You answered: Pleomorphic adenoma with mucoid stroma
Sorry, that is INCORRECT
The correct diagnosis is: Low-grade mucoepidermoid carcinoma
- 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
- 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
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.