Parotid gland report can anyone make sense if it

Hi I’m new here!

i was diagnosed with early stage 1 lung cancer in november and begin radiotherapy next week.  During investigations the PET scan picked up parotid gland and although 2 different lung consultants felt it was nothing to worry about they wanted to get it checked with an ultra sound and FNA.

I had an appt with an ENT assistant who read the report to me (below) and said they couldn't get a diagnosis so recommend surgery! I found this a tad extreme to be honest. I have since been offered a contrast MRI and a core needle procedure.

 Would these procedures give a more accurate diagnosis? What is a core needle procedure?   Obviously I do not want surgery if it is not necessarily needed.   
This is the lab report if anyone can explain it to me please!                   

Parotid gland lab report

Rt lung (illegible) referred for radiotherapy - PET scan showed Lt parotid nodule (very small) with avid uptake ?

MACROSCOPY:

'US guided fine needle aspiration'

Approx Volume: 5ml

Opacity: Clear

Colour: Red

Fragments/Clots: Yes, fragments

MICROSCOPY:

This is a cellular aspirate showing numerous oncocytes with dense cytoplasm and nuclei showing nucleoli. The cells are dyscohesive. There are also sheets in which magenta matrix is seen. There are histocytes present as well.

Calcification is noted. Only a few lymphocytes, if any are seen. The cytological features are suggestive of aspirate from an oncocytic lesion. The differentials include showing oncocytic change, Warthin's tumour and an oncocytoma.

Excision of pleomorphic salivary adenoma is needed to accurately diagnose the lesion

Thank you for any advice you can offer.




  • Hi Buttercups,

    I am sorry to read of your lung cancer diagnosis and that you have now found something in the parotid gland. I hope you’re doing as well as you can under the circumstances.

    I’m currently undergoing the tests to diagnose a lump in my parotid gland. I have had ultrasound and MRI scans and the results for my needle aspiration are awaited. I have only seen the ENT doctor once so far (in the initial consultation), but I was told in that initial consultation that I would need surgery too.

    A pleomorphic adenoma is a benign tumour in the parotid gland. Another you mention, warthin’s tumour, is another type of benign tumour. Mine is believed to be a pleomorphic adenoma, but as I say the FNA is still awaited. 

    I understand that some needle aspirations can come back with unclear results and it is only after the mass is removed and tested more closely that it can be determined one way or the other what it actually is. I understand a core needle biopsy is where a cut is made into the skin to extract the cell samples, rather than the needle biopsy where the needle is inserted and cells taken that way. The fact that you’re being offered a couple more tests will be helpful to shed more light on it for you, so perhaps a good idea to have all that information before you make a decision on surgery.

    I’m afraid I’m not a medical professional so I can’t help with a lot of the terminology. However, I hope that was somewhat helpful! 

  • Thank you so much for replying and for shedding some light on the lab terminology! 
    I appreciate you explaining the core biopsy, I had heard different things about it, one being a needle and the other a small cut so I am pleased you have clarified that for me.  As you say, it is best to wait until I have had the MRI and the core biopsy before making any decisions re surgery.  

    I do hope your FNA results return favourably, you will be in my thoughts.

    Thank you again