Cytomorphological spectrum of pleomorphic adenoma with emphasis on differential diagnosis and diagnostic pitfalls
Journal Title: Indian Journal of Pathology and Oncology - Year 2017, Vol 4, Issue 3
Abstract
Introduction: Pleomorphic adenoma exhibit wide morphological spectrum varying from predominantly epithelial types to predominantly stromal types which often pose diagnostic challenge to cytopathologists. Aim: The aim of the present study was to evaluate varied cytomorphological features of pleomorphic adenoma with an emphasis on differential diagnosis and to highlight diagnostic pitfalls. Materials and Method: This was a retrospective study from January 2011 to December 2015 in our Department of Pathology. During this period 220 patients with salivary gland space occupying lesions underwent FNAC, out of which 190 aspirates were satisfactory for evaluation, 75 aspirates were reported as pleomorphic adenoma and these 75 cases were reviewed by two cytopathologists independently for cytomorphological findings, diagnosis and differential diagnosis where needed. Results: On revised cytology 67 cases out of the 75 cases reported initially as pleomorphic adenoma were concordant with the earlier diagnosis. The remaining 8 cases on revised reporting were diagnosed as adenoid cystic carcinoma in 5 cases, mucoepidermoid carcinoma in 2 cases and basal cell adenoma in one case. The cytological smears of 67 cases of pleomorphic adenoma were categorized on basis of cellularity as mild (4.477%), moderate (44.776%) and marked (50.746%) as well as for ratio of epithelial to mesenchymal component. Varied morphological variations like squamous metaplasia (17.9%), mucinous metaplasia (2.9%), oncocytic change (5.9%), hyaline globule (2.9%), giant cells(4.47%), cystic degeneration (22.38%) and plasmacytoid cell differentiation (32.83%) were observed in cytological smears of pleomorphic adenoma. Conclusion: We conclude that adequate and representative sample is essential for proper cytological examination, further Romanowasky stain is mandatory for FNA of salivary gland lesions. Cytopathologists should be aware of varied cytomorphological characteristic of pleomorphic adenoma in order to minimize the possibility of diagnostic errors.
Authors and Affiliations
Vaneet Kaur Sandhu, Navtej Singh
Keywords
Related Articles
- EP ID EP315704
- DOI 10.18231/2394-6792.2017.0102
- Views 67
- Downloads 0
Histomorphological patterns of thyroid lesions: A study from a Tertiary Care Teaching Hospital of Dr BR Ambedkar Medical College
Introduction and Objective: Thyroid gland lesions are seen worldwide with geographical variation in incidence and histopathological pattern related to age, sex, dietary and environmental factors. This study is aimed to d...
Novel Transfusion parameters in Blood bank for Thalassemia patients
Introduction: Thalassemia major is most common monogenic disorder in the world. Around 1,00,000 children are born each year with the severe b homozygous state of the disease in India. The objectives of this study was to...
Immunohistochemistry in breast carcinoma
Introduction Breast Carcinoma has emerged as most common type of malignant tumor in women surpassing cervical carcinoma which was commonest few decades ago Hence a proper diagnostic protocol is very much necessary for di...
Evaluation of nucleic acid testing [NAT] of blood donors
Context Human immunodeficiency virus HIV hepatitis C virus HCV and hepatitis B virus HBV are easily transmitted through infected blood to prevent this serological screening of blood units is a routine norm Many cases cou...
Early renal biopsy in acute renal failure - Expect the unexpected
Present study was carried out to determine the contribution of early renal biopsy in diagnosis and management of acute renal failure ARF cases suspected on clinical grounds to be other than acute tubular necrosis non ATN...