Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA.
Otolaryngology-Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Ann Diagn Pathol. 2022 Dec;61:152058. doi: 10.1016/j.anndiagpath.2022.152058. Epub 2022 Oct 29.
We are presenting a case of a 74-year-old female with a parotid gland mass. Fine-needle aspiration (FNA) of the mass demonstrated cohesive groups of epithelial cells with overall bland-appearing nuclei and abundant vacuolated cytoplasm, consistent with sebaceous cells, in a background of polymorphous lymphocytes, scattered histiocytes, and adipose tissue. Immunostains showed that the epithelial cells stain positive for p63, but negative for CD117 and DOG-1. CD3 and CD20 showed a mixture of T- and B-cells. On the PAP-stained slides, there were numerous sac-like structures, consistent with myospherules. These findings were suggestive of neoplasm with sebaceous differentiation. The main differential diagnosis included sebaceous adenoma, sebaceous lymphadenoma, and other benign lesions with sebaceous differentiation. The parotid mass was resected. Histology sections demonstrated a well-circumscribed neoplasm with multicystic epithelial component and surrounding lymphoid infiltrate, consistent with sebaceous lymphadenoma. Sebaceous lymphadenoma (SLA) is a rare benign salivary gland neoplasm that is most commonly seen in the parotid gland. Preoperative FNA diagnosis of sebaceous neoplasms is challenging. To the best of our knowledge, this is the third case of sebaceous lymphadenoma diagnosed preoperatively. In this manuscript, we detail the epidemiological characteristics and histogenesis of sebaceous salivary gland neoplasms, and the cytomorphologic differential diagnosis of SLA with key diagnostic features of each entity.
我们呈现了一例 74 岁女性的腮腺肿块病例。该肿块的细针穿刺(FNA)显示,上皮细胞呈凝聚力团块,细胞核总体呈温和外观,胞质丰富空泡化,符合皮脂腺细胞,背景为多形性淋巴细胞、散在的组织细胞和脂肪组织。免疫染色显示上皮细胞 p63 染色阳性,CD117 和 DOG-1 染色阴性。CD3 和 CD20 显示 T 细胞和 B 细胞混合存在。在巴氏染色切片上,有许多囊状结构,符合肌球体。这些发现提示具有皮脂腺分化的肿瘤。主要鉴别诊断包括皮脂腺腺瘤、皮脂腺淋巴腺瘤和其他具有皮脂腺分化的良性病变。腮腺肿块被切除。组织学切片显示边界清楚的多囊性上皮成分和周围的淋巴浸润,符合皮脂腺淋巴腺瘤。皮脂腺淋巴腺瘤(SLA)是一种罕见的良性涎腺肿瘤,最常见于腮腺。术前 FNA 诊断皮脂腺肿瘤具有挑战性。据我们所知,这是第三个术前诊断为皮脂腺肿瘤的病例。在本文中,我们详细描述了皮脂腺涎腺肿瘤的流行病学特征和组织发生,以及 SLA 的细胞形态学鉴别诊断,重点介绍了每个实体的关键诊断特征。