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Cytopathology of the Head and Neck: Ultrasound Guided FNAC, Second Edition. Gabrijela Kocjan. © 2017 John Wiley & Sons Ltd. Published 2017 by John Wiley & Sons Ltd.

Companion website: www.wiley.com/go/kocjan/clinical_cytopathology_head_neck2e

Index

Note: Page references in italics refer to Figures; those in bold refer to Tables acantholysis 58

acinar cells 14, 15 mucinous acinar cells 14 merous acinar cell 14 acinic cell carcinoma 11, 42–3, 44

cytological feature 43, 44 papillary variant 42 acute sialadenitis 22 acute (purulent) thyroiditis 85

adenocarcinoma (not otherwise specified) 57, 57 adenoid cystic carcinoma (AdCC) 11, 33, 45–51, 48, 49

adenolymphoma (Warthin’s tumour). salivary gland 19, 29, 35–7, 35, 36, 37 adenomatous nodule 79

alveolar rhabdosarcoma 184, 186 ameloblastomas 183, 184

anaplastic large cell 140, 158, 160, 161 angiolipoma 176

antimalarial drug hypersensitive lymphadenopathy 131 architectural atypia 89, 89

atypia of uncertain significance (AUS)/Follicular lesion of uncertain significance (FLUS) 88–90, 89, 90

architectural atypia 89, 89

atypia secondary to preparation arterfact 90 atypical cyst‐lining cells 90

nuclear atypia 89, 90

atypical follicular adenoma, thyroid gland 92 atypical meningioma 191

B‐cell lymphoma 114, 143–53 cutaneous 150, 151

diffuse large 140, 145, 150, 150, 151 small lymphocytic 140, 143–4 see also lymphocytic lymphoma basal cell adenocarcinoma 53, 53 basal cell adenoma (BCA) 37–9, 37 benign nerve sheath tumour 35, 180, 181 benign lymphoepithelial lesion (BLEL) 23 bening neurilemmoma 60

berylliosis 122

biphasic adenosquamous carcinoma 58 biphasic basaloid squamous carcinoma 58 BRAF mutation 78

brachial cleft cyst 19 branchial cyst 42, 181–2, 182 brucellosis 122 Burkitt’s lymphoma 140, 151–2, 154 WHO classification 154 capillary technique salivary gland 3 thyroid lesions 73

carbamazepine hypersensitive lymphadenopathy 131

carcinoma ex pleomorphic adenoma 57–8, 57, 58 carotid body tumours 187, 187, 188, 189 Castleman’s disease 131, 133 cat scratch fever 122–4, 126

CD30‐positive lymphoproliferative conditions of skin 157 CD31 103, 190

CD34 190 CD44 78 CD45 (LCA)

anaplastic large cell lymphoma 160 diffuse large B‐cell lymphoma 150 Hodgkin cells 137 L&H cells 137, 139 lymphoblastic leukaemia/lymphoma 142 CD57 (HNK‐1) L&H cells 139 CD79a Burkitt’s lymphoma 152 diffuse large B‐cell lymphoma 150 folliicular lymphoma 148 lymphocytic lymphoma 144 mantle zone lymphoma 146 post‐transplant lymphadenopathy 135 CD99 185

CD99/O13 186 CDw75 (LN1) 137 cell block (CB) 4

centroblastic lymphoma see diffuse large‐lymphoma cervical thymic cyst 183

chromogranin 103, 189 clinical history 2, 3 cMYC 152

colloid (multinodular; non‐toxic) goitre 76, 79–81 adenoma vs adenomatous nodule 79 cytological features 79–81, 80 degenerative changes 81, 82 diagnostic evaluation 79 psammoma bodies 79–81, 81 regenerative changes 82 colour Doppler 14 colour flow Doppler 14 composite lymphoma 140 computed tomography 2 core needle biopsy (CNB) vs FNAC

lymphoma 117 thyroid lesions 77 cost effectiveness 13, 77

cribiform adenoma of aminor salivary gland 60 cryptococcosis 125–7, 127, 131

cutaneous B‐cell lymphoma 150, 151 cutaneous T‐cell lymphoma 116, 156 cyclin D1 146

