The main goal of fine-needle aspiration (FNA) of salivary gland lesions is
to assist the clinician in the management of patients who present with a ma
ss lesion, Cytologic examination aims to determine, if a process is inflamm
atory and/or reactive, benign or malignant neoplasm and if possible renders
a specific diagnosis. It has been argued that in the area of salivary glan
d tumors, surgical management relies less heavily on a specific preoperativ
e diagnosis, because almost all neoplastic salivary gland lesions will unde
rgo surgical excision. However, knowing beforehand if a lesion is malignant
or benign, will aid in planning surgery and may prompt or postpone decisio
ns for surgical intervention. The salivary glands are unique in their histo
logic complexity and morphological variability of tumors, which is reflecte
d in the cytologic material. In addition to the overlapping morphologic pat
terns of salivary gland tumors, they also represent relatively rare lesions
, thus making it more difficult to acquire diagnostic expertise in FNA, Oth
er than approaching salivary gland tumors by a description of single entiti
es in their benign and malignant categories, we favor a more practical appr
oach to diagnosis based on the key morphologic features noted in FNAs. This
article addresses differential diagnoses according to the predominant cyto
logic presentation with attention to the cell type and size, nature of the
cytoplasm, and the smear background. Copyright (C) 2001 by W.B. Saunders Co
mpany.