{"id":45912,"date":"2025-11-19T17:29:52","date_gmt":"2025-11-19T09:29:52","guid":{"rendered":"https:\/\/medicine.nus.edu.sg\/pathweb\/?page_id=45912"},"modified":"2026-03-16T10:36:25","modified_gmt":"2026-03-16T02:36:25","slug":"fna-salivary-gland","status":"publish","type":"page","link":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-salivary-gland\/","title":{"rendered":"Picture Atlas &#8211; FNA: Salivary gland"},"content":{"rendered":"\n<h2>\n\t\tpicture atlas\n\t<\/h2>\n<h2>\n\t\tFINE NEEDLE ASPIRATION: salivary gland\n\t<\/h2>\n\t<p>Here are some examples of classical conditions, organised according to categories in The Milan System for Reporting Salivary Gland Cytology.<\/p>\n<p>Click on the specific condition to view pic:<\/p>\n<h3><strong>Milan Category: Classical cases<\/strong><\/h3>\n<ul>\n<li>\n<h4>Non-neoplastic<\/h4>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<ul>\n<li><a href=\"https:\/\/blog.nus.edu.sg\/cytoweb\/picture-atlas\/salivary-gland\/#Normal\"><\/a><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-salivary-gland\/#normal\">Normal<\/a><\/li>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-salivary-gland\/#Sialadenitis\">Sialadenitis<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<h4>Benign Neoplasm<\/h4>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<ul>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-salivary-gland\/#PA\">Pleomorphic Adenoma<\/a><\/li>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-salivary-gland\/#WT\">Warthin Tumour<\/a><\/li>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-salivary-gland\/#Oncocytoma\">Oncocytoma<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<h4>Malignant<\/h4>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<ul>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-salivary-gland\/#Acinic\">Acinic Cell Carcinoma<\/a><\/li>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-salivary-gland\/#Adenoid\">Adenoid Cystic Carcinoma<\/a><\/li>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-salivary-gland\/#MEC\">Mucoepidermoid Carcinoma<\/a><\/li>\n<li><a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-salivary-gland\/#SDC\">Salivary Duct Carcinoma<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3>\n\t\tNon-neoplastic entities\n\t<\/h3>\n<h4>\n\t\tcase 1\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Normal-SC-case-1.jpg\" alt=\"Normal SC case 1\" itemprop=\"image\" height=\"678\" width=\"1244\" title=\"Normal SC case 1\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Normal salivary gland<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Normal-SC-case-1.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<ul>\n<li>Aspiration usually in microfragments of tissue.<\/li>\n<li>Acinar cells forming grape-like clusters display an eccentric small round nuclei with indistinct nucleoli and abundant vacuolated cytoplasm.<\/li>\n<li>Flat cohesive sheet of tubule of ductal cells display uniform, small cuboidal cells with round or oval nuclei and dense, sometimes squamoid, cytoplasm.<\/li>\n<li>Fibrovascular stroma holding acinar and ductal cells together.<\/li>\n<li>Adipose tissue can be seen.<\/li>\n<li>Scattered bared acinar cell nuclei may mimic lymphocytes derives from intraparotid or adjacent lymph nodes.<\/li>\n<\/ul>\n<h4>\n\t\tcase 2\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Sialadenitis-case-2.jpg\" alt=\"Sialadenitis case 2\" itemprop=\"image\" height=\"678\" width=\"1244\" title=\"Sialadenitis case 2\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Acute Sialadenitis<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Sialadenitis-case-2.1.jpg\" alt=\"\" width=\"1130\" height=\"616\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n<ul>\n<li>Aspirated material may be grossly purulent.<\/li>\n<li>Varying numbers of neutrophils seen.<\/li>\n<li>Small sheets of ductal cells admixed with fibrin, +\/- background of necrotic debris.<\/li>\n<\/ul>\n<h3>\n\t\tBenign Neoplasm\n\t<\/h3>\n<h4>\n\t\tcase 3\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/PA-case-3.jpg\" alt=\"PA case 3\" itemprop=\"image\" height=\"678\" width=\"1244\" title=\"PA case 3\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Pleomorphic adenoma (PA)<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/PA-case-3.1.jpg\" alt=\"\" width=\"1244\" height=\"678\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n\n\n<ul>\n<li>Epithelial cells &#8216;blend&#8217; into stroma, becoming more spindled within the stroma.<\/li>\n<li>Myoepithelial cells can appear in several forms: epithelioid, plasmacytoid and spindle-shaped and are commonly found within the metachromatic fibrillary stroma which stained intensely red to purple with Romanowsky stains.<\/li>\n<li>Plasmacytoid cells may also be seen singly dispersed in the background.<\/li>\n<\/ul>\n<h4>\n\t\tcase 4\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/WT-case-4.jpg\" alt=\"WT case 4\" itemprop=\"image\" height=\"678\" width=\"1244\" title=\"WT case 4\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Warthin Tumour<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/WT-case-4.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<ul>\n<li>Aspiration may yield cyst fluid.