BACKGROUND: Primary oncocytic salivary gland tumors and oncocytic subtypes of traditionally non-oncocytic salivary gland neoplasms are occasionally encountered in fine needle aspiration specimens, biopsies, and resections. Oncocytes are cells, either non-neoplastic or neoplastic, containing increased numbers of mitochondria resulting in cells with abundant eosinophilic cytoplasm and a low N/C ratio. SUMMARY: A broad range of salivary gland tumors can be oncocytic including oncocytoma, Warthin tumor, mucoepidermoid carcinoma, salivary duct carcinoma, and others, especially those tumors where the oncocytic pattern represents a subtype of neoplasm; the oncocytic pattern can create a diagnostic challenge due to marked similarities in the oncocytic pattern of cells. KEY MESSAGES: While their microscopic cytologic and histologic features may be similar, these tumors differ intrinsically at the molecular level. Ancillary studies such as immunologic (e.g., androgen receptor for salivary duct carcinoma) and molecular analysis, e.g., FISH for detecting the MAML2 or PLAG1/HMGA2 gene alterations in mucoepidermoid carcinoma and pleomorphic adenoma, respectively, can be used to classify these oncocytic tumors in difficult cases.

Biopticka laboratory Ltd Pilsen Czechia

Department of Pathology Charles University Faculty of Medicine in Pilsen Pilsen Czechia

Department of Pathology Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA

i3S Institute for Research and Innovation University of Porto Porto Portugal

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Acta Cytol. 2025 Jul 10:1. doi: 10.1159/000546955. PubMed

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