Malik Vipra, Dixit Mallika, Sharma Shivani, Jain Asheesh, Dhankad Adesh, Mohanty Sambit K
Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurugram, India.
Histopathology and Cytology, Asheesh Pathology Laboratory, Meerut, India.
Pathol Res Pract. 2023 Nov;251:154884. doi: 10.1016/j.prp.2023.154884. Epub 2023 Oct 11.
Papillary cystadenoma (PC) of the salivary gland is an uncommon benign epithelial neoplasm that shows predominantly multicystic growth pattern with intraluminal papillary proliferation and areas of oncocytic differentiation. We report a case of papillary cystadenoma of the parotid gland in a 44-years-old female. The patient presented with painful nodular swelling in the right parotid region for two months. Ultrasonography revealed a well marginated oval lesion with altered signal intensity involving the superficial lobe. The excision specimen showed a neoplasm with multicystic spaces having papillary projections lined by benign low-grade epithelium and supported by fibrovascular cores. No significant cytological atypia or mitosis was observed. The cells were immunoreactive for Keratin, Keratin 7, and were negative for Keratin 20, AR, HeR2/neu, TTF1, CDX2, and GATA3. p63 and Keratin 5/6 highlighted the myoepithelial cell layer lining the cystic spaces as well as the papillary projections. The Ki-67 proliferation index was 6%. The patient is on close clinical and imaging follow-up for the last 1year and 8 months without any evidence of disease recurrence or metastasis. Rarity of the lesion and distinct histomorphology warrants appropriate knowledge and discussion of the subject.
涎腺乳头状囊腺瘤（PC）是一种罕见的良性上皮性肿瘤，主要表现为多房性生长模式，伴有管腔内乳头状增生和嗜酸性细胞分化区域。我们报告一例44岁女性腮腺乳头状囊腺瘤病例。患者右侧腮腺区出现疼痛性结节状肿胀2个月。超声检查显示一个边界清晰的椭圆形病变，信号强度改变，累及浅叶。切除标本显示一个肿瘤，有多个囊腔，囊腔内有乳头状突起，由良性低级别上皮衬覆，并由纤维血管轴心支撑。未观察到明显的细胞学异型性或有丝分裂。细胞对角蛋白、角蛋白7呈免疫反应性，对角蛋白20、雄激素受体（AR）、人表皮生长因子受体2/neu（HeR2/neu）、甲状腺转录因子1（TTF1）、尾型同源盒转录因子2（CDX2）和GATA结合蛋白3（GATA3）呈阴性。p63和角蛋白5/6突出显示了囊腔以及乳头状突起内衬的肌上皮细胞层。Ki-67增殖指数为6%。在过去的1年8个月里，患者接受密切的临床和影像学随访，没有任何疾病复发或转移的迹象。该病变的罕见性和独特的组织形态学值得对该主题有适当的认识和讨论。