<\/li>\n<li>Flat cohesive monolayered sheets of oncocytes displaying round to oval, centrallu placed nuclei with bland chromatin and inconspicuous nucleoli and abundant densely granular cytoplasm which are orangeophilic.<\/li>\n<li>Mixed population of background lymphocytes, mainly mature lymphocytes.<\/li>\n<li>Amorphous and granular debris present in the background<\/li>\n<\/ul>\n<h4>\n\t\tcase 5\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Oncocytoma-case-5.jpg\" alt=\"Oncocytoma case 5\" itemprop=\"image\" height=\"678\" width=\"1244\" title=\"Oncocytoma case 5\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Oncocytoma<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/Oncocytoma-case-5.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<ul>\n<li>Cohesive, multilayered aggregates of oncocytes displaying round to oval, central placed nuclei with bland chromatin and inconspicuous nucleoli and abundant densely granular cytoplasm which is orangeophilic. Sometimes a nested architecture is discernible, unlike the flatter monolayered sheets seen in Warthin tumour.<\/li>\n<li>Scattered bare nuclei may be present.<\/li>\n<li>Absence of cyst debris and lymphocytes (both often present in Warthin tumour).<\/li>\n<li>Oncocytoma vs nodular oncocytosis is difficult to distinguish with radiologic correlation.<\/li>\n\n<\/ul>\n<h3>\n\t\tmalignant\n\t<\/h3>\n<h4>\n\t\tcase 6\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ACC-case-6.1.jpg\" alt=\"ACC case 6.1\" itemprop=\"image\" height=\"576\" width=\"1024\" title=\"ACC case 6.1\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ACC-case-6.2.jpg\" alt=\"ACC case 6.2\" itemprop=\"image\" height=\"565\" width=\"1024\" title=\"ACC case 6.2\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ACC-case-6.3.jpg\" alt=\"ACC case 6.3\" itemprop=\"image\" height=\"565\" width=\"1024\" title=\"ACC case 6.3\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ACC-case-6.4.jpg\" alt=\"ACC case 6.4\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"ACC case 6.4\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Acinic Cell Carcinoma<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ACC-case-6.1.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ACC-case-6.2.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ACC-case-6.3.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ACC-case-6.4.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n\n<ul>\n<li>Large branching tissue fragments with central vessels.<\/li>\n<li>Polygonal neoplastic cells forming vague acinar structures.<\/li>\n<li>The nuclei are usually round and fairly bland, sometimes with prominent nucleoli.<\/li>\n<li>Cytoplasm is abundant and granular or vacuolated.<\/li>\n<li>Bared round nuclei may be seen in the background.<\/li>\n<li>DDx: Normal salivary gland parenchyma &#8211; Tighter, well-formed grape-like clusters; some lobules may also feature ductal cells; may also have adipose stroma (which is not seen in Acinic cell carcinoma).<\/li>\n<\/ul>\n<h4>\n\t\tcase 7\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ADCC-case-7.1.jpg\" alt=\"ADCC case 7.1\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"ADCC case 7.1\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ADCC-case-7.2.jpg\" alt=\"ADCC case 7.2\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"ADCC case 7.2\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ADCC-case-7.3.jpg\" alt=\"ADCC case 7.3\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"ADCC case 7.3\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ADCC-case-7.4.jpg\" alt=\"ADCC case 7.4\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"ADCC case 7.4\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ADCC-case-7.5.jpg\" alt=\"ADCC case 7.5\" itemprop=\"image\" height=\"566\" width=\"1024\" title=\"ADCC case 7.5\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Adenoid Cystic Carcinoma<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ADCC-case-7.1.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ADCC-case-7.2.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ADCC-case-7.3.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ADCC-case-7.4.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/ADCC-case-7.5.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n\n\n\n<ul>\n<li>Three variants: Tubular, cribriform and solid.<\/li>\n<li>May present in combination.<\/li>\n<li>Abundant acellular matrix which stains intensely metachromatic with Romanowsky stain while nearly invisible on Papanicolaou stain.<\/li>\n<li>Matrix\/stroma is arranged in discrete, large globules with sharp borders and sometimes as cylinders.<\/li>\n<li>The cells are basaloid and uniform with oval to angulated, hyperchromatic nuclei and scant cytoplasm.<\/li>\n<li>Cells often surround balls of matrix.<\/li>\n<li>Sometimes bare oval nuclei are seen in the background.<\/li>\n<li>Rarely, nucleoli, mitoses and necrosis may be observed in high-grade tumours.