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Pleomorphic Adenoma
Salivary Gland
79 years
79 year old female Patient with mass in the left parotid gland. History of mammary carcinoma
Cellular FNA consisting of basaloid and myoepithelial cells partially arranged around acellular hyalinised matrix. The larger fragments show some dense matrix with embedded spindled myoepithelial cells.
This case is challenging as the characteristic fibrillary matrix is lacking and the acellular hyalinised spheres are a typical feature of adenoid cystic carcinoma The presence of two cell types (epithelial and myoepithelial) and of matrix with embedded myoepitelial cells should guide the differential diagnosis in the direction of a pleomorphic adenoma. In cellular pleomorphic adenomas, which lack the characteristic fibrillary matrix a distinction from adenoid cystic carcinoma can be impossible and a descriptive diagnosis including a differential diagnosis should be made. Histology confirmed the diagnosis of pleomorphic adenoma.
Manuel Schlageter, University of Basel
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