Authors: Schmitt F, Rossi ED, Iglesias C, Fadda G

Abstract

The correct cytological discrimination between benign and malignant lesions is the first invaluable point for the adequate clinical and/or surgical management of head and neck lesions. This chapter offers a detailed and specific overview of both the common and rare benign and malignant lesions of the head and neck district. We deem the increasing role of cytology in some areas, such as nasal, sinonasal, oropharyngeal, major and minor salivary glands, and odontogenic, offering specific diagnostic features in a territory that has been mainly and largely diagnosed from a histological perspective. A specific section underlines the cytological features of head and neck cystic lesions, and a focused attention is directed to the cytological evaluation of benign and malignant mesenchymal and lymphoid lesions. Furthermore, the growing number of different cytological methods (i.e., conventional cytology, liquid-based cytology, and cell blocks) is highlighted mainly because of the application of ancillary techniques such as immunocytochemistry, flow cytometry and molecular analysis. A final detailed section points to all the possible and different benign and malignant thyroid lesions which are assessed with both conventional and liquid-based cytology. The conclusive point is a discussion about the problem of reporting thyroid diagnoses as emerged in the different thyroid classification systems used. All of these critical limits are analyzed in detail in the present chapter with appropriate references and pertinent illustrations. In this regard and taken together both all the advantages and the pitfalls and drawbacks, cytology might be the first and worldwide diagnostic tool in achieving a correct diagnosis and guiding the most appropriate management.

Pathology of the Head and Neck: Second Edition, 2017, pp. 753–805