<\/li>\n<\/ul>\n<h4>\n\t\tcase 8\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MEC-case-8.1.jpg\" alt=\"MEC case 8.1\" itemprop=\"image\" height=\"581\" width=\"1024\" title=\"MEC case 8.1\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MEC-case-8.2.jpg\" alt=\"MEC case 8.2\" itemprop=\"image\" height=\"565\" width=\"1024\" title=\"MEC case 8.2\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MEC-case-8.3.jpg\" alt=\"MEC case 8.3\" itemprop=\"image\" height=\"565\" width=\"1024\" title=\"MEC case 8.3\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MEC-case-8.4.jpg\" alt=\"MEC case 8.4\" itemprop=\"image\" height=\"565\" width=\"1024\" title=\"MEC case 8.4\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Mucoepidermoid Carcinoma<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MEC-case-8.1.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MEC-case-8.2.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MEC-case-8.3.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/MEC-case-8.4.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n\n\n\n\n<ul>\n<li>Three cell types:\n<ul>\n<li>Mucin-secreting cells: Eccentric nuclear with vacuolated cytoplasm which can be mistaken as histiocytes.<\/li>\n<li>Epidermoid cells: Polygonal and squamoid with dense cytoplasm.<\/li>\n<li>Intermediate cells: May have an immature squamous metaplasia-like appearance; or may exhibit relatively high N\/C ratios.<\/li>\n<\/ul>\n<\/li>\n<li>Low-grade MECs are commonly cystic with abundant extracellular mucin and a predominance of mucin-secreting cells showing bland nuclear features.\n<ul>\n<li>Because of the hypocellular nature and bland nuclei, low-grade MEC may be categorised as AUS or suspicious for malignancy, if there are insufficient definitive features for malignancy.<\/li>\n<li>DDx: Mucous retention cysts with squamous\/mucinous metaplasia; Benign neoplasms with metaplastic changes.<\/li>\n<\/ul>\n<\/li>\n<li>High-grade MECs have a predominance of epidermoid cells with marked cytologic atypia, and may not be recognised specifically as MEC.<\/li>\n\n<\/ul>\n<h4>\n\t\tcase 9\n\t<\/h4>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/SDC-case-9.1.jpg\" alt=\"SDC case 9.1\" itemprop=\"image\" height=\"565\" width=\"1024\" title=\"SDC case 9.1\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/SDC-case-9.2.jpg\" alt=\"SDC case 9.2\" itemprop=\"image\" height=\"565\" width=\"1024\" title=\"SDC case 9.2\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/SDC-case-9.3.jpg\" alt=\"SDC case 9.3\" itemprop=\"image\" height=\"565\" width=\"1024\" title=\"SDC case 9.3\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/SDC-case-9.4.jpg\" alt=\"SDC case 9.4\" itemprop=\"image\" height=\"565\" width=\"1024\" title=\"SDC case 9.4\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/SDC-case-9.5.jpg\" alt=\"SDC case 9.5\" itemprop=\"image\" height=\"565\" width=\"1024\" title=\"SDC case 9.5\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Diagnosis and Annotations<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<p><strong>Salivary Duct Carcinoma<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/SDC-case-9.1.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/SDC-case-9.2.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/SDC-case-9.3.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/SDC-case-9.4.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/11\/SDC-case-9.5.1.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n\n\n\n\n<ul>\n<li>High grade malignant cells occurring in clusters and singly.<\/li>\n<li>The cells exhibit large nuclei and abundant cytoplasm.<\/li>\n<li>Necrosis in the background.<\/li>\n<\/ul>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t\tCytopathology Home\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/quick-approaches\/%20\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t\tQuick Approaches\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/cyto-mystery-cases\/\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t\tMystery cases\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t\tPicture Atlas\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/sscyto\/\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t\tSSC Cytoquiz\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/www.youtube.com\/playlist?list=PL2TaQ3CT3zlCdQ4ntNg3pE93krOQSrBGt\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t\tTalking cases\n\t\t\t\t\t<\/a>\n\n","protected":false},"excerpt":{"rendered":"<p>picture atlas FINE NEEDLE ASPIRATION: salivary gland Here are some examples of classical conditions, organised according to categories in The Milan System for Reporting Salivary Gland Cytology. Click on the specific condition to view pic: Milan Category: Classical cases Non-neoplastic Normal Sialadenitis Benign Neoplasm Pleomorphic Adenoma Warthin Tumour Oncocytoma Malignant Acinic Cell Carcinoma Adenoid Cystic [&hellip;]<\/p>\n","protected":false},"author":828,"featured_media":0,"parent":46695,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-45912","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>NUS Pathweb<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/picture-atlas\/fna-salivary-gland\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:description\" content=\"picture atlas FINE NEEDLE ASPIRATION: salivary gland Here are some examples of classical conditions, organised according to categories in The Milan System for Reporting Salivary Gland Cytology. 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