cytopathology conference 10/20/05 - case 3
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Cytopathology Conference 10/20/05 - Case 3TRANSCRIPT
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Cytopathology Conference
10/20/2005
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Case 3
13-year-old girl with a 3 cm left cheek mass.
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Differential Diagnosis
• Pleomorphic adenoma
• Monomorphic adenoma
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Diagnosis?
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Pleomorphic Adenoma
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Pleomorphic Adenoma
• Most common salivary gland neoplasm
• Parotid gland (superficial lobe)
• Females>males (4:1)
• Rx: Excision with good margin of tissue
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Pleomorphic Adenoma: variable appearance
Epithelial and mesenchymal elements present.
Cystic, papillary, hyalinized or tubular.
Backround can have chondroid, myxoid, osteoid.
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Pleomorphic Adenoma
The stroma is the most outstanding feature. It is intensely metachromatic and stains a beautiful bright (fibrillary) magenta on diff-quick.
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Pleomorphic Adenoma
Hyaline cells
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Pleomorphic Adenoma
Mucous metaplasia and squamous metaplasia
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Pleomorphic Adenoma
Oncocytic metaplasia and sebaceous metaplasia
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Pleomorphic Adenoma
Tyrosine crystals and focal atypia
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Pleomorphic Adenoma
Hyaline Cells
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Pleomorphic Adenoma
Hyaline Globules: differential - adenoid cystic carcinoma - pleomorphic adenoma - monomorphic adenoma - mucus producing adenocarcinoma - acinic cell carcinoma - others with myoepithelial cells