fnac findings of pleomorphic adenoma

Found insideThis book provides cytopathologists a succinct but comprehensive reference covering common diagnostic dilemmas caused by normal, iatrogenic, inflammatory and reactive/reparative changes in cytology samples. Pleomorphic adenoma was the most common neoplasm (63%), followed by Warthin’s tumor (17.5%). It mainly arises from the parotid glands and it involves the minor salivary glands in approximately 8% of the cases, with the hard palate being the most common site of its occurrence. Three cases were false negative on FNAC, one case of pleomorphic adenoma and other two were benign lesions. BACKGROUND. STUDY DESIGN: The clinical presentation of 24 CXPAs was compared with 300 pleomorphic adenomas (PAs). Found insideThis book introduces basic ROSE techniques and resources required to set up ROSE service. No false positive cases were seen among all FNAC cases. 1) was the commonest and among malignant tumours, mucoepidermoid carcinoma 5 (4.06%) was common (Fig. Manifestations vary depending on the primary location of proliferation. Found inside – Page iIn response, this book compiles these relevant aspects in a single source. Radiation oncology is a dynamic field, and is continuously evolving. However, tracking down the latest findings is both difficult and time-consuming. Pleomorphic adenoma is the most common benign tumour of parotid gland (80%). FNAC in this study was 90%. Histology was available in 232 cases. It is composed of an array of tissue types, of both epithelial and mesen- chymal origins, and is regarded as benign in clinical be- ... FNAC findings of left pre-auricular swelling; (a) The case of a 63-year-old male, his management and … Patients are typically middle aged1, and prior head and neck irradiation is a risk factor for the development of these tumours. Pleomorphic adenoma "dubmbell tumour" is a common benign salivary gland neoplasm characterised by neoplastic proliferation of parenchymatous glandular cells along with myoepithelial components, having a malignant potentiality. In the present study, out of 30 cases, 29 cases of pleomorphic adenoma were confirmed by histopathology, and one was diagnosed as basal call adenoma. [5,6] It is more commonly seen in females of middle age group. In the current series, 5 of 10 (50%) aspirated carcinomas in pleomorphic adenomas demonstrated false-negative results and were misdiagnosed as pleomorphic adenomas in four cases. The most frequent benign and malignant lesions were pleomorphic adenoma and squamous cell carcinoma, respectively. Focal or All 21 patients underwent parotid tumor removal. FNAC findings were suggestive of pleomorphic adenoma in 9 patients, mucoepidermoid carcinoma in 5 patients, carcinoma ex pleomorphic in 3 patients, adenoid cystic carcinoma in 2 patients, poorly differentiated carcinoma, adenocarcinoma and acinic cell carcinoma in 1 patient each (Table 1). Adenoid cystic carcinoma was seen in two cases and mucoepidermoid carcinoma was present in one case. This text presents serious challenges for trainees, clinicians, and practicing pathologists and cytopathologists due to the wide spectrum of diagnoses that may be seen in children and the lack of familiarity with these entities. The tumors occur most commonly in patients aged 30-50 years and are slightly more common in females. This book presents wide ranging information on the applied surgical anatomy, clinical presentations and management of different salivary gland pathologies. FNAC was done in all the 25 patients. This second edition has been fully revised, with new topics added, to provide students with the latest advances in the field. Fine needle aspiration cytology in a case of pleomorphic adenoma of the parotid gland The smears from the FNA of the parotid contained abundant cells. Small groups of epitelial cells and abundant myxoid stroma. The volume is organized on the basis of the most recent WHO classification used in surgical pathology in order to provide a practical guide for modern cytologic diagnosis of surgical soft tissue and bone pathology. Twenty (10%) malignancies included 16 salivary gland carcinomas. FNAC had a diagnostic sensitivity of 100%, a positive-predictive value of 85% and accuracy of 85.7% for diagnosing benign parotid tumor. This edition of ICD-O, the standard tool for coding diagnoses of neoplasms in tumour and cancer registrars and in pathology laboratories, has been developed by a working party convened by the International Agency for Research on Cancer / ... Carcinoma ex pleomorphic Adenoma: A In an analysis of three skeletal metastases from a pleomorphic adenoma, Jin et al found that the karyotypic features of the metastases were different from those of benign pleomorphic adenoma and carcinoma ex pleomorphic adenoma. Carcinoma ex pleomorphic adenoma arises from a pre-existing benign mixed tumor. Pleomorphic adenoma (PA) is by far the most common salivary gland tumor (SGT), accounting for 44% of all and for nearly 70% of benign lesions [1, 2].When considering the parotid gland