Su Cheng-Chuan, Chou Chien-Wen, Yiu Ching-Yi
Department of Clinical Pathology, Buddhist Dalin Tzu Chi General Hospital, Chiayi County, Taiwan.
J Oral Pathol Med. 2008 Jan;37(1):56-8. doi: 10.1111/j.1600-0714.2007.00543.x.
Fine-needle aspiration cytology (FNAC) is a highly accurate tool for the diagnosis of pleomorphic adenomas; however, this common salivary gland neoplasm can be diagnostically challenging, causing pitfalls in cytodiagnosis. A 50-year-old woman suffered from a painless, slowly-growing mass in the right posterior upper neck for 5 months. FNAC from this mass revealed many discohesive parakeratotic cells and keratin flakes, and a few stromal elements. Under the impression of metastatic well-differentiated squamous cell carcinoma, the tumor mass was totally excised. Histology confirmed a pleomorphic adenoma with marked squamous metaplasia and frequent keratin pearl formations without the evidence of malignancy. Pleomorphic adenoma occasionally reveals focal squamous metaplastic changes, when extensive, it may be misdiagnosed as metastatic well-differentiated squamous cell carcinoma in FNAC, particularly in the neck region.
细针穿刺细胞学检查（FNAC）是诊断多形性腺瘤的一种高度准确的工具；然而，这种常见的唾液腺肿瘤在诊断上可能具有挑战性，会在细胞诊断中造成陷阱。一名50岁女性右侧上颈部后方无痛性、生长缓慢的肿块已持续5个月。对该肿块进行的FNAC显示有许多散在的不全角化细胞和角质鳞片，以及一些间质成分。在转移性高分化鳞状细胞癌的印象下，肿瘤肿块被完全切除。组织学证实为多形性腺瘤，伴有明显的鳞状化生和频繁的角化珠形成，无恶性证据。多形性腺瘤偶尔会出现局灶性鳞状化生改变，当这种改变广泛时，在FNAC中可能会被误诊为转移性高分化鳞状细胞癌，尤其是在颈部区域。
