risk of malignancy of these lesions using the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC).

Methods: We retrospectively reviewed salivary gland FNA cases (2021–2025) categorized as Milan IVa: Benign neoplasm with oncocytic features, including Warthin tumor and oncocytoma/nodular oncocytic hyperplasia (NOH), and Milan IVb: Salivary gland neoplasm of uncertain malignant potential (SUMP) with oncocytic features, with surgical follow‐up. Cytomorphological analysis was performed on liquid‐based cytology (LBC), direct smears, and cell blocks. Features including architectural patterns, cytological details, and background were correlated with histology.

Results: Forty‐nine cases were included. All 43 cases diagnosed as Milan IVa were confirmed as Warthin tumor or oncocytoma/nodular oncocytic hyperplasia. Warthin tumor shows cohesive, flat clusters of oncocytes along with a cystic debris‐like background, while oncocytoma/NOH shows compact globoid clusters of oncocytes with a “bunch of grapes” pattern and clean background. In the six Milan IVb cases, follow‐up histology included oncocytic mucoepidermoid carcinoma (OMEC, n = 2), oncocytoma/nodular oncocytic hyperplasia (n = 2), oncocytic lipoadenoma (n = 1), and spindle cell lipoma (n = 1). The OMEC cases form discohesive clusters and single cells. Cell block preparations revealed focal glandular structures and rare intracytoplasmic mucin.

Conclusion: The MSRSGC effectively risk‐stratifies low‐grade oncocytic salivary gland lesions. While cohesive, organoid architecture supports a benign diagnosis, the presence of isolated cells and discohesive clusters is better classified as SUMP. Cell block preparation is useful for identifying mucin and glandular differentiation.

Related

  1. Proximal Tracheal Mucoepidermoid Carcinoma Complicated by Early Anastomotic Stenosis—A Case Report
    Shivanjali Pandya, Gani Nuredini, Jahangir Ahmed +1
    Clinical case reportsPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  2. Primary pulmonary mucoepidermoid carcinoma: a case report
    Shaoyong Dong, Jing Sun, Ying Yang
    Frontiers in MedicinePeer-reviewedCC BY 4.0Full textSurgery & anaesthesiaPMCEurope PMC
  3. Imaging features of synchronous bilateral primary tumors of oncocytic thyroid carcinoma and papillary thyroid carcinoma: A case report
    Qi-Shu Gong, Xiao-Wen Liu, Xun-Peng Luo +1
    World journal of radiologyPeer-reviewedCC BY-NCFull textEndocrinology & metabolismEurope PMCPMC
  4. MALAT1::PLAG1 Fusion in Pleomorphic Adenoma with Mucinous and Squamous Metaplasia: A Diagnostic Pitfall Mimicking Mucoepidermoid Carcinoma (ex Pleomorphic Adenoma)
    Liang Lu, Martina Bradová, Elan Hahn +4
    Head and Neck PathologyPeer-reviewedCC BY 4.0Full textSurgery & anaesthesiaPMC
  5. Excellent prognosis of oncocytic thyroid carcinoma in Japanese patients: a single-institution study
    Yasuhiro Ito, Mitsuyoshi Hirokawa, Hiroo Masuoka +4
    Endocrine JournalPeer-reviewedCC BY-NC-NDFull textEndocrinology & metabolismJ-STAGE

Cite

BibTeXRIS
BibTeX
@article{araneta2026fineneedle,
  title = {{Fine‐Needle Aspiration of Salivary Gland Tumors With Low‐Grade Oncocytic Features: Focusing on Oncocytoma Versus Oncocytic Mucoepidermoid Carcinoma}},
  author = {Lois Araneta and Ying‐Ju Kuo and Jen‐Fan Hang},
  journal = {Diagnostic Cytopathology},
  year = {2026},
  month = aug,
  doi = {10.1002/dc.70202},
  url = {https://doi.org/10.1002/dc.70202},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Fine‐Needle Aspiration of Salivary Gland Tumors With Low‐Grade Oncocytic Features: Focusing on Oncocytoma Versus Oncocytic Mucoepidermoid Carcinoma
AU  - Lois Araneta
AU  - Ying‐Ju Kuo
AU  - Jen‐Fan Hang
PY  - 2026
DA  - 2026/08/25
JO  - Diagnostic Cytopathology
DO  - 10.1002/dc.70202
UR  - https://doi.org/10.1002/dc.70202
AB  - Background: Salivary gland fine‐needle aspirates (FNAs) with low‐grade oncocytic features are diagnostically challenging due to the substantial morphologic overlap between benign oncocytic tumors and their malignant mimickers. This study evaluates the diagnostic discriminators, performance, and risk of malignancy of these lesions using the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC).  Methods: We retrospectively reviewed salivary gland FNA cases (2021–2025) categorized as Milan IVa: Benign neoplasm with oncocytic features, including Warthin tumor and oncocytoma/nodular oncocytic hyperplasia (NOH), and Milan IVb: Salivary gland neoplasm of uncertain malignant potential (SUMP) with oncocytic features, with surgical follow‐up. Cytomorphological analysis was performed on liquid‐based cytology (LBC), direct smears, and cell blocks. Features including architectural patterns, cytological details, and background were correlated with histology.  Results: Forty‐nine cases were included. All 43 cases diagnosed as Milan IVa were confirmed as Warthin tumor or oncocytoma/nodular oncocytic hyperplasia. Warthin tumor shows cohesive, flat clusters of oncocytes along with a cystic debris‐like background, while oncocytoma/NOH shows compact globoid clusters of oncocytes with a “bunch of grapes” pattern and clean background. In the six Milan IVb cases, follow‐up histology included oncocytic mucoepidermoid carcinoma (OMEC, n = 2), oncocytoma/nodular oncocytic hyperplasia (n = 2), oncocytic lipoadenoma (n = 1), and spindle cell lipoma (n = 1). The OMEC cases form discohesive clusters and single cells. Cell block preparations revealed focal glandular structures and rare intracytoplasmic mucin.  Conclusion: The MSRSGC effectively risk‐stratifies low‐grade oncocytic salivary gland lesions. While cohesive, organoid architecture supports a benign diagnosis, the presence of isolated cells and discohesive clusters is better classified as SUMP. Cell block preparation is useful for identifying mucin and glandular differentiation.
SN  - 8755-1039
SN  - 1097-0339
ER  -