Fine needle aspiration cytology of basal cell adenoma of parotid simulating adenoid cystic carcinoma

Pal, Subrata; Mondal, Palash Kr; Sharma, Abhishek; Sikder, Mrinal

doi:10.4103/joc.joc_46_16

Cited by 6 publications

(5 citation statements)

References 7 publications

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“…Indeed, AdCC is a notoriously difficult neoplasm to accurately identify in an FNA sample; a College of American Pathologists survey revealed a false‐negative rate of 36.4%, with the most common culprits of cytologic misinterpretation being PA and monomorphic adenoma . Among BCAs, the membranous subtype is particularly problematic because it can show abundant globular hyaline matrix material resembling that seen in AdCC . However, Singh et al emphasized that the cell‐stroma interface can help to differentiate BCA, in which the cells are intermingled with adjacent stroma, from AdCC, in which the cells are sharply demarcated from the stroma.…”

Section: Discussionmentioning

confidence: 99%

Cytohistologic correlation of basaloid salivary gland neoplasms: Can cytomorphologic classification be used to diagnose and grade these tumors?

Gargano

Sebastiano

Solomides

et al. 2019

Cancer Cytopathology

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BACKGROUND: Basaloid salivary gland neoplasms (BSNs), which include benign primary tumors and primary or metastatic malignancies, show overlapping morphology in fine-needle aspiration (FNA). The Milan system recommends assigning a grade (low or high) to malignant salivary neoplasms because of the impact on surgical planning. This study investigated cytomorphologic features of BSNs on FNA that would help to favor a high-grade malignancy over a low-grade malignancy or a benign tumor. METHODS: Two pathologists performed a double-blinded cytologic evaluation of FNA cases diagnosed as BSNs that had corresponding surgical resections. The diagnosis made with the Milan system was correlated with the final surgical diagnosis and grade. Cytologic sensitivity, specificity, and predictive values were calculated. RESULTS: There were 132 BSN FNA cases; cytology slides were available for 77 of 87 patients who had undergone resection. The risk of malignancy for the benign neoplasm (BN), salivary gland neoplasm of uncertain malignant potential (SUMP), suspicious for malignancy (SFM), and malignant categories were 13.6%, 22%, 100%, and 100%, respectively. The sensitivity of the malignant/SFM category was 51.7%; another 37.9% of confirmed malignancies were diagnosed as SUMP. The specificity of the BN category was 86%. Favoring a high-grade malignancy on FNA had 100% accuracy (5 of 5). Favoring a low-grade malignancy on FNA had 75% accuracy (6 of 8). The most specific cytomorphologic clues for a high-grade malignancy were necrotic/ apoptotic debris, mitoses, discohesion, and anisonucleosis. CONCLUSIONS: BSNs encompass a broad spectrum of primary and metastatic tumors. Necrotic/apoptotic debris, mitotic activity, discohesion, and significant anisonucleosis, alone or especially in combination, should make a cytopathologist suspect a high-grade malignancy. Cancer Cytopathol 2020;128:92-99.

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Section: Discussionmentioning

confidence: 99%

Cytohistologic correlation of basaloid salivary gland neoplasms: Can cytomorphologic classification be used to diagnose and grade these tumors?

Gargano

Sebastiano

Solomides

et al. 2019

Cancer Cytopathology

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“…10 In basal cell adenoma and basal cell adenocarcinoma, the tumour cells are typically closely associated with the stroma, and exhibit nuclear β-catenin expression, which is negative in ACC. 7,11,12 Cytomorphological distinction may not always be possible, so the term 'basaloid neoplasm' is appropriate. Basaloid squamous cell carcinoma exhibits at least focal squamous differentiation, which ACC lacks, and usually demonstrates higher nuclear grade features.…”

Section: Discussionmentioning

confidence: 99%

“…Pleomorphic adenoma is characterised by its fibrillary matrix, in which myoepithelial and epithelial cells are embedded; PLAG1 and HMGA2 expression may be useful in diagnostically challenging cases 10 . In basal cell adenoma and basal cell adenocarcinoma, the tumour cells are typically closely associated with the stroma, and exhibit nuclear β‐catenin expression, which is negative in ACC 7,11,12 . Cytomorphological distinction may not always be possible, so the term ‘basaloid neoplasm’ is appropriate.…”

Section: Discussionmentioning

confidence: 99%

Malignant pleural effusion and pericardial effusion, an unusual presentation of metastatic adenoid cystic carcinoma of the floor of mouth: A case report with cyto‐histopathological correlation

Lin,

Nandakumar

2023

Diagnostic Cytopathology

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Adenoid cystic carcinoma (ACC) is an uncommon tumour that represents 5%–10% of salivary gland tumours and 1% of all head and neck malignancies. It is characterised by a protracted clinical course with late metastasis and poor long‐term prognosis. We report the case of a 38‐year‐old woman presenting with pulmonary and pleural metastases, on the background of ACC of the floor of mouth, which had been treated 4 years ago with surgical excision and radiotherapy. Cytological evaluation of the pleural effusion showed exfoliated ACC tumour cells. Despite palliative chemotherapy, the patient developed disease progression including metastatic spread to the pericardium, and died of disease within a year. This case illustrates an unusual presentation of ACC and highlights the importance of considering this entity when encountering a basaloid neoplasm in extra‐salivary locations.

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“…FNA is commonly used in conjunction with MRI. However, it is crucial to have a clinical suspicion, and even if the accuracy of FNA is low, the routine application of core biopsy and frozen section is not appropriate [ 11 ].…”

Section: Literature Reviewmentioning

confidence: 99%

Basal cell adenoma of parotid gland: two case reports and literature review

Yoon,

Kim,

Moon

2023

Arch Craniofac Surg

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Most of salivary tumors are benign in nature and are typically diagnosed and classified based on their histopathological presentation. Basal cell adenoma of the salivary glands is a rare, benign disease accounting for 1% to 3% of salivary gland tumors. Despite its low incidence, basal cell adenoma is the third most common benign tumor of the salivary gland after pleomorphic adenoma and Warthin’s tumor. It usually appears as a firm and slow-growing mass. Due to the prognosis, differential diagnosis with basal cell adenocarcinoma, adenoid cystic carcinoma and basaloid squamous cell carcinoma is required. In this report, we present two cases; a 62-year-old woman who presented with an asymptomatic, and slow-growing mass and a 64-year-old woman with a static-sized mass in the parotid gland. In both cases, the mass was completely excised, postoperative pathology reports confirmed the diagnosis of basal cell adenoma. We also review the literature and discuss this rare entity.

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Fine needle aspiration cytology of basal cell adenoma of parotid simulating adenoid cystic carcinoma

Cited by 6 publications

References 7 publications

Cytohistologic correlation of basaloid salivary gland neoplasms: Can cytomorphologic classification be used to diagnose and grade these tumors?

Cytohistologic correlation of basaloid salivary gland neoplasms: Can cytomorphologic classification be used to diagnose and grade these tumors?

Malignant pleural effusion and pericardial effusion, an unusual presentation of metastatic adenoid cystic carcinoma of the floor of mouth: A case report with cyto‐histopathological correlation

Basal cell adenoma of parotid gland: two case reports and literature review

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