Salivary gland tumor fine-needle aspiration biopsy (FNAB)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Biopsy of the tumor tissue is diagnostic of salivary gland tumor. Histopathological findings on biopsy can be found here.

Fine-needle aspiration biopsy

A biopsy is required to establish a definitive diagnosis of a salivary gland tumor and to plan therapy. A preoperative biopsy (either fine needle aspiration cytology or ultrasound guided core needle) can be performed to avoid operating on a nonsurgically-managed disease process and to aid in surgical planning, if anatomically feasible. However, a preoperative histologic diagnosis is not always possible.

• In most cases, local excision with a margin of normal tissue is the appropriate form of biopsy for a major salivary gland tumor. In the parotid region, this requires identification of the facial nerve. For submandibular tumors, the entire submandibular triangle is cleared. In contrast, minor salivary gland tumors have a higher likelihood of being malignant, and an incisional biopsy is performed initially so that definitive treatment can be planned.
• In the parotid region, the presence of pain, recent rapid enlargement of a preexisting nodule, skin involvement, or facial nerve paralysis suggests cancer. Enlarged cervical lymph nodes in association with a salivary gland tumor are considered a manifestation of cancer until proved otherwise. Fine-needle aspiration is indicated if accurate diagnosis will allow for better treatment planning.

During a biopsy, tissues or cells are removed from the body so they can be tested in a laboratory. The pathology report from the laboratory will confirm whether or not cancer cells are present in the sample. The biopsies that could be used for salivary gland cancer are:

• Fine needle aspiration (FNA)
  • Fine needle aspiration (FNA) provides a highly accurate assessment of the cells for diagnosis. It helps to determine whether a lump is a salivary gland tumor, an infection or another type of cancer. Fine needle aspiration (FNA) biopsy: The removal of tissue or fluid using a thin needle. A pathologist views the tissue or fluid under a microscope to look for cancer cells. In order to make a final diagnosis of salivary gland cancer a sample of tissue from the area is taken and examined under a microscope to look for signs of cancer.
  • Ultrasound-guided needle biopsy. During ultrasound-guided needle biopsy, the images produced by an ultrasound is used to guide a needle into the tumor.
• Incisional biopsy
  • A small piece of the lump is removed and looked at under a microscope to see if cancer cells are present. It may be done if the FNA does not provide enough tissue for diagnosis, but is not done very often. If doctors cannot confirm the diagnosis of a salivary gland tumour even after imaging tests or FNA, surgery is done and the tumour is tested for cancer cells after it is surgically removed.