PMC4500055_01
Magnetic resonance image (MRI) axial images. A) T1 sequence pre-Gadolinium demonstrates a well-circumscribed right parotid lesion hyperintense relative to muscle B) T1 sequence post-Gadolinium demonstrates partial enhancement C) T2 sequence demonstrates hyperintensity relative to parotid gland.
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F1
Figure 1). Fine needle aspiration (FNA) was described as a high-grade carcinoma with extensive necrosis, with a differential diagnosis including salivary duct carcinoma, acinic cell carcinoma, mucoepidermoid carcinoma, and adenocarcinoma NOS, among others (see Figure 2).
Fine needle aspirate. A-B) Papanicolaou stained ThinPrep slide showing tumor cells with crowding, enlarged nuclei with promiment nucleoli, and cytoplasmic vacuolization C) Hematoxylin and eosin stained cell block preparation showing cells with vacuolization of the eosinophilic cytoplasm and a microcystic architecture.
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F2
Figure 1). Fine needle aspiration (FNA) was described as a high-grade carcinoma with extensive necrosis, with a differential diagnosis including salivary duct carcinoma, acinic cell carcinoma, mucoepidermoid carcinoma, and adenocarcinoma NOS, among others (see Figure 2).
Gross and histologic pathology of the tumor. A) Gross appearance is that of a well-circumscribed partially cystic tumor B-C) Low-powered view demonstrates solid, microcystic and pseudopapillary architectural patterns with abundant eosinophilic, colloid-like secretions D) High-powered view reveals tumor cells with eosinophilic finely granular to vacuolated cytoplasm and round to oval nuclei with prominent nucleoli. (B-D, Hematoxylin and Eosin stains).
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F3
The large parotid tumor was classified as T2N0 mammary analogue secretory carcinoma (MASC) of the salivary gland (see Figure 3), with subsequent FISH analysis confirming a translocation of the ETV6 gene on chromosome 12p13.