CORRECT!!

CYTOPATHOLOGY:

• The specimen consists of clusters of intermediate cells mixed with mildly atypical mucous-producing cells in a background containing abundant mucous 
• Consistent with low-grade mucoepidermoid carcinoma

DISCUSSION:

• The biopsy reveals numerous mucous-secreting cells with focal sheets of intermediate cells
• Marked cystic change and a dense collagenous stroma were also identified in areas of the tumour
• Low-grade MEC is one of the most common salivary gland malignancies occurring in all age groups
• It is usually well-demarcated, slow-growing and painless
• Coexistence of intermediate cells showing epidermoid differentiation and mucin-secreting cells is required for definitive diagnosis in cytologic preparations
• Abundant mucous may suggest salivary duct cyst but the presence of mucous/goblet cells favours mucoepidermoid carcinoma that may rarely be rich in oncocytes
• Pleomorphic adenoma may have mucous and squamous metaplasia but it is usually focal.  Chondromyxoid stroma best identified on Giemsa stain and free lying myoepithelial cells suggest pleomorphic adenoma
• Low grade tumours have a predominance of uni- or multilocular cystic mucinous components versus high grade tumours that are mainly solid with intermediate and squamous cells, high grade nuclear features and minimal mucous differentiation.

BACK TO IMAGES                        HISTOLOGY

REFERENCES:

Orell SR, Sterrett GF, Whitaker D.  Fine Needle Aspiration Cytology, 4th ed.  Elsevier Churchill Livingstone; 2005. pp67-69.

Elhosseiny A. Salivary Glands in Koss' Diagnostic Cytology and Its Histopathologic Bases, 5th ed.  Lippincott Williams & Wilkins; 2006pp 1243-1246.