FINE-NEEDLE ASPIRATION OF NORMAL TISSUE FROM ENLARGED SALIVARY-GLANDS- SIALOSIS OR MISSED TARGET

Salivary gland enlargement by hypertrophy of normal-appearing parotid or submaxillary tissue is known as sialosis. It can be idiopathic, or may be associated with malnutrition, diabetes, bulimia, or alcoholism. When normal tissue is aspirated from an enlarged gland, one is tempte d to diagnose sialosis. We performed 26 such aspirates over a 5-yr per iod. In all cases, the cytology featured abundant acinar and ductal ti ssue in a clean (noninflammatory) background. Six cases were excluded when the records showed no return visits to the clinic. The remaining 20 patients included 9 men and II women, aged 24-92 yr (median 56), wh o harbored 12 parotid (2 bilateral) and 8 unilateral submaxillary enla rgements Clinical findings included ethanol abuse (2), diabetes (I), a nd previously diagnosed head and neck carcinoma (3). In six patients, the duration of the mass was described as months or years. Excision (6 ), reaspiration (3), radiographic evaluation (2), and clinical follow- up of patients nor evaluated by other means (9 cases with median follo w-up of 6 months) revealed no malignancies. One excised gland containe d a pleomorphic adenoma measuring 0.5 cm in diameter. This had been di agnosed by repeat fine-needle aspiration (FNA) prior to surgery. We su ggest that sialosis is a meaningful FNA diagnosis in patients who are carefully examined skillfully aspirated, and reasonably followed. (C) 1995 Wiley-Liss, Inc.