You answered:
Normal salivary gland tissue
Sorry, that is
INCORRECT
The correct diagnosis is:
Acinic cell carcinoma
CYTOPATHOLOGY:
- This FNA specimen shows loosely cohesive, atypical serous acinic cells without ductal cells.
- The nuclei are oval, bland, and eccentric, with mild variation in nuclear size. Nucleoli are observed.
- The cytoplasm is abundant and granular.
- These findings are consistent with an acinic cell carcinoma.
DISCUSSION:
- The biopsy reveals acinic cell carcinoma. The neoplastic cells have abundant, granular cytoplasm and fairly bland and uniform nuclei.
- Acinic cell carcinoma is a rare neoplasm of low grade malignancy, and is found most often in the parotid, and most commonly in women in their 40s.
- The cytoplasm contains mucopolysaccharide which is positive with PAS/diastase, and mucicarmine negative.
- The differential diagnosis might include Warthin's tumour, mucoepidermoid carcinoma, or normal salivary gland tissue.
- The oncocytes of Warthin's tumour have much denser cytoplasm with finer PAS/D-negative mitochondrial granules, and a background of lymphocytes.
- Mucoepidermoid carcinoma is comprised of a more pleomorphic cell population and is usually mucicarmine-positive.
- Normal salivary gland tissue contains acini in tight, cohesive ball-like fragments and normal ductal cells.
BACK TO IMAGES
HISTOLOGY
REFERENCES:
Bibbo, Marluce. Comprehensive Cytopathology. Philadelphia: WB Saunders Company, 1991; 636-639.
Demay, Richard M. The Art and Science of Cytopathology. Chicago: ASCP Press; 1996; 670-680.
Kini, Sudha R. Color Atlas of Differential Diagnosis in Exfoliative and Aspiration Cytopathology. Baltimore: Williams and Wilkins, 1999; 316.