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cystadenoma, salivary gland 42 cystic lesions

goitre 76, 82 head and neck 181

salivary gland 11, 17–21, 18, 23 thyroid 83, 83

cystic lymphoid hyperplasia, salivary gland 23 cytological preparation methods 5

cytomegalovirus sialadenitis 23 cytopathologist 2, 2 cytopathology report 4, 6 De Quervain’s thyroiditis 85 dermatopathic lymphadenopathy 122 dermoid cyst, salivary gland 19

diffuse large‐cell lymphoma 140, 150, 151, 152 cytological features 145, 150, 151 immunophenotype 150 WHO classification 150

diffusion‐weighted (DWI) MR techniques 12 DNA microarray technologies

basal cell adenocarcinoma 53 lymphoma 141 drug‐related lymphadenopathy 131, 132 Dutcher bodies 144 elastography vs FNAC lymphoma 118 embryonal rhabdomyosarcoma 185, 186 emperipolesis (lymphophagocytosis) 122 eosinophilic granuloma 132 epidermoid cysts 19, 183, 185

epithelial membrane antigen 39, 57, 60, 99, 134 epithelial‐‐myoepithelial carcinoma 50, 52–3, 52

cytological features 52, 53

smooth muscle‐specific protein immunohistochemistry 52 epithelioid sarcoma‐like hemangioendothelioma 190, 192 Epstein‐Barr virus 59, 128, 135, 139, 151

ethmoid sinus intestinal type adenocarcinoma 191–2, 194 extraskeletal Ewing’s sarcoma 186, 187

cytological features 186 immunocytochemistry 186 fibroblastic meningioma 191

fibromatosis colli (sternocleidomastoid tumour) 176–8 fine needle aspiration cystology 1–5

combined US/FNAC approach 2 fluids 4

rapid staining and examination 4, 4 sampling technique 2–5, 2, 3 ultrasound guidance 1 flow cytometry 1

Castleman’s disease 131

diffuse sclerosing variant of papillary carcinoma (DSPC) 99 lymphoma 114, 141

clonality analysis 114

post‐transplant lymphoproliferative disorder 135 lymphoproliferative lesions of salivary glands [49]. 11 salivary gland tumours 42

follicle centre lymphoma 140, 144 follicular adenoma, thyroid gland 85, 91–2

atypical 92 cytological features 92

follicular carcinoma, thyroid gland 101, 101, 102 clear cell variant 101

cytological features 101 Hürthle cell variant 101 insular variant 101, 103

follicular hyperplasia, lymph node 118–19, 118 cytological features 118–19, 119, 120

progressive transformation of germinal centres 118 follicular lymphoma 113, 115, 116, 140, 146–8, 148

immunophenotype 148 WHO classification 146, 147

frozen section histology salivary gland lesions 12–13 thyroid lesions 77

fungal lymphadenitis 125–6, 127 ‘follicular lesions’ 90–4 galectin‐3 99 GCDFP‐15 57

glandular fever (infectious mononucleosis) 128–9, 130 goitre 79–85

colloid (multinodular non‐toxic) 76, 79–81, 80, 81, 82

hyperactive 84–5, 84 granular cell tumour 192–4, 195 granulocytic sarcoma, salivary gland 62 granulomatous lymphadenitis 122–7

mycobacterial infection 122 granulomatous sialadenitis 22–3, 26 granulomatous thyroiditis 85–6, 86 Graves’ disease 84–5

haemangiopericytoma, salivary gland 61 Hand Schüller‐Christian syndrome 132 Hashimoto’s thyroiditis see lymphocytic thyroiditis HBME‐1 60, 78, 91, 96, 99, 103

heavy chain gene rearrangements 114, 117 diffuse large‐cell lymphoma 150 marginal zone (MALT type lymphoma) 150 post‐transplant lymphoproliferative disorder 135 hepatitis C 23

histiocytosis X see Langerhans’ cell histiocytosis histoplasmosis 126, 127, 131

sialadenitis 23 HIV infection/AIDS

FNAC‐detected infections 130–1 lymph node mass FNAC 131

mycobacterial granulomatous lymphadenitis 122 persistent generalised lymphadenopathy 130–1, 131 reactoid lymphoid proliferations 23

salivary gland pathology 18 salivary lymphepithelial cyst 19 p24 marker 19 HLA‐DR 134 HNK‐1 see CD57 Hodgkin’s cells 121, 137, 139 Hodgkin’s lymphoma 113, 137–9, 137 cell phenotype 137 cytological diagnosis 139 diagnostic difficulties 139 granulomatous reactions 125 Hodgkin cells 137, 139 immunophenotype 139

