Navigating small biopsies of salivary gland tumors: a pattern-based approach

J. Stephen Nix, Lisa M. Rooper

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Diagnosis of salivary gland tumors on small biopsy can be difficult because of overlapping morphology, limited tissue availability, and technical artifact. Although a specific diagnosis is not feasible in all cases, a cautious and thoughtful approach to the differential diagnosis and a keen awareness of clinical consequences can facilitate the most complete and useful classification possible. In this review, we present a general strategy for the evaluation of small salivary biopsies, including consideration of clinical and radiographic information, systematic assessment of histologic patterns, and judicious use of immunohistochemistry and molecular studies. We then focus on the distinctive differential diagnoses raised by 6 specific histologic patterns: tubular and cribriform architecture, squamous differentiation, mucin and other secretions, high-grade cytology, epithelial and lymphoid elements, and oncocytic features. Throughout this systematic and pattern-based approach, we focus on practical and cost-effective strategies to overcome the most common diagnostic challenges in limited material.

Original languageEnglish (US)
Pages (from-to)369-382
Number of pages14
JournalJournal of the American Society of Cytopathology
Issue number5
StatePublished - Sep 1 2020


  • Adenoid cystic carcinoma
  • Immunohistochemistry
  • Molecular diagnostics
  • Mucoepidermoid carcinoma
  • Salivary gland neoplasms
  • Small biopsy

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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