D'Antonio Antonio, Baldi Carlo, Memoli Domenico, Caleo Alessia, Rosamilio Rosa, Zeppa Pio
Department of Pathologic Anatomy and Oncology, A.O.U. San Giovanni di Dio e Ruggi d'Aragona via S. Leonardo, Salerno, Italy.
Diagn Cytopathol. 2013 Feb;41(2):171-3. doi: 10.1002/dc.21801. Epub 2011 Oct 24.
Intraparotid spindle cell lipoma (SCL) of the salivary gland is a rare entity. Review of the literature revealed only two previous reports describing its cytological features. We report a case of a 44-year-old man who complained for a slowly growing, asymptomatic mass in the left parotid gland that since 12 months. Fine needle aspiration biopsy (FNAB) showed a loose collections of bland-appearing spindle cells in a myxoid background admixed with capillary fragments and some mature fat cells suggesting a diagnosis of SCL. A cytological diagnosis of mesenchymal myxoid spindle cell tumor with lipomatous differentiation, possibly an intraparotideal SCL was performed. Histological examination of the mass and the positive immunostaining for CD34 and negativity for S-100, CK-cocktail, and actin confirmed the diagnosis of SCL. The diagnosis of intraparotid SCL can be made by examining cytologic material containing mature fat with bland spindle cells in a myxoid background. FNAB diagnosis on SCL also allows to rule out other primary salivary gland tumors that may be clinically and instrumentally indistinguishable and thereby permits an appropriate surgical procedure to ensue.
腮腺内涎腺梭形细胞脂肪瘤(SCL)是一种罕见的病变。文献回顾显示此前仅有两篇报道描述过其细胞学特征。我们报告一例44岁男性患者,他主诉左侧腮腺有一个缓慢生长、无症状的肿块,已持续12个月。细针穿刺活检(FNAB)显示在黏液样背景中有散在的形态温和的梭形细胞,混有毛细血管片段和一些成熟脂肪细胞,提示SCL的诊断。作出了间叶性黏液样梭形细胞肿瘤伴脂肪化生的细胞学诊断,可能为腮腺内SCL。对肿块进行组织学检查,以及CD34免疫染色阳性、S - 100、细胞角蛋白混合抗体和肌动蛋白免疫染色阴性,证实了SCL的诊断。腮腺内SCL的诊断可通过检查含有成熟脂肪且在黏液样背景中有形态温和的梭形细胞的细胞学材料来作出。对SCL的FNAB诊断还可以排除其他在临床和影像学上难以鉴别的原发性涎腺肿瘤,从而能够进行适当的外科手术。