L&H (lymphocytic and histiocytic) cells 137, 139 lymphocyte depletion type 137

lymphocyte‐rich type 137 mixed cellularity type 137

nodular lymphocyte predominance type 137, 140 nodular sclerosis type 137

nodular stenosis type 137, 140 Reed‐Sternberg cells 137, 139 role of FNAC in management 140 Rye classification 137

human herpesvirus‐8 117, 131, 151, 162

human papillomavirus (HPV), squmous cell carcinomas of head and neck (HNSCC) 180

human T‐lymphotropic virus‐1 (HTLV‐1) associated T cell lymphoma 154, 156 Hürthle cell tumour

adenoma 85 carcinoma 92–3, 93

papillary with lymphoplasmacytic stroma 98 hyalinising trabecular adenoma, thyroid gland 92, 93–4

immunocytochemistry 94 hybernoma 176, 178

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hydantoin‐induced lymphadenopathy 131, 132 hyperthyroidism, hyperactive goitre 84–5, 84 immunocytochemistry 1, 4

immunocystoma see lymphoplasmacytic lymphoma immunoglobulin‐negative malignant lymphoma 140 immunohistochemistry

anaplastic thyroid carcinoma 157 Castleman’s disease 131

cribriform adenocarcinoma of minor salivary gland (CAMSG) 60 cribriform‐morular variant of papillary carcinoma 98–9 epithelial myoepithelial carcinoma 52

follicular hyperplasia 118–19, 119 hyalinising trabecular adenoma (HTA) 94 lymphomas 113–14

MALT lymphoma 23

mammary analogue secretory carcinoma (MASC) 60 myoepithelioma, salivary gland 41

oncocytoma 45

papillary thyroid carcinoma 99–100 salivary duct carcinoma 55 salivary gland lesions 23 tumour malignancy 45 small cell carcinoma 59 thyroid lesions 78, 78 see also immunophenotype immunophenotype 4, 114

anaplastic large cell lymphoma 158 Burkitt’s lymphoma 151–2 diffuse large‐cell lymphoma 150 follicular lymphoma 150 lymphocytic lymphoma 144

lymphoplastic lymphoma (immunocytoma) 144 MALT lymphoma 150

mantle zone lymphoma 144 peripheral T cell lymphoma 154 reactive lymphoid hyperplasia 114 immunosuppression

cryptococcosis 125

Mycobacterium avium intracellulare lymphadenitis 122 in situ hybridisation 117

Epstein‐Barr virus demonstration 135

infectious mononucleosis (glandular fever) 129–30, 130 intraductal papillary adenocarcinoma, salivary gland 42 intraductal papilloma, salivary gland 41–2

intramuscular lipoma 176 intraosseous cyst 183, 184 intraparotid lymphadenitis 35

inverted duct papilloma, salivary gland 42 iodine deficiency 79 Kaposi’s sarcoma 131, 151 keratin 57, 59, 103 keratocyst 184 Ki‐67 (MIB‐1) Burkitt’s lymphoma 152

hyalinising trabecular adenoma, thyroid gland 94 lymphomas 113

mammary analogue secretory carcinoma (MASC) 60 salivary gland lesions 11

tumour malignancy 42 parotid gland tumours 11 Kikuchi’s lymphadenitis 128 Kimura’s disease 135–6, 136

Kuttner’s tumour see sialadenitis, chronic L&H (lymphocytic and histiocytic) cells 137, 139 Langerhans’ cell histiocytosis (histiocytosis) 132–5, 133, 134 large cell T‐cell lymphoma 156

laser scanning cytometer 141 LCS see CD45

leiomyosarcoma, salivary gland 61 Leishman‐Donovan bodies 127 leishmaniasis 122, 127

leprosy 122, 127 Letterer‐Siwe syndrome 132 leu 6 (CD1a) 134, 154

light chain gene rearrangements 152 light chain ratio (LCR) 114 lipoma 176 angiolipoma 176 hybernoma 176, 177 intramuscular lipoma 176 pleomorphic lipoma 176 spindle‐cell lipoma 176, 177 LN1 (CDw75) 137 local anaesthesia 2, 3 needle‐free system 3, 3, 4 lymph node 112–68

