Stanley M W, Horwitz C A, Bardales R H, Stern S J, Korourian S
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
Diagn Cytopathol. 1997 Mar;16(3):247-52. doi: 10.1002/(sici)1097-0339(199703)16:3<247::aid-dc11>3.0.co;2-l.
A disparate group of salivary gland neoplasms is characterized by small, uniform, hyperchromatic, basaloid cells. This "small blue cell" pattern is most common in non-Warthin's types of monomorphic adenoma, or in adenoid cystic carcinoma. Small cell anaplastic carcinoma (primary or metastatic), metastatic basaloid squamous cell carcinoma, basal cell adenocarcinoma, and metastatic nasopharyngeal carcinoma are rarely encountered but may present a cytologically similar appearance. We report one female and two male patients (median age = 84 yr) with cutaneous-type basal cell carcinoma (BCC) aspirated from metastatic deposits in the parotid (2 cases) or the submandibular (1 case) gland. One was correctly classified at the time of aspiration, based on a previous history of multiple facial BCC. One was interpreted as carcinoma, the previous history being unavailable at the time of FNA. Smears in these two cases show necrosis and rare keratotic cells. The third cases was mistaken for pleomorphic adenoma (PA); the smears showed metachromatic fragments of collagenous tumor stroma that were misinterpreted as the matrix material typical PA. Similar material was identified in the other two cases. When the "small blue cell" pattern is encountered in salivary bland cytology, one should consider BCC, especially if necrosis is identified. The desmoplastic tumor stroma of BCC may mimic the chondroid matrix of PA. Careful consideration of previous history is very important.
一组不同的唾液腺肿瘤以小的、形态一致的、核深染的基底样细胞为特征。这种“小蓝细胞”模式在非沃辛瘤型单形性腺瘤或腺样囊性癌中最为常见。小细胞间变性癌（原发性或转移性）、转移性基底样鳞状细胞癌、基底细胞腺癌和转移性鼻咽癌很少见，但可能呈现出细胞学上相似的外观。我们报告了1例女性和2例男性患者（中位年龄 = 84岁），他们的腮腺（2例）或下颌下腺（1例）转移灶中吸出了皮肤型基底细胞癌（BCC）。其中1例根据既往面部多发BCC病史在吸出时被正确分类。1例被诊断为癌，在细针穿刺抽吸活检（FNA）时无法获取既往病史。这两例的涂片显示坏死和罕见的角化细胞。第3例被误诊为多形性腺瘤（PA）；涂片显示胶原性肿瘤基质的异染性碎片被误认作PA典型的基质材料。在其他两例中也发现了类似物质。当在唾液腺细胞学检查中遇到“小蓝细胞”模式时，应考虑BCC，尤其是发现坏死时。BCC的促结缔组织增生性肿瘤基质可能会模仿PA的软骨样基质。仔细考虑既往病史非常重要。
