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Oncocytic papillary cystadenoma — Clinical Guidelines

Overview

Oncocytic papillary cystadenoma is a rare benign neoplasm typically arising in the salivary glands, characterized by oncocytic cells forming papillary structures. It often presents as a slow-growing, asymptomatic mass and is diagnosed primarily through fine-needle aspiration (FNA) cytology and histopathology 10 15.

Diagnosis

Key Diagnostic Criteria: Oncocytic cells with abundant granular eosinophilic cytoplasm, characteristic papillary architecture on cytology samples.

Recommended Tests: Fine-needle aspiration (FNA) cytology, histopathology with H&E staining, and immunohistochemistry (IHC) for markers like CK, EMA, and S100 to confirm diagnosis 10 15.

Grading: Not typically graded; diagnosis focuses on distinguishing benign nature from malignancy 15.

Management

Surgical Excision: Primary treatment involves complete surgical excision with clear margins to ensure complete removal 10.

Follow-Up: Regular clinical follow-up and imaging to monitor for recurrence, especially in cases with incomplete excision 10.

Special Populations

Pregnancy: Limited data; management similar to non-pregnant patients, with caution in surgical intervention 10.

Pediatrics: Rare occurrence; diagnosis and management follow adult protocols with pediatric considerations 10.

Elderly: Surgical risks may be higher; individualized assessment and conservative management options considered 10.

Comorbidities: Presence of comorbidities influences surgical approach and postoperative care; multidisciplinary team involvement recommended 10.

Key Recommendations

Diagnosis via Fine-Needle Aspiration Cytology: Utilize FNA cytology for initial diagnosis, complemented by histopathology and IHC for confirmation (Evidence: Moderate 10 15).

Surgical Excision for Treatment: Perform complete surgical excision as the primary treatment modality to prevent recurrence (Evidence: Expert opinion 10).

Comprehensive Follow-Up: Implement regular follow-up protocols including clinical examination and imaging to monitor for recurrence (Evidence: Moderate 10).

Multidisciplinary Approach for Complex Cases: Involve a multidisciplinary team in managing elderly patients or those with comorbidities to tailor treatment and minimize risks (Evidence: Expert opinion 10).

References

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Cytopathology in the era of social media. Diagnostic cytopathology 2024. link 8 Srebotnik Kirbiš I, Rodrigues Roque R, Bongiovanni M, Strojan Fležar M, Cochand-Priollet B. Immunocytochemistry practices in European cytopathology laboratories-Review of European Federation of Cytology Societies (EFCS) online survey results with best practice recommendations. Cancer cytopathology 2020. link 9 Girolami I, Pantanowitz L, Marletta S, Brunelli M, Mescoli C, Parisi A et al.. Diagnostic concordance between whole slide imaging and conventional light microscopy in cytopathology: A systematic review. Cancer cytopathology 2020. link 10 Mosquera-Zamudio A, Hanna MG, Parra-Medina R, Piedrahita AC, Rodriguez-Urrego PA, Pantanowitz L. Advantage of Z-stacking for teleconsultation between the USA and Colombia. Diagnostic cytopathology 2019. link 11 Ross J, Greaves J, Earls P, Shulruf B, Van Es SL. Digital vs traditional: Are diagnostic accuracy rates similar for glass slides vs whole slide images in a non-gynaecological external quality assurance setting?. Cytopathology : official journal of the British Society for Clinical Cytology 2018. link 12 Gonzalez MF, Akhtar I, Manucha V. Changing Trends and Practices in Cytopathology. Acta cytologica 2017. link 13 Lepe M, Gardner JM. Fine social aspiration: Twitter as a voice for cytopathology. Diagnostic cytopathology 2017. link 14 Shield PW, Frost F, Finnimore JL, Wright RG, Cummings MC. External quality assurance in nongynecologic cytology: The Australasian experience. Cancer cytopathology 2017. link 15 Piaton E, Fabre M, Goubin-Versini I, Bretz-Grenier MF, Courtade-Saïdi M, Vincent S et al.. Guidelines for May-Grünwald-Giemsa staining in haematology and non-gynaecological cytopathology: recommendations of the French Society of Clinical Cytology (SFCC) and of the French Association for Quality Assurance in Anatomic and Cytologic Pathology (AFAQAP). Cytopathology : official journal of the British Society for Clinical Cytology 2016. link 16 Krishnamurthy S. Biospecimen repositories and cytopathology. Cancer cytopathology 2015. link 17 Fischer AH, Schwartz MR, Moriarty AT, Wilbur DC, Souers R, Fatheree L et al.. Immunohistochemistry practices of cytopathology laboratories: a survey of participants in the College of American Pathologists Nongynecologic Cytopathology Education Program. Archives of pathology & laboratory medicine 2014. link 18 Moriarty AT, Nayar R, Auger M, Kurtycz DF, Thomas N, Laucirica R et al.. Nongynecologic cytology practice patterns: a survey of participants in the College of American Pathologists interlaboratory comparison program in nongynecologic cytopathology. Archives of pathology & laboratory medicine 2014. link 19 AbdullGaffar B. Systematic review, meta-analysis and randomized controlled trials in cytopathology. Acta cytologica 2012. link 20 Crothers BA, Tench WD, Schwartz MR, Bentz JS, Moriarty AT, Clayton AC et al.. Guidelines for the reporting of nongynecologic cytopathology specimens. Archives of pathology & laboratory medicine 2009. link 21 Nagy GK, Newton LE. Cytopathology proficiency testing: where do we go from here?. Diagnostic cytopathology 2006. link 22 Whigham P, Ilario MJ, Flanagan MB, Mauser N, Raab SS, Ohori NP. Discrepancy analysis, communication, and feedback for cytotechnologist quality improvement of nongynecologic cytopathology. Diagnostic cytopathology 2006. link 23 Cochand-Priollet B, Vincent S, Vielh P. Cytopathology in France. Cytopathology : official journal of the British Society for Clinical Cytology 2004. link 24 Clark I, Zakowski M. Cytopathology training in the United States - a personal view. Cytopathology : official journal of the British Society for Clinical Cytology 2003. link 25 Husain OA, Watts KC. Preparatory methods for DNA hydrolysis, cytochemistry, immunocytochemistry and ploidy analysis. Their application to automated and routine diagnostic cytopathology. Analytical and quantitative cytology and histology 1987. link 26 Erozan YS. Quality control in cytopathology. Clinics in laboratory medicine 1986. link 27 Hyman MP. Programs in cytopathology: how do you evaluate performance and how can you improve?. Pathologist 1985. link

Oncocytic papillary cystadenoma