Stanley M W, Bardales R H, Farmer C E, Frierson H F, Suhrland M, Powers C N, Rollins S D
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
Diagn Cytopathol. 1995 Jul;13(1):37-43. doi: 10.1002/dc.2840130109.
We reviewed the clinical and fine-needle aspiration (FNA) findings in 20 patients with poorly differentiated carcinomas presenting initially as parotid or as submandibular masses. There were 11 primary tumors and nine metastatic malignancies in 14 males and six females ranging in age from 39 to 89 yr (median = 66). The tumor types included three primary carcinomas with oncocytic features, three additional cases of high-grade parotid carcinoma, one case of primary neuroendocrine carcinoma, two examples of malignant mixed tumor, one high-grade mucoepidermoid carcinoma, and a single example of malignant lymphoepithelial lesion. Six patients with metastatic carcinoma had previous diagnoses of malignancy. In the three remaining individuals, primary carcinomas of the lung (two cases), and an unknown primary site presented initially as parotid masses. Five examples of metastatic squamous cell carcinoma, one metastatic basal cell carcinoma, and two metastatic renal cell carcinomas were identified. One parotid lymphoepithelioma was interpreted cytologically as an atypical lymphoproliferative process suggestive of Hodgkin's disease. Nineteen cases (95%) were correctly classified as carcinoma at the time of FNA. High-grade carcinomas aspirated from the parotid may be primary, but are frequently metastatic to either the gland, or to an intraparotid lymph node. Our experience indicates that some metastatic carcinomas present at this site, without a previous history of malignancy. Distinguishing primary from metastatic lesions has important therapeutic implications.
我们回顾了20例最初表现为腮腺或下颌下肿块的低分化癌患者的临床及细针穿刺抽吸（FNA）结果。14例男性和6例女性患者年龄在39至89岁之间（中位数=66岁），其中有11例原发性肿瘤和9例转移性恶性肿瘤。肿瘤类型包括3例具有嗜酸性细胞特征的原发性癌、另外3例高级别腮腺癌、1例原发性神经内分泌癌、2例恶性混合瘤、1例高级别黏液表皮样癌以及1例恶性淋巴上皮病变。6例转移性癌患者之前有恶性肿瘤诊断。在其余3例患者中，原发性肺癌（2例）和1例原发部位不明的肿瘤最初表现为腮腺肿块。确定了5例转移性鳞状细胞癌、1例转移性基底细胞癌和2例转移性肾细胞癌。1例腮腺淋巴上皮瘤在细胞学上被解释为提示霍奇金病的非典型淋巴增殖性病变。19例（95%）在FNA时被正确分类为癌。从腮腺吸出的高级别癌可能是原发性的，但常转移至腺体或腮腺内淋巴结。我们的经验表明，一些转移性癌在此部位出现，且之前无恶性肿瘤病史。区分原发性和转移性病变具有重要的治疗意义。
