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Adenoidcystic carcinoma
Salivary Gland
75 years
75 year old male Patient with palpable angular lymph node on the left.
Highly cellular FNA consisting of basaloid cells with moderate degree of nuclear atypia, arranged in 2- and 3-dimensional clusters. Apoptotic cells and background necrosis present. There is no obvious matrix component.
The anatomic location and the only moderate degree of nuclear atypia raise the differential diagnosis of a solid adenoid cystic carcinoma, which typically lacks the characteristic acellular matrix and spheres. Basaloid squamous cell carcinoma enters the differential diagnosis, but has high-grade features and often shows at least focal squamous differentiation. Apoptotic cells, necrosis and moderate nuclear atypia are not features of cellular pleomorphic adenoma. Histology confirmed the diagnosis of adenoid cystic carcinoma, which was partially solid.
Manuel Schlageter, University of Basel
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