PMC5941585_01
a, b O/E a diffuse swelling over the root of nose, measuring approx. 2 x 2 cm, hard and cystic in feel, non-tender, overlying skin was pinchable; c, d, e MDCT scan of paranasal sinuses showed a large mass lesion involving the nasal cavity with bony destruction of nasal septum, thinning of nasal turbinate's, deossification of hard palate, nasal bones &medial wall of the maxillary sinuses
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Fig1
External examination showed a small cystic swelling over root of nose extending to mid portion of nose (Fig. 1a, b). The mass measured approximately 5.7 x 4.7 x 3.3 cm (Fig. 1c, d, e).
a, b, c, d Cytosmears were very cellular with clusters and papillaroid fragments of basaloid looking cells. Seen admist were tumor cells are rounded globules & islands of uniform hyaline material that stained magenta. (Toluidine blue, x 10, 40; Geimsa, x 10,x 40)
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Fig2
A few papillaroid fragments with central fibro vascular core were also noted (Figs. 2 and 3).
a, b Cytosmears with clusters and papillaroid fragments of basaloid looking cells and transparent homogenous looking hyaline globules.(Pap, x 10,x 40); (c, d): Immunocytochemistry of the acetone fixed slide was strong positive for c-Kit(IHC,x 10,x 40)
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Fig3
A few papillaroid fragments with central fibro vascular core were also noted (Figs. 2 and 3). C-kit IHC was done on the cell block material and it showed strong and diffuse positivity (Figs. 3c, d and 4) Thus, a diagnosis of a sinonasal malignant salivary gland type neoplasm - adenoid cystic carcinoma was given.
a, b Cell block preparation showed classical cribriform pattern of ACC with IHC positivity for c-Kit (c, d) (H&E, x 10,x 40)
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Fig4
C-kit IHC was done on the cell block material and it showed strong and diffuse positivity (Figs. 3c, d and 4) Thus, a diagnosis of a sinonasal malignant salivary gland type neoplasm - adenoid cystic carcinoma was given.