Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
Second Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Apr;133(4):e91-e95. doi: 10.1016/j.oooo.2021.08.019. Epub 2021 Aug 30.
Cribriform adenocarcinoma of minor salivary gland (CAMSG) is a rare malignancy presenting cytologic features resembling papillary thyroid carcinoma, localized in the oral cavity and oropharynx. Although cervical lymph node (LN) metastasis is a frequent manifestation of CMSG, there are few publications evaluating its cytology. The aim of this report was to present a CAMSG in an unusual location in the light of cytologic features, thereby enriching the spectrum of fine-needle aspiration biopsy (FNAB) differential diagnosis. We report a case of a 76-year-old woman presenting an enlarged submandibular LN on physical examination. Computed tomography revealed a submucosal lesion situated predominantly in the nasopharynx. FNAB and subsequently an open biopsy of submandibular LN were conducted. In cytologic smear cribriform, dense clusters of monomorphic round-oval tumor cells with scant cytoplasm were observed. Histologically, the tumor was composed of oval, overlapping cells with bright nuclear chromatin and nuclear grooves forming cribriform, papillary, and solid structures. Immunohistochemistry panel revealed the following: TTF-1 (-), thyroglobulin (-), S100 (+), p63 (+), Gal-3 (+), and CK19 (+) focally. The diagnosis of CAMSG should be considered when dealing with nasopharyngeal mass. Commonly, nodal metastases are observed in this tumor; therefore, appropriate evaluation of cytologic smear is crucial for patient management.
小唾液腺癌（CAMSG）的筛状腺癌是一种罕见的恶性肿瘤，其细胞学特征类似于甲状腺乳头状癌，局限于口腔和口咽。虽然颈淋巴结（LN）转移是 CMSG 的常见表现，但很少有文献评估其细胞学表现。本报告的目的是根据细胞学特征描述一个不常见部位的 CAMSG，从而丰富细针抽吸活检（FNAB）的鉴别诊断范围。我们报告了一例 76 岁女性，体检时发现下颌下淋巴结肿大。计算机断层扫描显示位于鼻咽部的黏膜下病变。进行了 FNAB，随后进行了下颌下 LN 的开放性活检。在细胞学涂片上，观察到密集的圆形或卵圆形肿瘤细胞形成筛状、致密的簇状，细胞浆稀少。组织学上，肿瘤由椭圆形、重叠的细胞组成，核染色质明亮，核沟形成筛状、乳头状和实性结构。免疫组织化学小组显示：TTF-1（-），甲状腺球蛋白（-），S100（+），p63（+），Gal-3（+），CK19（+）局灶性。当处理鼻咽部肿块时，应考虑 CAMSG 的诊断。通常，这种肿瘤会出现淋巴结转移；因此，对细胞学涂片进行适当评估对于患者的管理至关重要。
