Primary peripheral pulmonary adenoid cystic carcinoma: Report of a case diagnosed by fine needle aspiration cytology

Chon, Soon-Ho; Park, Yong Wook; Oh, Yu Whan; Shinn, Sung Ho

doi:10.1002/dc.21409

Cited by 8 publications

(6 citation statements)

References 9 publications

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“…Lacrimal gland is the other primary site in this region 14 . Nonsalivary primary sites were lung, trachea, breast and paravaginal skin and soft tissue in our study as they were reported 6‐9,23,24 . The cytomorphology of all cases both salivary and nonsalivary was identical.…”

Section: Discussionsupporting

confidence: 59%

“…14 Nonsalivary primary sites were lung, trachea, breast and paravaginal skin and soft tissue in our study as they were reported. [6][7][8][9]23,24 The cytomorphology of all cases both salivary and nonsalivary was Our study showed that this tumor occurred primarily and mostly in major and minor salivary glands (50% of cases), followed by head and neck region (15% of cases). The lymph nodes (10% of cases) were Table 3 for details.…”

Section: Discussionmentioning

confidence: 56%

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Adenoid cystic carcinoma cytology: Salivary gland and nonsalivary gland

Chowsilpa

An²,

Maleki

2020

Diagnostic Cytopathology

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Objectives: Adenoid cystic carcinoma (ACCA) is an uncommon primary malignancy of salivary glands and rarely nonsalivary tissue. This study aims to evaluate the diagnostic accuracy of ACCA on fine needle aspiration (FNA) material and the associated challenges. Methods: A search on electronic pathology database from 2006 to 2016 at The Johns Hopkins Hospital found 83 cytology specimens diagnosed as ACCA, 49 with histology follow-up. Results: Fifty-two females and 31 males were found ranging from 37 to 95 years old (mean 62.5). The tumor size was 1 to 11.5 cm (mean 3.4). FNAs were performed on 46 salivary glands (54.88%), 12 head and neck masses (14.45%), 9 lymph nodes (10.84%), 9 tracheas/lungs (10.84%), 4 vaginal/perineum/gluteal masses (4.82%), and one for each kidney, liver and abdominal/pelvic mass (1.21%). 83 FNA diagnoses revealed 3 nondiagnostics (3.61%), 20 neoplasms with unspecified features (24.10%), 30 basaloid neoplasms (36.14%), 18 ACCA (21.69%), and 12 other malignancies (14.46%). The accuracy of FNA in diagnosis of ACCA comparing to histologic follow-up in 49 cases was 87.5% sensitivity, 66.67% specificity, with 92.11% positive predictive value and 54.55% negative predictive value. The most common mimicker was pleomorphic adenoma. Conclusion: ACCA can be diagnosed not only in the salivary gland FNAs, but also respiratory tract, intra-abdominal, kidney, and gynecologic regions. FNA is a preferred technique to assess mass lesions. However, a diagnosis of ACCA on FNA material should be rendered with caution since there are benign and malignant neoplasms with overlapping features. Awareness of prior medical history and ancillary studies can improve the diagnosis. K E Y W O R D S adenoid cystic carcinoma, basaloid neoplasm, fine needle aspiration, nonsalivary gland adenoid cystic carcinoma, the Milan system for reporting salivary gland cytopathology 1 | INTRODUCTION Adenoid cystic carcinoma (ACCA) is an uncommon malignancy. It accounts for approximately 1% of all head and neck tumors and is a well-known salivary gland malignancy. The most common site is minor salivary glands, followed by parotid, submandibular, and sublingual glands. 1-4 However, the tumors may arise in other organs such as lacrimal glands, nasal and paranasal sinuses, larynx and trachea, breast, skin, and vulva. 2,3,5-12 Patients are in middle age or older during the initial presentation of the tumor, with high frequency in fifth and sixth decades. 2-4 Males and females are affected equally, 2 but some studies reported female

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 56%

Adenoid cystic carcinoma cytology: Salivary gland and nonsalivary gland

Chowsilpa

An²,

Maleki

2020

Diagnostic Cytopathology

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“…The focal sieve-like structure of pleomorphic adenoma may resemble PACC, but distinguishing between the two can be done based on cell morphology, structural pattern, interstitial composition, and immunohistochemistry. Pleomorphic adenomas share a common histogenesis at the intercalated duct level and often exhibit a combination of neoplastic basaloid cells [ 32 ]. Diagnosis of pleomorphic adenomas was unlikely as this benign tumor typically has a Ki-67 value of less than 5%.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Adenoid Cystic Carcinoma Mimicking Asthma-Like Symptoms: A Case Report and Literature Review

