腮腺腺泡细胞癌中的乳头样结构：细针穿刺抽吸活检（FNAC）中一个潜在的诊断陷阱。

Bansal Anju, Kaur Manveen, Dalal Varsha, Siraj Fouzia

Department of Pathology, National Institute of Pathology (ICMR), Safdarjang Hospital Campus, New Delhi, India.

J Cytol. 2018 Jan-Mar;35(1):57-59. doi: 10.4103/0970-9371.223597.

Fine needle aspiration cytology (FNAC) is often the first investigation in the work up of salivary gland lesions. However, its diagnostic accuracy is limited by the high rates of false positives and false negatives. Usually, acinic cell carcinoma is prone to be underdiagnosed because of the cytological similarity of the tumor cells to normal acinar cells, however rarely, a predominant papillary architecture on cytology may cause confusion with adenocarcinomas. We present a case of a 45-year-old male with a painful swelling of the right parotid region. FNA smears revealed a predominant papillary architecture and focal acinar pattern. A provisional diagnosis of acinic cell carcinoma was given, which was confirmed on histopathology. Familiarity with the cytomorphologic features of acinic cell carcinoma is cardinal for an accurate diagnosis and appropriate management.

细针穿刺细胞学检查（FNAC）通常是唾液腺病变检查中的首要手段。然而，其诊断准确性受到较高的假阳性和假阴性率的限制。通常，腺泡细胞癌容易被漏诊，因为肿瘤细胞在细胞学上与正常腺泡细胞相似，不过很少见的是，细胞学上以乳头状结构为主可能会与腺癌混淆。我们报告一例45岁男性，右侧腮腺区出现疼痛性肿胀。细针穿刺涂片显示以乳头状结构为主且有局灶性腺泡样形态。初步诊断为腺泡细胞癌，组织病理学检查证实了这一诊断。熟悉腺泡细胞癌的细胞形态学特征对于准确诊断和恰当处理至关重要。