Course Area: Head and Neck

Malignant myoepithelioma

This uncommon tumor is composed of malignant myoepithelial cells arranged in an infiltrative growing pattern and showing high mitotic activity. The cytology is that of a highly malignant tumor, the cells are rounded or elongated, marked nuclear atypia is present. Many bare atypical nuclei are usually visible. In some occasion cytoplasmic vacuolization, nuclear and cytoplasmic […]

Squamous cell carcinoma, Undifferentiated carcinoma

This tumor is similar to the same type of tumors found in other anatomical sites: keratinizing or non-keratinizing atypical squamous cells are found in true tissue fragments, as well as in cell clusters. The center of the lesion is frequently colliquated and necrotic, which results in a fluid aspirate resembling purulent material. All well known […]

Sampling and preparation methods

Sampling methods Simple cytobrush sampling is easier in the oral cavity in case the lesion is localized (vesicular, ulcerated lesions). Free hand FNAB is useful in superficial lesions since they must be localized and fixed using the sampler’s fingers. Superficial, subcutaneous or submucosal lesions may not need US guidance; US guidance is useful to see […]

Mixed tumor

This tumor  is also called pleomorphic adenoma for its composite structure. It consists of myoepithelial elements, in some cases differentiating into squamous keratinizing cells or glandular structures, together with a stromal component. The myoepithelial cells may be plasmacytoid or epithelioid. Formation of cysts may occur. The stroma may be chrondroid, hyalinized, fibrotic or even osseous, […]

Oral cavity

Exfoliative cytology of oral cavity Infections without inflammation (AIDS): cells of the superficial squamous epithelium in a dirty background which contains many different types of infectious agents, such as bacteria, fungi, etc. The complete absence of inflammatory cells is diagnostic in these cases! The differential diagnostics is certainly any kinds of immunosuppressed status (anti-cancer treatment, […]

Warthin tumor

It occurs mainly in males, it is frequently bilateral. It has a cystic, oncocytic lymphoepithelial appearance. The cytology is that of a cystic lesion. The aspirated material is usually brown, dirty and thick. The background of the smear is composed by this ‘cystic’ dirty fluid, which contains oncocytic cells, lymphocytes and histiocytes. The oncocytes are […]

Cystic lesions

One of the most complicated diagnoses in the head and neck region is that of cystic lesions. Most of the benign cysts (branchial cleft cysts, medial cysts) are covered by squamous epithelium, many of them easily undergo inflammation. Superficial and intermediate like squamous cells, sometimes reactive (amphophilic cytoplasm, large nucleus and large nucleolus, etc.), and […]

Oncocytoma

There are monomorphous middle-sized epithelial cells in a clear background. The cytoplasm is abundant and eosinophilic (non metachromatic with Giemsa stain). The cell population is homogeneous. The cells are similar to the oncocytic cells of Whartin tumor, but lymphocytes and necrotic background are missing. Typical oncocytic cells arranged in loose sheets (A). The background is […]

Anatomy and cytology of salivary glands

Anatomy of the salivary glands There are three pairs of main salivary glands: sublingual, submandibular and parotid gland. The sublingual gland is the smallest in size, characterized mainly by mucinous glands. The submandibular gland is more lobulated with mixed glandular structure: there are both serous and mucinous structures in it. The parotid gland is characterized […]