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Cytopathology Conference 10/20/05 - Case 3

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Cytopathology Conference 10/20/05 - Case 3

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Cytopathology Conference 10/20/05 - Case 3

  1. 1. Cytopathology Conference 10/20/2005
  2. 2. Case 3 13-year-old girl with a 3 cm left cheek mass.
  3. 7. Differential Diagnosis <ul><li>Pleomorphic adenoma </li></ul><ul><li>Monomorphic adenoma </li></ul>
  4. 8. Diagnosis?
  5. 9. Pleomorphic Adenoma
  6. 10. Pleomorphic Adenoma <ul><li>Most common salivary gland neoplasm </li></ul><ul><li>Parotid gland (superficial lobe) </li></ul><ul><li>Females>males (4:1) </li></ul><ul><li>Rx: Excision with good margin of tissue </li></ul>
  7. 11. Pleomorphic Adenoma: variable appearance Epithelial and mesenchymal elements present. Cystic, papillary, hyalinized or tubular. Backround can have chondroid, myxoid, osteoid.
  8. 12. Pleomorphic Adenoma The stroma is the most outstanding feature. It is intensely metachromatic and stains a beautiful bright (fibrillary) magenta on diff-quick .
  9. 13. Pleomorphic Adenoma Hyaline cells
  10. 14. Pleomorphic Adenoma Mucous metaplasia and squamous metaplasia
  11. 15. Pleomorphic Adenoma Oncocytic metaplasia and sebaceous metaplasia
  12. 16. Pleomorphic Adenoma Tyrosine crystals and focal atypia
  13. 17. Pleomorphic Adenoma Hyaline Cells
  14. 18. Pleomorphic Adenoma Hyaline Globules: differential - adenoid cystic carcinoma - pleomorphic adenoma - monomorphic adenoma - mucus producing adenocarcinoma - acinic cell carcinoma - others with myoepithelial cells

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