{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T20:51:18Z","timestamp":1761598278187,"version":"build-2065373602"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,11,19]],"date-time":"2020-11-19T00:00:00Z","timestamp":1605744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["1P01CA240239\u201001"],"award-info":[{"award-number":["1P01CA240239\u201001"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>High\u2010grade transformation (HGT) is a rare process whereby conventional low\u2010 to intermediate\u2010grade salivary gland carcinomas (SGC) transform into high\u2010grade, poorly or undifferentiated malignancies with focal or complete loss of their conventional histomorphologic features. Because tumors with HGT are associated with a worse prognosis than their conventional counterparts, preoperative recognition of HGT may be of benefit for optimal patient management. Using a multi\u2010institutional approach, we describe the largest fine needle aspiration (FNA) cohort of salivary gland carcinomas with HGT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The archives of 9 large academic medical centers were searched, and 22 cases of SGC with HGT were identified by surgical excision accompanied by preoperative FNA. Clinical and cytomorphologic features were retrospectively reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The male\u2010to\u2010female ratio was 14:8, and the mean patient age was 60.2 years. The average tumor size was 3.6 cm, and 19 cases were from the parotid gland. Acinic cell carcinoma with HGT was the most common tumor subtype, comprising 12 cases with HGT, followed by adenoid cystic carcinoma, secretory carcinoma, and other subtypes. Eighteen cases were classified as malignant; however, a specific diagnosis of HGT was not made. Sixteen cases contained a high\u2010grade cytologic component, and 7 cases had a mixture of both conventional and high\u2010grade components retrospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SGC with HGT should be considered in the differential diagnosis of a salivary gland aspirate exhibiting high\u2010grade cytomorphologic features. The presence of distinct tumor populations, conventional and high\u2010grade, should prompt consideration of HGT, especially when the conventional component is acinic cell carcinoma or adenoid cystic carcinoma.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.22388","type":"journal-article","created":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T00:26:56Z","timestamp":1605832016000},"page":"318-325","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Fine needle aspiration of salivary gland carcinomas with high\u2010grade transformation: A multi\u2010institutional study of 22 cases and review of the literature"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6987-3043","authenticated-orcid":false,"given":"Masato","family":"Nakaguro","sequence":"first","affiliation":[{"name":"Departments of Pathology Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9043-7171","authenticated-orcid":false,"given":"William C.","family":"Faquin","sequence":"additional","affiliation":[{"name":"Departments of Pathology Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zubair W.","family":"Baloch","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard L.","family":"Cantley","sequence":"additional","affiliation":[{"name":"Department of Pathology The University of Michigan\u2013Michigan Medicine Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret L.","family":"Compton","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim A.","family":"Ely","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brittany J.","family":"Holmes","sequence":"additional","affiliation":[{"name":"Department of Pathology Stanford University School of Medicine Stanford California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rong","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of Wisconsin School of Medicine and Public Health Madison Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3228-2044","authenticated-orcid":false,"given":"Darcy A.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Dartmouth\u2010Hitchcock Medical Center Lebanon New Hampshire"},{"name":"Geisel School of Medicine at Dartmouth Dartmouth College Hanover New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen T.","family":"Montone","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4692-4981","authenticated-orcid":false,"given":"Michiya","family":"Nishino","sequence":"additional","affiliation":[{"name":"Departments of Pathology Beth Israel Deaconess Medical Center and Harvard Medical School Boston 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