Zhou,

Jiang,

et al. 2024

Case Rep Oncol

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Introduction: Pulmonary adenoid cystic carcinoma (PACC) is a rare, low-grade malignant salivary gland-type tumor characterized by a dormant onset and slow progression, often leading to misdiagnosis. Due to its rarity, limited cases have been reported in the literature. This report aimed to enhance clinicians’ understanding of this infrequent disease. Case Presentation: We present the case of a 41-year-old female patient diagnosed with PACC. Our report provides a comprehensive analysis of the patient’s imaging, pathology, and treatment, with a particular focus on immunohistochemical results. Importantly, we emphasize the significance of considering foreign bodies and tumors in the bronchus when encountering asthma-like symptoms unresponsive to conventional treatments. Due to the uncertain etiology and pathophysiology of PACC, there are currently no established guidelines for chemotherapy and radiotherapy. Conclusion: PACC predominantly manifests as bronchial lesions without significant clinical heterogeneity. Therefore, it is crucial to consider foreign bodies and tumors in the bronchus when dealing with asthma-like symptoms, especially in patients without chronic lung disease who do not respond to anti-infective, antispasmodic, and antiasthmatic treatments. Additionally, meticulous examination of lesions is essential for timely diagnosis and intervention, ultimately improving patient survival rates.

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“…Cytological findings include cohesive clusters of repetitive medium-sized cells, with scant cytoplasm and uniform, small, hyperchromatic nuclei containing a finely granular, evenly distributed chromatin (Figures 2C–F). Tumor cells are often arranged around a central core of homogeneous myxoid material, or form three-dimensional, “ball-like” clusters (Table 4) (10–13, 15, 19–22, 24, 26, 33). All of these features that recapitulate the histopathology of AdCC are helpful in correctly orienting the cytological diagnosis of this neoplasm.…”

Section: Discussionmentioning

confidence: 99%

“…All of these features that recapitulate the histopathology of AdCC are helpful in correctly orienting the cytological diagnosis of this neoplasm. Sometimes, isolated hyaline globules can be observed (7, 20, 24, 26); singly dispersed cells are present on some smears (11, 26). The basement membrane material, forming globules that have a light blue appearance on PAP stain and bright magenta on MGG stain, is the characteristic feature of AdCC; diagnostic difficulties arise when they are not present on cytological material, as the pattern could mimic carcinoid tumor, SCLC, NSCLC, and reserve cell hyperplasia (19).…”

Section: Discussionmentioning

confidence: 99%

Cytology of Primary Salivary Gland-Type Tumors of the Lower Respiratory Tract: Report of 15 Cases and Review of the Literature

et al. 2017

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Primary pulmonary salivary gland-type tumors are rare neoplasms arising from the seromucinous submucosal glands of the lower respiratory tract (LRT), the most common of which are mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma. They are morphologically indistinguishable from their salivary gland counterpart and recognizing them is a challenge, especially on cytological specimens. We analyzed 15 cases of histologically proven primary salivary gland tumors of the LRT to identify cytomorphological features and define potential diagnostic clues that might assist cytopathologists in the preoperative diagnosis of these neoplasias. Three out of the four cases of adenoid cystic carcinomas showed the characteristic tridimensional cell clusters and hyaline globules, whereas the last one did not show malignant cells; only two cases of MEC presented the three characteristic cell types (i.e., squamous, intermediate, and mucin secreting) on cytology. Since these neoplasms are rare and do not have a completely specific set of cytological features, it is important for practicing cytopathologists to be aware of the possibility of encountering them, in specimens from patients with LRT masses, in order to render the correct diagnosis.

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Primary peripheral pulmonary adenoid cystic carcinoma: Report of a case diagnosed by fine needle aspiration cytology

Cited by 8 publications

References 9 publications

Adenoid cystic carcinoma cytology: Salivary gland and nonsalivary gland

Adenoid cystic carcinoma cytology: Salivary gland and nonsalivary gland

Pulmonary Adenoid Cystic Carcinoma Mimicking Asthma-Like Symptoms: A Case Report and Literature Review

Cytology of Primary Salivary Gland-Type Tumors of the Lower Respiratory Tract: Report of 15 Cases and Review of the Literature

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