Vande Haar Mark A, DeFrias Denise, Lin Xiaoqi
Department of Pathology, Northwestern Memorial Hospital, Northwestern University, Chicago, Illinois.
Diagn Cytopathol. 2014 Nov;42(11):959-63. doi: 10.1002/dc.23081. Epub 2013 Dec 20.
Sebaceous lymphadenoma (SLA) is a histologic variant of lymphadenoma or sebaceous adenoma of the salivary gland. The fine-needle aspiration (FNA) cytology of SLA has not been well-described. In this report, we reported a case that involved an 81-year-old male with a long-standing left parotid mass and was diagnosed on FNA cytology. The FNA smears showed clusters of three types of epithelial cells in a background of abundant lymphoid cells, macrophages and abundant proteinaceous materials. The predominant epithelial cells were large polygonal cells with abundant cytoplasm filled with multiple, uniform, small, and clear vacuoles, ill-defined cytoplasmic borders, and small centrally located round nuclei with finely granular chromatin, conspicuous nucleoli and indented nuclear membranes apparently imprinted by cytoplasmic vacuoles. These cells were surrounded by polygonal or flat cells with less or more dense cytoplasm, indistinct cell borders and round or oval small nuclei with smooth nuclear membranes, which correspond to germinative or basaloid cells. Some cells had granular cytoplasm. Large three dimensional clusters of nonkeratinized squamous cells have oval nuclei containing evenly distributed chromatin, and scant to moderate dense cytoplasm that were arranged in a "stream of fish" pattern. Rare granulomas and cystic contents (degenerated cells, inflammatory cells, macrophages, and abundant granular debris/proteinaceous material) were also seen. The diagnosis of SLA was confirmed by the surgical resection.
皮脂腺淋巴腺瘤(SLA)是涎腺淋巴腺瘤或皮脂腺腺瘤的一种组织学变体。SLA的细针穿刺(FNA)细胞学表现尚未得到充分描述。在本报告中,我们报告了一例81岁男性患者,其左侧腮腺肿物长期存在,通过FNA细胞学检查得以确诊。FNA涂片显示在大量淋巴细胞、巨噬细胞和丰富蛋白质物质的背景下有三种上皮细胞簇。主要的上皮细胞是大的多边形细胞,胞质丰富,充满多个均匀、小而透明的空泡,胞质边界不清晰,中央有小圆形核,核染色质细颗粒状,核仁明显,核膜有凹陷,明显是由胞质空泡压印而成。这些细胞被多边形或扁平细胞围绕,这些细胞胞质或多或少致密,细胞边界不明显,有圆形或椭圆形小核,核膜光滑,对应生发细胞或基底样细胞。一些细胞有颗粒状胞质。非角化鳞状细胞的大的三维细胞簇有椭圆形核,核内染色质分布均匀,胞质稀少至中等致密,呈“鱼群”状排列。还可见到罕见的肉芽肿和囊性内容物(退变细胞群、炎症细胞、巨噬细胞和丰富的颗粒状碎片/蛋白质物质)。通过手术切除证实了SLA的诊断。