Algorithm for cytological diagnosis of nonneoplastic lesions of the salivary glands

The aim of this study was to formulate an algorithm for the cytologic diagnosis of nonneoplastic enlargements of the salivary gland.Smear cellularity and cytological features such as presence of epithelial cells and types of inflammation were assessed in a retrospective study of 201 aspirates. One hundred and forty-six were inflammatory, 19 were noninflammatory nonneoplastic, and 36 were cystic lesions. Of the cystic lesions, cytological evidence of retention cyst was seen in seven, while two aspirates with only hemosiderin-laden macrophages were hematomas. The remaining 27 defied subclassification. Noninflammatorynonneoplastic lesions included 5 fatty infiltrations, 2 sialadenosis, and 12 normal salivary glands. Forty-two lesions were acute inflammations, 89 were chronic, and 15 were granulomatous. Cytomorphologic patterns identified in samples with acute inflammation were 9 abscesses, 29 acute obstructive sialadenitis, and 4 acute infective sialadenitis. Three aspirates with chronic inflammation were lymphoepithelial lesions, 82 chronic sialadenitis, and 4 lymph node in salivary gland. Fifteen granulomatous lesions were 10 tuberculosis, 3 sarcoidosis, and 2 foreign body granulomas. Using the proposed algorithmic approach, nonneoplastic salivary gland enlargement could be placed into distinct, clinically relevant diagnostic categories.