Cytopathology Conference 10/20/2005

Case 3 13-year-old girl with a 3 cm left cheek mass.

Differential Diagnosis Pleomorphic adenoma Monomorphic adenoma

Pleomorphic adenoma

Monomorphic adenoma

Diagnosis?

Pleomorphic Adenoma

Pleomorphic Adenoma Most common salivary gland neoplasm Parotid gland (superficial lobe) Females>males (4:1) Rx: Excision with good margin of tissue

Most common salivary gland neoplasm

Parotid gland (superficial lobe)

Females>males (4:1)

Rx: Excision with good margin of tissue

Pleomorphic Adenoma: variable appearance Epithelial and mesenchymal elements present. Cystic, papillary, hyalinized or tubular. Backround can have chondroid, myxoid, osteoid.

Pleomorphic Adenoma The stroma is the most outstanding feature. It is intensely metachromatic and stains a beautiful bright (fibrillary) magenta on diff-quick .

Pleomorphic Adenoma Hyaline cells

Pleomorphic Adenoma Mucous metaplasia and squamous metaplasia

Pleomorphic Adenoma Oncocytic metaplasia and sebaceous metaplasia

Pleomorphic Adenoma Tyrosine crystals and focal atypia

Pleomorphic Adenoma Hyaline Cells

Pleomorphic Adenoma Hyaline Globules: differential - adenoid cystic carcinoma - pleomorphic adenoma - monomorphic adenoma - mucus producing adenocarcinoma - acinic cell carcinoma - others with myoepithelial cells