Fine‐needle aspiration findings in patients with polymorphous low grade adenocarcinoma of the salivary glands

• Published in: Cancer Vol. 87; no. 1; pp. 31 - 36
• Main Authors: Gibbons, David, Saboorian, M. Hossein, Vuitch, Frank, Gokaslan, S. Tunc, Ashfaq, Raheela
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 25-02-1999; Wiley-Liss
• Subjects: Adenocarcinoma - secondary; Adenoma, Pleomorphic - pathology; Adult; Aged; Biological and medical sciences; Biopsy, Needle; Carcinoma, Adenoid Cystic - pathology; Diagnosis, Differential; fine‐needle aspiration; Humans; Lymphatic Metastasis - pathology; Medical sciences; Otorhinolaryngology. Stomatology; Parotid Neoplasms - pathology; polymorphous low grade adenocarcinoma; salivary glands; Salivary Glands, Minor - pathology; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Human; Adenocarcinoma; Salivary gland; Malignant tumor; Aspiration punction; Differential diagnostic; Fine needle aspiration biopsy; Case study; Pathology; Salivary gland disease; Fine needle; Low malignancy; ENT disease; Adult; Cytopathology
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/(SICI)1097-0142(19990225)87:1<31::AID-CNCR6>3.0.CO;2-G

BACKGROUND
Polymorphous low grade adenocarcinoma of the salivary glands (PLAC) is a low grade neoplasm that predominantly occurs in the minor salivary glands. In this site it is amenable to biopsy and histologic diagnosis. However, experience with fine‐needle aspiration (FNA) biopsy findings in these tumors is limited. The authors describe the FNA cytology of this entity.
METHODS
Fine‐needle aspirates from two primary parotid and three metastatic PLACs were reviewed and correlated with their histology.
RESULTS
All aspirates showed similar cytologic features, with hypercellular smears showing branching papillae, sheets and clusters composed of bland uniform cells with round‐to‐oval nuclei, dispersed chromatin, and absent or inconspicuous nucleoli. The cells generally had a scant‐to‐moderate amount of eosinophilic cytoplasm. Mitoses and nuclear pleomorphism were absent. These cells formed tubular structures containing hyaline globules in all cases and often a dispersed myxohyaline stroma. Bare nuclei also frequently appeared in the background. Two cases, which had prior histologic diagnoses, were diagnosed on FNA as metastatic PLAC. One metastatic case was diagnosed as benign metastasizing pleomorphic adenoma. One primary case was diagnosed as adenoid cystic carcinoma and one case as PLAC on FNA.
CONCLUSIONS
The cytologic differential diagnosis of PLAC includes adenoid cystic carcinoma, pleomorphic adenoma, and monomorphic adenoma. PLAC should be considered in the differential diagnosis of head and neck masses, where the cytology suggests one of these tumors, even when the clinical context (involvement of a major salivary gland, lymph node metastasis) is not typical of PLAC. Cancer (Cancer Cytopathol) 1999;87:31–6. © 1999 American Cancer Society.
The fine‐needle aspiration cytomorphologic features of five cases of polymorphous low grade adenocarcinoma of the salivary glands, two primary and three metastatic, are described.