PMC5829550_01
Myoepithelial carcinoma, cytology. Smears have rich cellularity and are dominated by polygonal pleomorphic tumor cells with abundant delicate cytoplasm. Nuclear atypia in the form of hyperchromasia, coarse chromatine distribution, and occasional large nuclei are observed. Neoplastic cells occasionally form cohesive clusters, and isolated cells are frequently seen. Cell non-neoplastic small mature lymphocytes are also observed. Background is hemorrhagic. (obj. 20x, Papanicolaou stain)
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Atypical cells displayed characteristics of epithelial cells with moderate atypia (Figure 1).
Myoepithelial carcinoma, histology. The tumor shows a somewhat nodular and solid growth pattern. Tumor cells exhibit clear cut pleomorphism; many of them showing epithelial morphology or fusiform shape, vacuolated cytoplasm with eosinophilic and some myxoid material in the background. (obj. 20x, hematoxylin and eosin stain)
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Markedly hyaline stroma and widespread areas of the perineural invasion were also present (Figure 2).
PMC5829550_02
Oncocytic carcinoma, clinical aspect. A right-sided subcutaneous inferior retro-auricular mass is observed, with a somewhat bosselated surface. Overlying skin is shiny and shows a bluish red discoloration. (Face partially blurred for patient privacy)
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Physical examination showed a firm, fixed mass, measuring about 10 cm in greatest diameter, located at the inferior pole of the right parotid gland without facial nerve involvement or lymph node enlargement (Figure 3).
Oncocytic carcinoma, cytology. A group of oncocytic cell is observed. The cells show moderate nuclear atypia (hyperchromasia, slight nuclear membrane irregularities, anisonucleosis). The cells have abundant finely granular eosinophilic cytoplasm, nuclei are eccentrically located (obj. 40x, Papanicolaou stain)
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FNAC showed numerous neoplastic cells with oncocytic change (finely granular eosinophilic cytoplasm, well defined cytoplasmic borders, slightly discohesive, moderately eccentric nuclei), many nuclei lacking cytoplasm, with moderate nuclear atypia and an associated but reduced lymphocytic population (Figure 4).
PMC5829550_03
Undifferentiated lymphoepithelial carcinoma, cytology. Smears showed high cellularity composed of aggregates of atypical epithelial cells in a background of mature lymphocytes. Neoplastic cells are predominantly found as cohesive clusters with scattered isolated cells at the periphery. Atypical cells having poorly defined cytoplasmic borders, large vesicular nucleus, finely granular chromatin, occasionally with single prominent nucleolus. (obj. 20x, Papanicolaou stain)
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A diagnosis of undifferentiated carcinoma was assessed on the cytological examination (Figure 5).
PMC5829550_04
Marginal zone B-cell lymphoma, clinical aspect. A left-sided, relatively well-demarcated preauricular, firm, non-tender mass are observed. Overlying skin is shiny
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Physical examination revealed a mass located at the lower pole of the right parotid, with greatest diameter of about 4 cm, having a firm structure, not attached to adjacent structures, without right facial nerve involvement (Figure 7).
Marginal zone B-cell lymphoma, cytology. Smears are composed of two distinct lymphoid cell populations, both having indistinct cellular margins. One is composed of medium sized, containing relatively large nucleus, with atypical nuclear borders, occasional nuclear molding, irregular chromatin, occasional large nucleoli. The other consists of normal looking, small mature lymphocytes. Neoplastic cells apparently are clustered, however a propensity for decohesion is readily observed (obj. 20x, Papanicolaou stain)
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FNAC was suggestive of lymphoproliferative lesion, composed of numerous monomorphic lymphoid cells within a background of non-specific inflammatory cells (Figure 8).