alone, representing the site of origin of nearly 80% of all SGT, PA accounts for 70% of all tumors, whereas non-pleomorphic adenomas (NPAs), including myoepithelioma, basal cell adenoma, oncocytoma, … The swelling was painless, insidious in onset, and progressively increased in size. All cases that were suspicious for malignancy on FNAC were proven to be malignant as well. MEC ex pleomorphic adenoma (PA) was suspected. Pleomorphic adenoma of the breast is a rare benign tumor, with patients ranging age from 23 to 78years.206 Clinically, pleomorphic adenoma presents as a firm, nontender, mobile mass in the subareolar area. Pleomorphic adenoma is the most common neoplasm of both the major and minor salivary glands. Pleomorphic adenoma of minor salivary gland is most common in palate (10%), followed by lip (4%).Approximately 34.7-67.1% of salivary gland tumors arising from an intraoral site are benign.5The smaller the salivary gland that is affected, the more likely it is to trigger a malignant tumor. Compatibility between FNAC and histological diagnosis was found in 74% (55/74), of which 78.3% in benign lesions (36/46) and in … Pleomorphic adenoma usually develops as a nontender nodular lesion with a slow growth rate persisting for years. Carcinoma ex pleomorphic adenoma is a rare neoplasm, seen most commonly in parotid gland. Microscopic (histologic) description. Preoperative and Postoperative Fine Needle Aspiration Cytology (Table 13) Preoperative FNAC reported as pleomorphic adenoma had a different pathology on HPE postoperatively in five patients (6.5%). 23 and Tahoun and Ezzat. Pleomorphic adenoma was the most common lesion among benign neoplastic lesions. Found inside – Page iiiThis book covers the full range of pathologic conditions encountered during childhood and youth, including tumors and tumor-like conditions of all organ systems, with direct links to developmental biology pathways and genetics. The mammogram can reveal a mass with poorly outlined borders that suggest a malignant process. Antony J, Gopalan V, Smith RA, et al. DISCUSSION Pleomorphic adenoma, called mixed tumor because of its The other two cases with false negative diagnosis were that of mucoepidermoid and adenoid cystic carcinoma which were inaccurately diagnosed on FNAC as pleomorphic adenoma. 2). Pathologic findings The well circumscribed, encapsulated oval mass was histologically revealed to be a tumour composed of uni- This book provides an easily comprehensible and practicable framework for standardised histopathology reports in surgical cancer. 16, 17 As for lymphomas, Zurrida et al 18 reported five false-negative findings in seven lymphomas, whereas in the series of Al-Khafaji et al, … This text re-evaluates our understanding of salivary gland disease. It attempts to integrate the newer clinical findings with the historical pathological record and to highlight, and where possible resolve, any conflicts between the two. FNAC, correlate FNAC findings with histopathology and find out reasons for common diagnostic pitfalls in FNAC. The presence of these features on FNAC can be misleading in the presence of a pleomorphic adenoma as was present in our case, as further classification was not possible on the sample. This text will become a very useful resources for surgeons as it allows complex clinical pathways to be conveniently organized in logical algorithms. It will become a concise yet comprehensive manual to assist in clinical decision making. b) Acinic cell carcinoma. Findings: A normal FNAC of the salivary gland would show: a) Acinar cells. It thus changes the management. It is a firm and painless mass. Bosselated outer surface, often with tongue-like protrusions (pseudopods) Typically has 3 components: Epithelial (ductal) component forming the inner layer of cysts and tubules. Most common non neoplastic lesion was chronic sialadenitis while pleomorphic adenoma was commonest benign lesion and adenoid cystic carcinoma was more frequent malignant lesion. • FNAC plays an important role in the diagnosis of pleomorphic adenoma. Pleomorphic adenoma is a common benign salivary gland neoplasm characterised by neoplastic proliferation of parenchymatous glandular cells along with myoepithelial components, having a malignant potentiality. Histopathology indicated the level IIA mass to be an encapsulated classic pleomorphic adenoma with a predominant myoepithelial component, surrounded by clusters of normal salivary gland tissue embedded in fatty tissue (Figure 3). PLEOMORPHIC ADENOMA MIXED TUMOUR SITE : MC: PAROTID GLAND ( 90%)- MC –Tail of gland Submandibular gland (7%) Minor salivary glands-MC : PalateOccurs more commonly in females (3:1)AGE : any age . It is composed of an array of tissue types, of both epithelial and mesen- chymal origins, and is regarded as benign in clinical be- ... FNAC findings of left pre-auricular swelling; (a) Found insideThis book is a complete guide to the diagnosis and management of ENT diseases for undergraduate medical students and trainees in otolaryngology. Cut surface. malignant. BACKGROUND. