Cytopathology Conference

10/20/2005

Case 3

13-year-old girl with a 3 cm left cheek mass.

Differential Diagnosis

• Pleomorphic adenoma

• Monomorphic adenoma

Diagnosis?

Pleomorphic Adenoma

Pleomorphic Adenoma

• Most common salivary gland neoplasm

• Parotid gland (superficial lobe)

• Females>males (4:1)

• Rx: Excision with good margin of tissue

Pleomorphic Adenoma: variable appearance

Epithelial and mesenchymal elements present.

Cystic, papillary, hyalinized or tubular.

Backround can have chondroid, myxoid, osteoid.

Pleomorphic Adenoma

The stroma is the most outstanding feature. It is intensely metachromatic and stains a beautiful bright (fibrillary) magenta on diff-quick.

Pleomorphic Adenoma

Hyaline cells

Pleomorphic Adenoma

Mucous metaplasia and squamous metaplasia

Pleomorphic Adenoma

Oncocytic metaplasia and sebaceous metaplasia

Pleomorphic Adenoma

Tyrosine crystals and focal atypia

Pleomorphic Adenoma

Hyaline Cells

Pleomorphic Adenoma

Hyaline Globules: differential - adenoid cystic carcinoma - pleomorphic adenoma - monomorphic adenoma - mucus producing adenocarcinoma - acinic cell carcinoma - others with myoepithelial cells