accuracy of FNAC diagnosis 113 core biopsy vs FBAC 117 ancillary techniques 113–17 diagnostic pitfalls 113 elastography vs FNAC 118 distribution of pathology 112 lymphoma see lymphoma

metastatic carcinoma 113, 114, 160–8 reactive/inflammatory lesions 112 role of FNAC 112

lymph node follicular hyperplasia 118–19 lymphadenitis, chronic infective 128–31 lymphadenopathy

drug reactions 131 post‐transplant 135

lymphoblastic leukaemia/lymphoma 142–3, 144 lymphocyte‐predominant Hodgkin’s disease 113, 139–42

lymphocytic lymphoma (B‐cell small lymphocytic lymphoma) 113, 115, 143–4, 144

immunophenotype 144 role of FNAC in management 140

transformation of high‐grade lymphoma (Richter syndrome 139, 144, 145, 188

lymphocytic thyroiditis (Hashimoto’s thyroiditis) 76, 85–6, 87, 88 diagnostic problems 76

differential diagnosis 85 lymphoma association 103 lymphoepithelial carcinoma 59

lymphoepithelial cyst, salivary gland 19, 19, 20–1

lymphoepithelial (nasophryngeal) carcinoma, salivary gland 59 lymphoepithelial sialadenitis (benign lymphoepithelial lesion;

myoepithelial sialadenitis) 23, 27 lymphogranuloma venereum 122 lymphoid infiltrate in the parotid 26

lymphoid proliferations of the salivary gland 23–9, 27 neoplastic 23–9

reactive 23 lymphoma 1, 112, 187

anaplastic large cell 140, 157–8, 161 B‐cell 143–53

cutaneous 150, 151 Burkitt’s 140, 151–2, 154, 154 composite 140

diagnosis 112

core needle biopsy (CNB) vs FNAC 117 difficulties 113

elastography vs FNAC 118 flow cytometry 114, 115 immunohistochemistry 113–14 molecular techniques 113, 114–17, 159–60 diffuse large B‐cell 140, 146, 150, 150, 151 follicle centre 140

follicular 140, 144, 146–8, 147, 148 granulomatous reactions 122, 125 immunoglobulin negative 140 immunophenotyping 114, 144

lymphocytic (B‐cell small lymphocytic) 140, 143–4 lymphoplasmacytic (immunocytoma) 144 MALT see MALT lymphoma

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mantle zone 140, 142, 143, 144–6 parotid 62 peripheral T‐cell 139, 154, 155 primary effusion 150–1, 153 salivary gland 11, 23–5, 62, 62 HIV‐positive patient 19 T‐cell rich B‐cell 140 T/NK‐cell 154–8 thyroid gland 103–5

WHO classification 137, 137, 142, 143

see also Hodgkin’s lymphoma; non‐Hodgkin’s lymphoma lymphomatoid papulosis 157, 157

lymphophagocytosis (emperipolesis) 121 lymphoplasmacytic lymphoma (immunocytoma)

cytological features 144, 146 immunophenotype 144 lymphoproliferative disorders 1

non‐neoplastic 118–36 salivary gland 11

magnetic resonance imaging (MRI) 1

malignant haemangiopericytoma, salivary gland 61 malignant tumours

salivary 11, 42–59, 59–64 thyroid gland 94–106

mammary analogue secretory carcinoma (MASC) 60 MALT lymphoma 116, 144, 148–50, 149

accuracy of FNAC diagnosis 140 immunophenotype 150

salivary gland 23, 26, 27, 28–9, 29, 30, 62, 62 thyroid gland 105

mantle zone lymphoma 113, 114, 115, 140, 144–6 blastic variant 146

immunophenotype 146

marginal zone B‐cell lymphoma (MZCL) 23 marginal zone lymphoma 113, 140

see also MALT lymphoma

medullary carcinoma, thyroid gland 101–3, 104 meningioma 190–1, 193 atypical 191 fibroblastic 191 secretory 191 metastatic carcinoma 1 lymph node 112, 160–8 salivary gland 64 HIV‐positive patient 19, 23 thyroid gland 105–6, 106

methicillin‐resistant staphylococcal infection, AIDS patients 131 MIB‐1 see Ki‐67

molecular technique 1, 4 lymphoma 113, 114–17

papillary thyroid carcinoma 99–100 rhabdomyosarcoma 185

monomorphic adenoma, salivary gland 33, 37–8 mucinous adenocarcinoma, salivary gland 54 mucocoele, salivary gland 17, 17

