Performance characteristics of adenoid cystic carcinoma of the salivary glands in fine-needle aspirates

Results from the college of American Pathologists nongynecologic cytology program

Z. Laura Tabatabai, Manon Auger, Daniel F.I. Kurtycz, Alice Laser, Rhona J. Souers, Rodolfo Laucirica, Guliz A. Barkan, Barbara A. Crothers, Walid E. Khalbuss

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Context: Although the cytomorphology of adenoid cystic carcinoma (ACC) has been well described the accuracy of this diagnosis in fine-needle aspirates (FNAs) of the salivary glands has not been extensively evaluated. Objective: To assess participants' responses in the College of American Pathologists (CAP) Nongynecologic Cytology (NGC) Program to determine the accuracy and false-negative rate of ACC cases in salivary gland FNAs. Design: A retrospective review of the CAP NGC Program's cumulative data from 2000-2010 was performed for the general and the specific reference diagnosis categories for ACC in salivary gland FNAs according to preparation and participant types. Results: Of 5156 responses, the overall concordance rates for both the general category of malignancy and the specific category of ACC were 63.6% (3279 of 5156) and 38.6% (1966 of 5088), respectively, with a false-negative rate of 36.4% (1877 of 5156). The most frequent falsenegative responses were pleomorphic (1080) and monomorphic (526) adenoma (1614 of 5088, 31.5%), while lymphoma was the most frequent malignant misinterpretation. There was a significant statistical difference in concordance to the reference interpretation between the reader types: 39.9% (1006 of 2521) concordance rate for pathologists compared to 33.8% (503 of 1488) for cytotechnologists. However, there was no significant statistical difference for concordance to the general category or reference interpretation, based on preparation type (Papanicolaou versus modified Giemsa stained). Conclusions: In this interlaboratory comparison educational program, accurate identification of ACC has shown to be problematic, with ACC representing an important cause of false-negative responses. The most common diagnostic pitfall is distinguishing this entity from pleomorphic and monomorphic adenoma in the benign category and from lymphoma and adenocarcinoma in the malignant one.

Original languageEnglish (US)
Pages (from-to)1525-1530
Number of pages6
JournalArchives of Pathology and Laboratory Medicine
Volume139
Issue number12
DOIs
StatePublished - Dec 1 2015
Externally publishedYes

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Adenoid Cystic Carcinoma
Salivary Glands
Needles
Cell Biology
Adenoma
Lymphoma
Pleomorphic Adenoma
Pathologists
Adenocarcinoma
Neoplasms

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

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Performance characteristics of adenoid cystic carcinoma of the salivary glands in fine-needle aspirates : Results from the college of American Pathologists nongynecologic cytology program. / Tabatabai, Z. Laura; Auger, Manon; Kurtycz, Daniel F.I.; Laser, Alice; Souers, Rhona J.; Laucirica, Rodolfo; Barkan, Guliz A.; Crothers, Barbara A.; Khalbuss, Walid E.

In: Archives of Pathology and Laboratory Medicine, Vol. 139, No. 12, 01.12.2015, p. 1525-1530.

Research output: Contribution to journalArticle

Tabatabai, Z. Laura ; Auger, Manon ; Kurtycz, Daniel F.I. ; Laser, Alice ; Souers, Rhona J. ; Laucirica, Rodolfo ; Barkan, Guliz A. ; Crothers, Barbara A. ; Khalbuss, Walid E. / Performance characteristics of adenoid cystic carcinoma of the salivary glands in fine-needle aspirates : Results from the college of American Pathologists nongynecologic cytology program. In: Archives of Pathology and Laboratory Medicine. 2015 ; Vol. 139, No. 12. pp. 1525-1530.
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abstract = "Context: Although the cytomorphology of adenoid cystic carcinoma (ACC) has been well described the accuracy of this diagnosis in fine-needle aspirates (FNAs) of the salivary glands has not been extensively evaluated. Objective: To assess participants' responses in the College of American Pathologists (CAP) Nongynecologic Cytology (NGC) Program to determine the accuracy and false-negative rate of ACC cases in salivary gland FNAs. Design: A retrospective review of the CAP NGC Program's cumulative data from 2000-2010 was performed for the general and the specific reference diagnosis categories for ACC in salivary gland FNAs according to preparation and participant types. Results: Of 5156 responses, the overall concordance rates for both the general category of malignancy and the specific category of ACC were 63.6{\%} (3279 of 5156) and 38.6{\%} (1966 of 5088), respectively, with a false-negative rate of 36.4{\%} (1877 of 5156). The most frequent falsenegative responses were pleomorphic (1080) and monomorphic (526) adenoma (1614 of 5088, 31.5{\%}), while lymphoma was the most frequent malignant misinterpretation. There was a significant statistical difference in concordance to the reference interpretation between the reader types: 39.9{\%} (1006 of 2521) concordance rate for pathologists compared to 33.8{\%} (503 of 1488) for cytotechnologists. However, there was no significant statistical difference for concordance to the general category or reference interpretation, based on preparation type (Papanicolaou versus modified Giemsa stained). Conclusions: In this interlaboratory comparison educational program, accurate identification of ACC has shown to be problematic, with ACC representing an important cause of false-negative responses. The most common diagnostic pitfall is distinguishing this entity from pleomorphic and monomorphic adenoma in the benign category and from lymphoma and adenocarcinoma in the malignant one.",
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AU - Auger, Manon

