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Role of fine‑needle aspiration cytology and cell morphology in determining the histogenesis of salivary gland lesions

  • Authors:
    • Bisharah Soudah
    • Mahmoud Abbas
  • View Affiliations / Copyright

    Affiliations: Institute of Pathology, Hannover Medical School, D‑30625 Hannover, Germany, Gerhard‑Domagk‑Institute of Pathology, University Hospital Münster, D‑48149 Münster, Germany
    Copyright: © Soudah et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 237
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    Published online on: July 6, 2026
       https://doi.org/10.3892/etm.2026.13233
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Abstract

Fine‑needle aspiration (FNA) of suspicious salivary and neck swellings is a simple and cost‑effective diagnostic method for the evaluation of inflammatory and neoplastic conditions. The aim of the present study was to evaluate the diagnostic accuracy of FNA cytology (FNAC) in determining the histogenesis of salivary gland lesions based on cytomorphological features and associated histopathological outcomes to refine diagnostic criteria and contribute to improved diagnostic accuracy in salivary gland cytopathology. FNA was performed in 544 patients at the Institute of Pathology, Hannover Medical School (Hannover, Germany). The cytological smears were stained with May‑Grunwald Giemsa, Papanicolaou and periodic acid‑Schiff and compared with histological specimens from the same patients using immunohistochemical and molecular methods. The samples were anonymized and analyzed retrospectively. Of the total cases, 422 (77.57%) were benign lesions, 59 (10.85%) were malignant lesions and 26 (4.78%) were normal cases. Insufficient material was obtained in 37/544 cases (6.80%). No complications were observed. The concordance with histological findings for neoplastic lesions was >97.5%, with a false negative rate of 1.7%. The sensitivity of the diagnostic methods was 94% and the specificity was 98%. Of the 544 cases, 283 were female (52%) and 261 were male (48%). The diagnostic value of FNAC in representative material was relatively high in distinguishing between benign and malignant lesions. Sensitivity and specificity were variable (60.0 ‑97.5%). Correct diagnosis in the head and neck region requires interdisciplinary integration of findings and pathological‑clinical cooperation. 
View Figures

Figure 1

(A) Normal cells of the salivary
gland (magnification, x25). (B) Acute sialadenitis (magnification,
x25). (C) Chronic sialadenitis (magnification, x20). (D) Cyst with
actinomyces (magnification, x20), (E) a cystic cavity or dilated
duct, colonized by Actinomyces species, and often associated
with chronic suppurative inflammation (magnification, x20), and (F)
a cyst with actinomyces and crystal gaps (magnification, x20). (G)
Previous or resolved bleeding (magnification x20). (H) Pleomorphic
adenoma with myxoid background (magnification, x20). (I) Myxoid
background, epithelial and myoepithelial cell groups in pleomorphic
adenoma (magnification, x20). (J) Warthin's tumor, Lymphocytes and
oncocytic cells (magnification, x25). (K) Basal cell adenoma
(magnification, x20). (L) Oncocytic cells from oncocytoma
(magnification, x25).

Figure 2

(A) Adenocarcinoma NOS (MGG;
magnification, x25); (B) adenocarcinoma NOS of the salivary gland
(H&E; magnification, x20); (C) acinus cell carcinoma (MGG;
magnification, x25); (D) acinus cell carcinoma (H&E;
magnification, x20); (E) secretory carcinoma (MGG; magnification,
x25); (F) secretory carcinoma (H&E; magnification, x20). (G)
Squamous cell carcinoma (magnification, x40); (H) inflammatory
cells and necrotic cells in squamous cell carcinoma (magnification,
x40); (I) adenoid cystic ca. with globules (magnification, x40);
(J) adenoid cystic carcinoma (magnification, x25); (K)
mucoepidermoid carcinoma (magnification, x40); (L) malignant cells
of mucoepidermoid carcinoma (magnification, x40). NOS, not
otherwise specified; H&E, hematoxylin and eosin; MGG,
May-Grünwald-Giemsa.
View References

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Spandidos Publications style
Soudah B and Abbas M: Role of fine‑needle aspiration cytology and cell morphology in determining the histogenesis of salivary gland lesions. Exp Ther Med 32: 237, 2026.
APA
Soudah, B., & Abbas, M. (2026). Role of fine‑needle aspiration cytology and cell morphology in determining the histogenesis of salivary gland lesions. Experimental and Therapeutic Medicine, 32, 237. https://doi.org/10.3892/etm.2026.13233
MLA
Soudah, B., Abbas, M."Role of fine‑needle aspiration cytology and cell morphology in determining the histogenesis of salivary gland lesions". Experimental and Therapeutic Medicine 32.3 (2026): 237.
Chicago
Soudah, B., Abbas, M."Role of fine‑needle aspiration cytology and cell morphology in determining the histogenesis of salivary gland lesions". Experimental and Therapeutic Medicine 32, no. 3 (2026): 237. https://doi.org/10.3892/etm.2026.13233
Copy and paste a formatted citation
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Spandidos Publications style
Soudah B and Abbas M: Role of fine‑needle aspiration cytology and cell morphology in determining the histogenesis of salivary gland lesions. Exp Ther Med 32: 237, 2026.
APA
Soudah, B., & Abbas, M. (2026). Role of fine‑needle aspiration cytology and cell morphology in determining the histogenesis of salivary gland lesions. Experimental and Therapeutic Medicine, 32, 237. https://doi.org/10.3892/etm.2026.13233
MLA
Soudah, B., Abbas, M."Role of fine‑needle aspiration cytology and cell morphology in determining the histogenesis of salivary gland lesions". Experimental and Therapeutic Medicine 32.3 (2026): 237.
Chicago
Soudah, B., Abbas, M."Role of fine‑needle aspiration cytology and cell morphology in determining the histogenesis of salivary gland lesions". Experimental and Therapeutic Medicine 32, no. 3 (2026): 237. https://doi.org/10.3892/etm.2026.13233
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