PMC9987294_01
Ultrasonography of the right parotid gland and fine-needle aspiration cytology sample.. Axial (A) and longitudinal (B) sonogram of the right parotid gland showing a single lobulated and well circumscribed hypoechogenic cystic lesion inside the superficial parenchyma (black arrow) with acoustic enhancement (black asterisk). The lesion present with few echogenic foci (white arrow) in the upper part that may represent debris or particles suspended in fluid. Liquid-based preparation of fine-needle aspiration of right intraparotid lesion (C) displaying pseudopapillary cluster in a cystic background with << dirty >> necrosis and amorphous material (Papanicolau, 400x).
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F1
An ultrasonography was performed to determine differential diagnosis and identified a single lobulated and well circumscribed hypoechogenic cystic lesion with irregular edges, inside the superficial parenchyma of the gland (Figure 1A, B). Hence, an ultrasound-guided fine-needle aspiration (FNA) was performed revealing widespread "dirty" necrosis and cystic background with pseudo papillary clusters of moderately atypical cells with cyanophilic cytoplasm (Figure 1C).
Representative face contrast-enhanced CT slices. Coronal (A) and axial (B) reconstructions showing a single slightly heterogeneous, well circumscribed enhancing nodular lesion within superficial middle third (arrow) of right parotid gland characterized by a thin fibrous capsule surrounding the lesion.
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F2
Cut section and cell-block preparation of the right parotid gland. (A= The tumor appeared as a cyst within the parotid gland; B=An histologic overview of the lesion (hematoxylin-eosin); C=Papillary cluster of moderately atypical cell with macrophages and necrotic cellular debris (hematoxylin-eosin, 400x); D=Microscopically, the wall of the cyst was lined by a proliferation with a papillary and micropapillary architecture (hematoxylin-eosin)
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F3
Grossly, the lesion consisted of a single cystic space, with a diameter of 1,3 cm (Figure 3A). Microscopically, the cyst had a smooth contour and was surrounded by a fibrous capsule (Figure 3B,D). The wall of the cyst was lined by a proliferation with a papillary and micropapillary architecture (Figure 3D). The cells had ovoid nuclei and abundant cytoplasm, and showed no apocrine features (Figure 3C).