Cytopathology Conference
10/20/2005
Case 3
13-year-old girl with a 3 cm left cheek mass.
Differential Diagnosis
• 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
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