Kaba Sadayuki, Kojima Masaru, Matsuda Hazuki, Sugihara Shiro, Masawa Nobuhide, Kobayashi Tadao K, Fukuda Toshio
Department of Laboratory Science, School of Health Sciences, Faculty of Medicine, Gunma University, Shouwa-machi, Maebashi, Gunma, Japan.
Diagn Cytopathol. 2006 Sep;34(9):631-5. doi: 10.1002/dc.20505.
Küttner's tumor (KT) is a benign tumor-like lesion of the salivary gland that mimics neoplasm clinically because of presentation as a hard mass. Recently, the histomorphological and immunohistochemical findings of this lesion have been analyzed, and differential diagnostic problems relating to salivary gland lymphoma have been discussed. However, currently there is little information on the cytological findings of those lesions. We present cytological findings from five such cases using fine-needle aspiration cytology (FNAC). FNAC of this lesion may present a diagnostic challenge to the cytologist as lesions share some cytologic features with inflammatory process containing numerous lymphoid cells. Smears obtained from two cases contained moderate to large numbers of lymphoid cells without definite cytological atypia, scattered ductal structures, and acinar cell clusters. The remaining three cases showed low cellularity probably attributable to fibrosis that made it difficult to aspirate the cellular element. FNAC findings of scattered ductal structures surrounded by collagens and infiltrated by a mixed population of lymphoid cells, not specific for KT, are highly suggestive of the diagnosis with the appropriate clinical findings. However, a portion of cytological specimens of KT containing relatively large numbers of lymphoid cells should be differentiated from malignant lymphoma arising from the submandibular gland.
库特纳瘤(KT)是一种唾液腺的良性肿瘤样病变,因其表现为坚硬肿块,在临床上类似肿瘤。最近,对该病变的组织形态学和免疫组化结果进行了分析,并讨论了与唾液腺淋巴瘤相关的鉴别诊断问题。然而,目前关于这些病变的细胞学结果的信息很少。我们通过细针穿刺细胞学检查(FNAC)展示了5例此类病例的细胞学结果。该病变的FNAC可能给细胞学家带来诊断挑战,因为病变与含有大量淋巴细胞的炎症过程有一些共同的细胞学特征。从2例病例中获得的涂片含有中等数量到大量的淋巴细胞,无明确的细胞学异型性,散在的导管结构和腺泡细胞簇。其余3例显示细胞含量低,可能归因于纤维化,导致难以吸出细胞成分。FNAC发现散在的导管结构被胶原包围,并被混合的淋巴细胞浸润,这并非KT所特有,但结合适当的临床发现,高度提示诊断。然而,一部分含有相对大量淋巴细胞的KT细胞学标本应与下颌下腺来源的恶性淋巴瘤相鉴别。