AU - Kurtycz, Daniel F.I.

AU - Laser, Alice

AU - Souers, Rhona J.

AU - Laucirica, Rodolfo

AU - Barkan, Guliz A.

AU - Crothers, Barbara A.

AU - Khalbuss, Walid E.

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N2 - Context: Although the cytomorphology of adenoid cystic carcinoma (ACC) has been well described the accuracy of this diagnosis in fine-needle aspirates (FNAs) of the salivary glands has not been extensively evaluated. Objective: To assess participants' responses in the College of American Pathologists (CAP) Nongynecologic Cytology (NGC) Program to determine the accuracy and false-negative rate of ACC cases in salivary gland FNAs. Design: A retrospective review of the CAP NGC Program's cumulative data from 2000-2010 was performed for the general and the specific reference diagnosis categories for ACC in salivary gland FNAs according to preparation and participant types. Results: Of 5156 responses, the overall concordance rates for both the general category of malignancy and the specific category of ACC were 63.6% (3279 of 5156) and 38.6% (1966 of 5088), respectively, with a false-negative rate of 36.4% (1877 of 5156). The most frequent falsenegative responses were pleomorphic (1080) and monomorphic (526) adenoma (1614 of 5088, 31.5%), while lymphoma was the most frequent malignant misinterpretation. There was a significant statistical difference in concordance to the reference interpretation between the reader types: 39.9% (1006 of 2521) concordance rate for pathologists compared to 33.8% (503 of 1488) for cytotechnologists. However, there was no significant statistical difference for concordance to the general category or reference interpretation, based on preparation type (Papanicolaou versus modified Giemsa stained). Conclusions: In this interlaboratory comparison educational program, accurate identification of ACC has shown to be problematic, with ACC representing an important cause of false-negative responses. The most common diagnostic pitfall is distinguishing this entity from pleomorphic and monomorphic adenoma in the benign category and from lymphoma and adenocarcinoma in the malignant one.

AB - Context: Although the cytomorphology of adenoid cystic carcinoma (ACC) has been well described the accuracy of this diagnosis in fine-needle aspirates (FNAs) of the salivary glands has not been extensively evaluated. Objective: To assess participants' responses in the College of American Pathologists (CAP) Nongynecologic Cytology (NGC) Program to determine the accuracy and false-negative rate of ACC cases in salivary gland FNAs. Design: A retrospective review of the CAP NGC Program's cumulative data from 2000-2010 was performed for the general and the specific reference diagnosis categories for ACC in salivary gland FNAs according to preparation and participant types. Results: Of 5156 responses, the overall concordance rates for both the general category of malignancy and the specific category of ACC were 63.6% (3279 of 5156) and 38.6% (1966 of 5088), respectively, with a false-negative rate of 36.4% (1877 of 5156). The most frequent falsenegative responses were pleomorphic (1080) and monomorphic (526) adenoma (1614 of 5088, 31.5%), while lymphoma was the most frequent malignant misinterpretation. There was a significant statistical difference in concordance to the reference interpretation between the reader types: 39.9% (1006 of 2521) concordance rate for pathologists compared to 33.8% (503 of 1488) for cytotechnologists. However, there was no significant statistical difference for concordance to the general category or reference interpretation, based on preparation type (Papanicolaou versus modified Giemsa stained). Conclusions: In this interlaboratory comparison educational program, accurate identification of ACC has shown to be problematic, with ACC representing an important cause of false-negative responses. The most common diagnostic pitfall is distinguishing this entity from pleomorphic and monomorphic adenoma in the benign category and from lymphoma and adenocarcinoma in the malignant one.

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