Etit Demet, Pilch Ben Z, Osgood Rebecca, Faquin William C
Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA.
Diagn Cytopathol. 2007 Jul;35(7):444-7. doi: 10.1002/dc.20671.
Sclerosing polycystic adenosis (SPA) is a recently described, rare lesion of the salivary gland analogous to fibrocystic disease of the breast. Recognition of this benign entity is important since the differential diagnosis includes other more common benign and malignant salivary gland neoplasms, particularly mucoepidermoid carcinoma and tumors with cystic and oncocytic features. While the histomorphology of SPA is well documented, there is only one other cytologic description of SPA in the English-language literature. Here we describe the fine-needle aspiration biopsy findings in a case of SPA of the parotid gland in an 84-year-old woman. The aspirate was characterized by flat cohesive sheets of epithelial cells with moderate amounts of finely granular oncocytic cytoplasm and enlarged round nuclei with indistinct nucleoli. Some epithelial groups formed glandular structures with lumens, and the background contained small amounts of delicate mucoproteinaceous material. Occasional markedly vacuolated cells were present as well as many cells with apocrine change manifested by well-defined apical snouting. Familiarity with the cytomorphologic features of SPA, including its characteristic apocrine changes, is important for distinguishing it from other more clinically significant salivary gland lesions.
硬化性多囊性腺病（SPA）是一种最近才被描述的罕见唾液腺病变，类似于乳腺纤维囊性疾病。认识这种良性病变很重要，因为其鉴别诊断包括其他更常见的良性和恶性唾液腺肿瘤，特别是黏液表皮样癌以及具有囊性和嗜酸性特征的肿瘤。虽然SPA的组织形态学已有充分记录，但英文文献中仅有另一篇关于SPA的细胞学描述。在此，我们描述了一名84岁女性腮腺SPA病例的细针穿刺活检结果。吸出物的特征为扁平的上皮细胞黏附片，具有中等数量的细颗粒状嗜酸性细胞质，细胞核增大呈圆形，核仁不明显。一些上皮细胞团形成有腔隙的腺管结构，背景中含有少量细腻的黏液蛋白物质。偶尔可见明显空泡化的细胞，以及许多具有顶浆分泌改变的细胞，表现为明确的顶端隆起。熟悉SPA的细胞形态学特征，包括其特征性的顶浆分泌改变，对于将其与其他更具临床意义的唾液腺病变区分开来很重要。