mucoepidermoid carcinoma (MEC), salivary gland 37, 43–5, 46, 47, 48 cytological features 45, 46, 47

differential diagnosis 45 molecular genetics 43 prognostic features 45 mucus retention cyst 37, 182 multinodular goitre 79, 80, 81

diagnostic problems 79 non‐toxic see colloid goitre toxic see toxic goitre

multiple endocrine neoplasia (MEN) syndrome 103 multiple oncocytic cyst, salivary gland 21 mycobacterial granulomatous lymphadenitis 122 Mycobacterium avium intracellulare lymphadenitis 122, 124 myoepithelial sialadenitis (MESA) 23, 27, 27

myoepithelial differentiation, salivary tumour immunohistochemistry 52 myoepithelioma, salivary gland 31, 40–1, 41

myogenin 185

necrotising sialometaplasia, salivary gland 58 neurilemmoma see benign nerve sheath tumour nodular fasciitis 178, 179

salivary gland 41 non‐aspiration technique

salivary gland lesions 10 thyoid lesions 73 non‐Hodgkin’s lymphoma 37, 115 accuracy of FNAC 140 ancillary techniques 140–1 classification 142 frequency 141 obtaining material 142 precursor lesions 142–3 handling FNAC material 142 REAL classification 142

role of FNAC in management 140–1

non‐steroidal anti‐inflammatory drugs, hypersensitive lymphadenopathy 131 nuclear grooves 91, 93, 95–6, 95, 96, 97, 98

odontogenic cysts 183, 184

odontogenic keratocyst, salivary gland 21 oesthesioneuroblastoma see olfactory neuroblastoma olfactory neuroblastoma 1, 187, 188

oncocytic change thyroid lesions 79, 80 colloid goitre 79 multinodular goitre 80

lymphocytic (Hashimoto’s) thyroiditis 85, 88 oncocytic neoplasms

salivary gland crystalline structures 22 thyroid gland 79

oncocytoma, salivary gland 35, 35 malignant (oncocytic carcinoma) 54–5, 55 oncogene alterations

non‐Hodgkin’s lymphoma 117 One Stop Clinics 4, 13 p16 57, 60 p53 42, 146 p161NK4a 146 paediatric lesions

cat scratch disease 122–5

lymphoblastic leukaemia/lymphoma 142 salivary gland 62

papillary carcinoma, thyroid gland 75, 77, 78, 95–101 cutaneous needle track metastasis 78

cytological features 95, 96 differential diagnosis 100–1 FNAC in management 95 immunohistochemistry 99 molecular markers 99–100 nuclear grooves 95–6, 95, 96 psammoma bodies 95, 95, 97, 97, 99, 100 variants columnar cell 97 cribiform‐morular 98–9, 99 diffuse sclerosing 99 follicular 95–6, 98 macrofollicular 96

nodular fasciitis‐like stromal component 99

oncocytic variant of papillary carcinoma (OVPTC) 97–8 oxyphil cell 98

papillary Hürthle cell carcinoma with lymphoplasmacytic stroma 98 tall cell 96, 98

papillary cystadenocarcinoma, salivary gland 54

papillary Hürthle cell carcinoma with lymphoplasmacytic stroma 98 parathyroid cyst 183

parotid gland 13 normal appearance 13–14 pitfalls and scanning issues 14 ultrasound examination of 10 parotid lesions, FNAC‐related issues 14 parotid lymphoma 62

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parotid tumours 11, 29, 35, 42 parotid lymphoma 62 paediatric lesions 62

PAX3‐FOXO1 or PAX7‐ FOXO1 gene fusion 185 PC10 see proliferating cell nuclear antigen (PCNA) penicillin, hypersensitive lymphadenopathy 131 peripheral necuroectodermal tumour (PNET) 183, 186 peripheral T‐cell lymphoma 140, 154

cutaneous 156

cytological features 154, 155

human T‐lymphotropic virus‐1 (HTLV‐1) associated 154, 156 immunophenotype 154

large cell 156

persistent generalised lymphadenopathy 130–1 physical examination 2, 3

pleomorphic adenoma 29–35, 31, 32, 33, 34, 57 adenoid cystic carcinoma differentiation 48–50 cytological features 31–5

