Salivary duct carcinoma - Is a specific diagnosis possible by fine needle aspiration cytology?

OBJECTIVE: To review the cytomorphologic features of salivary duct carcinom a and to evaluate the likelihood of definitive diagnosis by fine needle asp iration. STUDY DESIGN: The cytomorphologic features of two cases of salivary duct ca rcinoma, both occurring in the parotid gland in men over 80 years of age, w ere evaluated by fine needle aspiration and compared to cytologic features described in the literature. Additionally, previously reported diagnoses re ndered by fine needle aspiration of salivary duct carcinomas were compiled from the cytology literature. The likelihood of arriving at a definitive di agnosis by fine needle aspiration was determined from the frequency of corr ect cytologic diagnoses reported in the literature. RESULTS: The most characteristic features of salivary duct carcinoma by fin e needle aspiration appear to be lat sheets with a cribriform pattern and t umor cells in a necrotic background with pleomorphic, eccentric nuclei and granular cytoplasm. However, no definitive diagnoses of salivary duct carci noma by fine needle aspiration have been recorded in the cytology literatur e. CONCLUSION: Because of the morphologic spectrum displayed by this tumor and the absence of definitive cytologic diagnoses in the literature to date, i t is unclear whether a diagnosis of salivary duct carcinoma can be rendered by fine needle aspiration. Nevertheless, if cribriform groups are noted in a salivary gland aspirate, the diagnosis of salivary duct carcinoma should at least be considered.