Cytopathology of a Newly Described Salivary Gland Neoplasm: A Case Report of Microsecretory Adenocarcinoma Presenting in the Parotid Gland.

IF 1.6 4区 医学 Q3 PATHOLOGY
Acta Cytologica Pub Date : 2024-01-01 Epub Date: 2024-10-14 DOI:10.1159/000541997
Rubina Razack, Justin A Bishop, Julandi Alwan, Liezel Coetzee, Daniel Rudolph De Wet, Wasim Mahomed, Marc Merven, Pawel Tomasz Schubert, Amir Afrogheh
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引用次数: 0

Abstract

Introduction: Microsecretory adenocarcinoma (MSA) is a novel entity defined by distinctive histology, a specific immunophenotype, and unique molecular fusion MEF2C::SS18. It occurs mainly in intra-oral minor salivary glands and the skin, with only one reported case affecting the parotid gland. To the best of our knowledge, no cytomorphological features of MSA have been published to date. We report the first case of fine-needle aspiration biopsy (FNAB) cytology of MSA diagnosed in the parotid gland.

Case presentation: A 48-year-old man presented with a 3.5 × 2.5-cm parotid mass. FNAB of the tumour revealed a cellular smear comprising a predominantly epithelial cell population showing luminal differentiation with secretory features and a distinctive background matrix with both myxoid and mucinous qualities. Scattered, but conspicuous multinucleated giant cells were present, a feature not commonly observed in salivary gland aspirates. Histology of the excised tumour revealed classic features of MSA with supportive immunohistochemistry and SS18 break apart fusion detected by fluorescence in situ hybridisation (FISH). Next-generation sequencing confirmed a MEF2C::SS18 gene fusion.

Conclusion: MSA is a rare neoplasm and should be considered in the cytological differential diagnosis of low-grade salivary gland neoplasms. Its unique cytomorphological features should raise the possibility of MSA in salivary gland FNABs. The diagnosis can be established on cellular cell block preparations using immunohistochemistry and FISH or PCR.

一种新描述的唾液腺肿瘤的细胞病理学。腮腺微分泌性腺癌病例报告。
简介:微分泌性腺癌(MSA)是一种新型实体瘤,具有独特的组织学、特异的免疫表型和独特的分子融合 MEF2C::SS18。它主要发生在口腔内小唾液腺和皮肤上,仅有一例报道影响到腮腺。据我们所知,MSA 的细胞形态学特征尚未发表。我们报告了首例经细针穿刺活检(FNAB)细胞学诊断为腮腺 MSA 的病例:一名 48 岁的男子因 3.5 x 2.5 厘米的腮腺肿块就诊。肿瘤的 FNAB 显示细胞涂片主要由上皮细胞组成,显示管腔分化,具有分泌特征,背景基质明显,同时具有肌浆和粘液特征。涎腺抽吸物中不常见的多核巨细胞散在分布,但非常明显。切除肿瘤的组织学检查显示了MSA的典型特征,免疫组化和荧光原位杂交(FISH)检测到了SS18断裂融合。下一代测序证实了MEF2C::SS18基因融合:MSA是一种罕见的肿瘤,应在低级别唾液腺肿瘤的细胞学鉴别诊断中予以考虑。其独特的细胞形态学特征应提高唾液腺 FNAB 中 MSA 的可能性。可使用免疫组化、FISH 或 PCR 对细胞块制备物进行诊断。
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来源期刊
Acta Cytologica
Acta Cytologica 生物-病理学
CiteScore
3.70
自引率
11.10%
发文量
46
审稿时长
4-8 weeks
期刊介绍: With articles offering an excellent balance between clinical cytology and cytopathology, ''Acta Cytologica'' fosters the understanding of the pathogenetic mechanisms behind cytomorphology and thus facilitates the translation of frontline research into clinical practice. As the official journal of the International Academy of Cytology and affiliated to over 50 national cytology societies around the world, ''Acta Cytologica'' evaluates new and existing diagnostic applications of scientific advances as well as their clinical correlations. Original papers, review articles, meta-analyses, novel insights from clinical practice, and letters to the editor cover topics from diagnostic cytopathology, gynecologic and non-gynecologic cytopathology to fine needle aspiration, molecular techniques and their diagnostic applications. As the perfect reference for practical use, ''Acta Cytologica'' addresses a multidisciplinary audience practicing clinical cytopathology, cell biology, oncology, interventional radiology, otorhinolaryngology, gastroenterology, urology, pulmonology and preventive medicine.
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