Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Secretory carcinoma (SC) is a rare tumor with diverse cytologic features.To improve diagnostic accuracy, we considered differential diagnosis. Materials and Methods:We evaluated the fine-needle aspiration (FNA) of 18 cases of histologically confirmed SCs from 8 centers in Japan, reviewed and analyzed the cellular features, and discussed the differential diagnosis.Results: The age group of patients ranged from 8 to 70 years, with the mean age being 45.1 years, and the male-to-female ratio was 0.8.The mean tumor diameter was 2.0 cm.Lymph nodes and distant metastases were noted in 1 case.The diagnoses were malignant (8 of 18 tumors, 44.4%), suspicious for malignancy (2 of 18 tumors, 11.1%), salivary gland neoplasm of uncertain malignant potential (5 of 18 tumors, 27.8%), atypia of undetermined significance (2 of 18 tumors, 11.1%), and nondiagnostic (1 of 18 tumors, 5.6%), according to the Milan System for Reporting Salivary Gland Cytopathology.Only 5 of 18 cases (27.8%) were diagnosed as SCs on cytology.FNA smears were cellular and demonstrated syncytial sheets, isolated cells, and microfollicular, ball-like, papillary clusters with capillaries in cores.The tumor cells had round, cuboidal, polygonal, columnar, or tadpole shapes.The cytoplasm had microvesicular, vacuolar, lacy, granular, or oncocytic features.Nuclei were round to oval and had a smooth nuclear contour and minimal irregularities, nuclear grooves, and/or prominent nucleoli.The background contained macrophages with hemosiderin, inflammatory cells, metachromatic mucin, and/or necrotic cells.Rarely only cystic fluid was seen.Depending on the cytologic features, differential diagnoses included simple cyst, acinic cell carcinoma, pleomorphic adenoma, myoepithelioma, sebaceous tumor, mucoepidermoid carcinoma, salivary duct carcinoma, polymorphous adenocarcinoma, and intraductal carcinoma.Conclusion: Familiarity with the cytomorphologic variety of SCs can enhance diagnostic accuracy.
Source: Acta Cytologica
DOI: 10.1159/000545256
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4410217797