Saini Tarunpreet, Kundu Reetu, Bhujade Harish, Singh Harmandeep
Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Cytopathology. 2023 Nov;34(6):607-610. doi: 10.1111/cyt.13275. Epub 2023 Jul 20.
Most salivary gland neoplasms are of epithelial origin. Sarcomas of the parotid gland, including leiomyosarcoma, are exceedingly rare mesenchymal tumours. A definitive diagnosis of leiomyosarcoma is challenging on cytomorphology alone. We herein describe a case of a 41-year-old woman who presented with parotid gland swelling. The patient was previously diagnosed with leiomyosarcoma of the parotid gland on histopathology. Fine needle aspiration cytology was done from this recurrent swelling. Cytomorphology combined with cell block immunocytochemistry was fruitful in confirming the tumour recurrence. Primary and recurrent/metastatic leiomyosarcoma of the parotid gland is a rarity and cannot be distinguished on cytology. Such a distinction is based on the known history of prior malignancy, which was forthcoming in the present case, or after an exhaustive work-up. Pertinent clinical history and radiology provide leads for the cytopathologist. They must be sought so that immunocytochemistry can be applied judiciously and a precise/nearly precise cytological diagnosis rendered, as it guides patient management. The diagnosis is challenging on cytology as the spindle cell lesions of the parotid gland range from reactive to benign to malignant tumours.
大多数唾液腺肿瘤起源于上皮组织。腮腺肉瘤，包括平滑肌肉瘤，是极为罕见的间叶性肿瘤。仅依靠细胞形态学对平滑肌肉瘤进行明确诊断具有挑战性。我们在此描述一例41岁女性患者，她因腮腺肿大前来就诊。该患者之前经组织病理学诊断为腮腺平滑肌肉瘤。对此次复发的肿块进行了细针穿刺细胞学检查。细胞形态学结合细胞块免疫细胞化学有助于确诊肿瘤复发。腮腺原发性和平滑肌肉瘤复发/转移极为罕见，且无法在细胞学上进行区分。这种区分基于既往恶性肿瘤的已知病史（本病例即如此），或者在进行详尽检查之后。相关的临床病史和影像学检查为细胞病理学家提供线索。必须获取这些信息，以便明智地应用免疫细胞化学并做出准确/近乎准确的细胞学诊断，因为这对患者的治疗管理具有指导作用。由于腮腺的梭形细胞病变涵盖从反应性病变到良性肿瘤再到恶性肿瘤的各种情况，所以在细胞学上进行诊断具有挑战性。
