Invasive salivary duct carcinoma ex pleomorphic adenoma of the parotid gland: a teaching case giving rise to the genuine diagnostic difficulty on an inadequate cytology specimen

Diagnostic Pathology

Yasuyuki Sasaguri¹  Shohei Shimajiri¹  Ke-Yong Wang¹  Takashi Tasaki¹  Xin Guo¹  Takahisa Tabata³  Atsunori Nabeshima¹  Sohsuke Yamada² 

[1] Departments of Pathology and Cell Biology School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan;Department of Pathology and Cell Biology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan;Departments of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan

关键词: Cytology;    Salivary gland;    Carcinoma ex pleomorphic adenoma;    Salivary duct carcinoma;   

Others  :  808077
DOI  :  10.1186/1746-1596-7-61

 received in 2012-03-15, accepted in 2012-04-23,  发布年份 2012

【 摘 要 】

A history of a recent rapid increase in long-standing swelling mass was presented in the right parotid gland of an 85-year-old male. The inadequate cytologic specimens contained few small clusters of three-dimensional malignant epithelial cells having hyperchromatic pleomorphic nuclei and prominent nucleoli, adjacent to a cluster of benign monomorphic myoepithelial cells. We first interpreted it merely as an adenocarcinoma, not otherwise specified. A radical parotidectomy was performed, and gross examination revealed an encapsulated and firm tumor lesion, looking grayish-blue to yellowish-white, focally associated with extracapsular invasion. On microscopic examination, the tumor was predominantly composed of a proliferation of highly atypical epithelial cells having abundant eosinophilic cytoplasm, often arranged in a Roman-bridge appearance with foci of comedo necrosis, alternating with extensive infiltration to adjacent stroma in a trabecular or alveolar fashion with severe vessel permeation. Within the background of pleomorphic adenoma, the carcinoma cells sometimes replaced ductal luminal cells while retaining an intact-like myoepithelial layer. Therefore, we finally made a diagnosis of invasive salivary duct carcinoma ex pleomorphic adenoma. We should be aware that owing to its characteristic features, cytopathologists might be able to determine correct diagnosis, based on multiple and adequate samplings.

【 授权许可】

   
2012 Yamada et al.; licensee BioMed Central Ltd.

【 图 表 】

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