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扁桃体发生的小涎腺筛状腺癌伴颈部淋巴结转移:一例报告及细针穿刺细胞学描述

Cribriform adenocarcinoma of the minor salivary gland arising in the tonsil with metastasis to a cervical lymph node: A case report with description of fine needle aspiration cytology.

作者信息

Pagano Alexa, Dennis Katie

机构信息

University of Kansas School of Medicine, Alexa Pagano, Kansas City, Kansas, 66160.

Department of Pathology, University of Kansas School of Medicine, Kansas City, Kansas, 66160.

出版信息

Diagn Cytopathol. 2017 May;45(5):468-471. doi: 10.1002/dc.23687. Epub 2017 Feb 16.

Abstract

Cribriform adenocarcinoma of minor salivary gland (CAMSG) is a rare tumor of the head and neck. We report a case of a 70-year-old female who presented with a 4-5-month history of a left neck mass. CT scan of the neck showed a left neck mass just inferior to the angle of the mandible and left tonsillar prominence. Fine-needle aspiration (FNA) of the neck mass showed epithelial groups with focal cribriform architecture. The cells had round to oval nuclei and fine chromatin. The background contained scattered lymphocytes. A preliminary diagnosis of low grade adenocarcinoma with cribriform features metastatic to a lymph node was made. Subsequent biopsy of the tonsil mass showed a tumor with a combination of tubular, solid, and papillary architecture containing round to ovoid nuclei with very fine chromatin, consistent with cribriform adenocarcinoma of the minor salivary gland. Cribriform adenocarcinoma of minor salivary gland has a documented tendency to metastasize to cervical lymph nodes. Since this neoplasm can cytologically and histologically resemble other neoplasms of the head and neck, including polymorphous low-grade adenocarcinoma (PLGA), papillary thyroid carcinoma (PTC), and occasionally adenoid cystic carcinoma, being aware of and familiar with the cytologic features of CAMSG on FNA smears is important for patient management. Diagn. Cytopathol. 2017;45:468-471. © 2017 Wiley Periodicals, Inc.

摘要

小涎腺筛状腺癌(CAMSG)是一种罕见的头颈部肿瘤。我们报告一例70岁女性患者,其左颈部肿块已有4 - 5个月病史。颈部CT扫描显示左颈部肿块位于下颌角下方及左扁桃体突出处。颈部肿块细针穿刺活检(FNA)显示上皮细胞团呈局灶性筛状结构。细胞具有圆形至椭圆形核及细染色质。背景中有散在淋巴细胞。初步诊断为低级别具有筛状特征的腺癌转移至淋巴结。随后扁桃体肿块活检显示肿瘤具有管状、实性和乳头状结构,包含圆形至卵圆形核及非常细的染色质,符合小涎腺筛状腺癌。小涎腺筛状腺癌有转移至颈部淋巴结的记录倾向。由于该肿瘤在细胞学和组织学上可类似于头颈部的其他肿瘤,包括多形性低级别腺癌(PLGA)、乳头状甲状腺癌(PTC),偶尔还类似于腺样囊性癌,因此了解并熟悉FNA涂片上CAMSG的细胞学特征对患者管理很重要。《诊断细胞病理学》2017年;45:468 - 471。© 2017威利期刊公司

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