differential diagnosis 31 paediatric lesions 62

salivary gland crystalloid structures 22 pleomorphic lipoma 176

Plummer’s disease see toxic goitre polymerase chain reaction (PCR) 4

human herpesvirus‐8 detection 117 lymphoma 114–17, 141

post‐transplant lymphoproliferative disorder 135

see also reverse transcriptase polymerase chain reaction (RT‐PCR) polymorphous low grade adenocarcinoma, salivary gland 42, 51–2, 51, 60 ‘Poor Man’s cell block’ 4

post‐transplant lymphoproliferative disorder 135 postirradiation salivary gland changes 11 PRAD‐1 146

primary effusion lymphoma 150–1, 153 human herpesvirus‐8 association 151

primitive neuroectodermal tumour, salivary gland 62–3 primary squamous cell carcinoma

parotid 58–9, 58, 60 salivary gland 58–9 procedure

salivary gland lesions 13–14 thyroid lesions 72–4, 74

progressive transformation of lymph nodes 113 proliferating cell nuclear antigen (PCNA; PC10) 11, 42 proliferative fasciitis 178–80

proliferative myositis 180 psammoma bodies

colloid (multinodular non‐toxic) goitre 79–81, 81 meningioma 191

papillary thyroid carcinoma 95, 95, 97, 97, 99, 100 rapid on site assessment (ROSE) 73–4

rapid reporting system, salivary gland lesion 13 reactive lymphoid hyperplasia

clonality analysis 114, 115 flow cytometry 114 immunophenotyping 114 role of FNAC in management 140

reactive lymphoid proliferations, salivary gland 23 reactive/inflammatory lesions 1

lymph node 112

Reed‐Sternberg cells 130, 137, 139, 157, 188 referrals 3

retention cyst, salivary gland 17, 19 rhabdomyosarcoma 1, 184–5 alveolar 185, 186 cytological features 185 embryonal 185, 186 morphological subtyping 185 salivary gland 61 rheumatoid arthritis 118 granulomatous lymphadenitis 122, 125 Richter’s syndrome 139, 144, 145, 188 Riedel’s thyroiditis 86–7

Rosai Dorfman disorder see sinus histiocytosis with massive lymphadenopathy S‐100 protein 60, 121, 122, 134, 185

salivary duct carcinoma 55–6, 56 salivary gland, cytology of 14–29

normal 14, 15 acinar cells 14, 15 ductal cells 14, 15

salivary gland adenocarcinoma 57 salivary gland crystalloid structures 22, 31 salivary gland cysts 17–21, 18

brachial cleft 19 dermoid 21 lymphoepithelial 19, 20–1 mucocoele 17, 17 multiple oncocytic 21 odontogenic keratocysts 21 retention 17, 19 salivary gland lesions 9–65

clinical management 64–5 cystic see salivary gland cysts diagnosis 9–10, 10, 13–14 accuracy 11, 11 difficulties 11–12, 14 FNAC cost effectiveness 13 FNAC versus frozen section 12–13 rapid reporting 13

ultrasound 12

ultrasound guided FNAC 10–11 neoplastic see salivary gland tumours non‐neoplastic/inflammatory 14 paediatric 62

ultrasound in 9

ultrasound‐guided FNAC 10–11 salivary gland lymphoid proliferation 23–9 salivary gland tumours 1, 11–12

benign 11, 29–42 malignant 11, 42–59, 59–64 flow cytometry 42 p53 overexpression marker 42 smooth muscle‐specific proteins 52 metastatic 63–4

WHO classification 11 sarcoidosis 23, 25, 122, 124 sarcoma, salivary gland 61

schwannoma see benign nerve sheath tumour sclerosing polycystic adenosis 40, 40 sebaceous adenoma, salivary gland 43 secretory meningioma 191 sensitivity

non‐Hodgkin’s lymphoma diagnosis 139, 141 salivary gland lesions

FNAC 10 frozen section 12–13 thyroid malignancy diagnosis 76 sialadenitis 21–3, 21, 22

acute 22

chronic (Kuttner’s tumour) 22, 23, 24 crystalloid formation 22, 25 cytomegalovirus 23 granulomatous 22–3

lymphoepithelial of Sjögren’s syndrome 23 marginal zone B‐cell lymphoma (MZCL) 23 myoepithelial (MESA) 23, 27

submandiblular ductal system scanning 21–2 ultrasound scanning for calculi 21 sialadenoma papilliferum 42 sialadenosis 14–17, 16 sialectasis 13 sialolithiasis 21 sialography 13

