Bai Y P, Zhang Y, Tian C, Xing L, Liu H G
Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Head and Neck Molecular Diagnostic Pathology of Beijing, Beijing 100730, China.
Zhonghua Bing Li Xue Za Zhi. 2018 Apr 8;47(4):279-283. doi: 10.3760/cma.j.issn.0529-5807.2018.04.010.
To describe the cytologic features of adenoid cystic carcinoma (ADCC) of salivary glands, and to identify distinguishing cytologic features of ADCC and basal cell adenoma (BCA). A retrospective review of cytology smears of 30 cases of ADCC and 12 cases of BCA of salivary glands were performed. All cases were collected from Beijing Tongren Hospital, Capital Medical University from January 2010 to January 2017. Except for 2 aspirate smears of ADCC, all were touch imprint smears. All cases had further histological confirmation. Neoplastic ductal cells of ADCC were arranged in three-dimensional clusters, sheets and singles. Hyaline globules were found in most cases (20/30, 66.7%). The nuclei were round to oval, showing varying degrees of nuclear atypia. These included (1) the nuclei were hyperchromatic, demonstrating coarse or slightly coarse, irregularly distributed chromatin; (2) the nuclei were slightly large and vary in size; (3) appearance of the nuclei had a different degree of irregularity (often mild). Nucleoli were common seen (21/30, 70.0%), and were prominent in some cases. Mitosis and necrosis were rare. Cytologically, BCA showed cell arrangements and nuclear features overlapped with those of ADCC. The cytologic difference between these two tumors included: (1) the tumor cells presented rarely in singles; (2) hyaline globules were very uncommon (1/12) in BCA; (3) nuclei of BCA were hypochromatic or slightly hyperchromatic, homogeneous and uniform in appearance and size, overall without nuclear atypia and they were smaller and slender then those of ADCC and (4) individual cells of BCA showed relatively abundant cytoplasm. The cytologic features of ADCC and BCA both overlap and different from each other. Most cases can be diagnosed by cytologic examination. The presence of hyaline globules is an important diagnostic clue of ADCC, although not pathognomonic. Nuclear atypia of neoplastic ductal cells is an essential cytological feature in the diagnosis of ADCC, and is the most reliable point for differential diagnosis of ADCC and BCA.
描述涎腺腺样囊性癌（ADCC）的细胞学特征，并识别ADCC与基底细胞腺瘤（BCA）的鉴别性细胞学特征。对30例涎腺ADCC和12例涎腺BCA的细胞学涂片进行回顾性研究。所有病例均收集自2010年1月至2017年1月首都医科大学附属北京同仁医院。除2例ADCC吸取涂片外，其余均为印片涂片。所有病例均有进一步的组织学证实。ADCC的肿瘤导管细胞呈三维团簇、片状和单个排列。多数病例（20/30，66.7%）可见透明小球。细胞核圆形至椭圆形，显示不同程度的核异型性。这些包括：（1）细胞核染色质深染，呈粗颗粒状或稍粗颗粒状，分布不规则；（2）细胞核稍大，大小不一；（3）细胞核外观有不同程度的不规则性（通常较轻）。核仁常见（21/30，70.0%），在某些病例中较突出。有丝分裂和坏死少见。在细胞学上，BCA显示出与ADCC重叠的细胞排列和核特征。这两种肿瘤的细胞学差异包括：（1）肿瘤细胞很少单个出现；（2）BCA中透明小球非常少见（1/12）；（3）BCA的细胞核淡染或稍深染，外观和大小均匀一致，总体无核异型性，且比ADCC的细胞核小且细长；（4）BCA的单个细胞显示相对丰富的细胞质。ADCC和BCA的细胞学特征既有重叠又有不同。多数病例可通过细胞学检查诊断。透明小球的存在是ADCC的重要诊断线索，尽管并非特异性的。肿瘤导管细胞核异型性是ADCC诊断的基本细胞学特征，也是ADCC与BCA鉴别诊断的最可靠依据。
