Siddaraju Neelaiah, Badhe Bhawana Ashok, Goneppanavar Mangala, Mishra Manisha Manaswini
Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
Acta Cytol. 2008 Jul-Aug;52(4):495-9. doi: 10.1159/000325561.
There are only rare case reports of preoperative fine needle aspiration cytologic (FNAC) diagnosis of myoepithelioma of the salivary gland. Myoepitheliomas with pure spindle cell morphology may simulate a variety of benign or malignant spindle cell soft tissue tumors.
A 54-year-old woman presented with a history of progressively increasing swelling in the right parotid region. The clinical diagnosis was parotid malignancy. Routine FNAC yielded highly particulate material. The smears were cellular, with tissue fragments, clusters of spindle cells and numerous small globules and strands of bright magenta material. High cellular yield and pure spindle cell population with an accentuated chromatin pattern in Papanicolaou-stained smears simulated a low-grade spindle cell soft tissue sarcoma. A vague resemblance to a schwannoma was also noted. However, based on the characteristic findings of the May-Grünwald-Giemsa (MGG)-stained smears, a preoperative diagnosis of myoepithelioma was made and confirmed by subsequent histopathologic examination and immunohistochemistry.
Cytologically, spindle cell myoepithelioma of the salivary gland may simulate low-grade spindle cell soft tissue sarcoma or schwannoma. However, optimal sampling of the lesion and logical interpretation of the MGG-stained smears, in the appropriate clinical situation, allow a confident preoperative diagnosis of these tumors.
涎腺肌上皮瘤术前细针穿刺细胞学（FNAC）诊断的病例报告极为罕见。具有纯梭形细胞形态的肌上皮瘤可能类似多种良性或恶性梭形细胞软组织肿瘤。
一名54岁女性，有右侧腮腺区肿胀逐渐加重的病史。临床诊断为腮腺恶性肿瘤。常规FNAC获取了高度颗粒状物质。涂片细胞丰富，有组织碎片、梭形细胞簇以及许多小的亮品红色物质小球和条索。巴氏染色涂片中细胞产量高且纯梭形细胞群体伴有染色质模式增强，类似低级别梭形细胞软组织肉瘤。还注意到与神经鞘瘤有模糊的相似之处。然而，基于改良巴氏染色涂片的特征性表现，术前诊断为肌上皮瘤，并经后续组织病理学检查和免疫组化证实。
在细胞学上，涎腺梭形细胞肌上皮瘤可能类似低级别梭形细胞软组织肉瘤或神经鞘瘤。然而，在适当的临床情况下，对病变进行最佳取材并对改良巴氏染色涂片进行合理解读，能够在术前对这些肿瘤做出可靠诊断。
