Leon Marino E, Santosh Neetha, Agarwal Amit, Teknos Theodoros N, Ozer Enver, Iwenofu O Hans
Department of Anatomic Pathology, Moffitt Cancer Center, University of South Florida, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA.
Divison of Oral and Maxillofacial Pathology and Radiology, The Ohio State University College of Dentistry, Columbus, OH, USA.
Head Neck Pathol. 2016 Sep;10(3):389-93. doi: 10.1007/s12105-016-0701-1. Epub 2016 Feb 24.
Chronic sclerosing sialadenitis (CSS) is a benign chronic inflammatory condition of the salivary gland. Clinically, CSS patients may present with a neck mass, often suggesting a neoplastic process. Fine-needle aspiration (FNA) is frequently used to evaluate these lesions. We present a series of 4 patients with CSS, in whom all but one had history of squamous cell carcinoma. The previous diagnosis of malignancy appeared to influence the interpretation of the cytologic preparations. Four patients who had undergone resection of a neck nodule that eventually was diagnosed as CSS were identified. FNA was performed in all 4 cases, and the final cytologic diagnosis in these cases included squamous cell carcinoma, basaloid neoplasm, and salivary gland neoplasm. During intraoperative consultation, the lesions were identified as benign, atrophic salivary gland with chronic inflammation, or sialadenitis with atypical glands. All resected specimens were submitted for histopathological examination and were considered diagnostic for CSS. CSS is a potential pitfall in the FNA interpretation of salivary gland lesions, especially if there is a previous history of head and neck malignancy. Awareness of this entity, adherence to strict cytologic criteria, and careful clinicopathologic correlation are helpful in preventing misinterpretation and unnecessary surgical intervention.
慢性硬化性涎腺炎（CSS）是涎腺的一种良性慢性炎症性疾病。临床上，CSS患者可能表现为颈部肿块，常提示肿瘤性病变。细针穿刺抽吸活检（FNA）常用于评估这些病变。我们报告了4例CSS患者，其中除1例患者外，其余患者均有鳞状细胞癌病史。既往的恶性肿瘤诊断似乎影响了对细胞学标本的解读。我们确定了4例曾接受颈部结节切除术的患者，最终这些结节被诊断为CSS。所有4例患者均进行了FNA，这些病例的最终细胞学诊断包括鳞状细胞癌、基底样肿瘤和涎腺肿瘤。在术中会诊时，病变被确定为良性、伴有慢性炎症的萎缩性涎腺或伴有非典型腺管的涎腺炎。所有切除标本均进行了组织病理学检查，均被诊断为CSS。CSS是涎腺病变FNA解读中的一个潜在陷阱，尤其是在有头颈部恶性肿瘤病史的情况下。认识到这一实体、遵循严格的细胞学标准以及仔细的临床病理相关性分析有助于防止误诊和不必要的手术干预。