(6)

sinus histiocystosis with massive lymphadenopathy (Rosai Dorfman) 119–22, 121

cytological features 119–22 dermatopathic lymphadenopathy 122 differential diagnosis 122

Sjögren’s syndrome, lymphoepithelial sialadenitis 23 MALT lymphoma 23–5

small cell carcinoma, salivary gland 59 small lymphocytic lymphoma 113, 115 small round cell tumours 183–8 smooth muscle myosin heavy chains 52, 57 smooth muscle‐specific proteins 52 soft tissue lesions, benign 176–81 sonoelastography 12

Southern blot analysis 117

Epstein‐Barr virus demonstration 135 lymphoma 141

specificity

non‐Hodgkin’s lymphoma diagnosis 139, 141 salivary gland lesions

FNAC 10 frozen section 12–13

thyroid malignancy diagnosis 76, 77 spindle‐cell lipoma 176, 177 spindle cell neoplasm 31

squamous cell carcinoma, primary of salivary gland 58–9 staining methods 4, 4

sublingual gland tumours 29 submandibular gland tumours

oncocytoma 35, 35 scanning difficulties 14

sulphonamide hypersensitive lymphadenopathy 131 surface Ig

Burkitt’s lymphoma 152 diffuse large‐cell lymphoma 150 follicular lymphoma 146

lymphoplasmacytic lymphoma (immunocytoma) 144 mantle zone lymphoma 146

marginal zone lymphoma (MALT type) 150 synaptophysin 187

synovial sarcoma, salivary gland 61, 61 syphilis 122, 127

syringes 3, 4

t(2;5)(p23;q35), anaplastic large cell lymphoma 158 t(8;14), Burkitt’s lymphoma 152

t(11;14), mantle zone lymphoma 146

t(11;22)(q24;q12), extraskeletal Ewing’s sarcoma/peripheral neuroectodermal tumour (PNET) 186

t(14;18)

diffuse large B‐cell lymphoma 148 follicular lymphoma 147, 148, 159 T‐cell lymphoma 113

cutaneous 156

T‐cell receptor gene rearrangements 122, 139 T‐cell rich B‐cell lymphoma 140

T/NK‐cell lymphoma 154–7 TdT 142, 146

telomerase assay 78 thymic, cervical, cyst 183

thyroglobulin 85, 94, 99 thyroglossal cyst 181, 181 thyroid cyst 83, 83 thyroid cancer incidence 71, 72, 72 mortality rate 71

thyroid hyperplasia (goitre) see colloid goitre thyroid lesions 1, 71–106 classification 74, 75 complications of FNAC 78–9 cost‐effectiveness of FNAC 71 diagnosis 73 accuracy 74–6

FNAC reporting categories 74

FNAC frozen section and core biopsy histology 77 physical examination 72

problems 76

ultrasound and FNAC 72–4, 73 follicular lesions 90–4 immunocytochemistry 78, 78 multinucleate giant cells 85 non‐neoplastic/inflammatory 79–87 post‐FNAC infarction 79 procedure 72–4, 74 ancillary techniques 78 complications of FNAC 78–9 ultrasound guidance 72–4, 73 role of FNAC 76–7, 78 sampling technique 4, 4

thyroid metastatic tumours 105–6, 106

Thyroid Imaging Reporting and Data System (TIRADS) 76 thyroiditis 76, 85–8 acute (purulent) 85 De Quervain’s 85 granulomatous 85, 86 lymphocytic (Hashimoto’s) 85–6, 87, 88 Riedel’s 86–7, 88 subacute 85

thyrotoxicosis, hyperactive goitre 84 toxic goitre 84–5, 84

toxoplasmosis 122, 126–7, 128 granulomatous lymphadenitis 125 training in FNAC interpretation 12 trisomies, lymphocytic lymphoma 144 tuberculosis granulomatous lymphadenitis 122, 122, 123, 124 granulomatous sialadenitis 23 HIV infection/AIDS 131 lipoma 177 tularaemia 122, 125

ultrasound guidance, thyroid lesions 72–4, 73 undifferentiated carcinoma, salivary gland 59 vimentin 41, 60, 103

Waldenström’s macroglobulinaemia 144

Warthin’s tumour see adenolymphoma, salivary gland zellballen 189

References

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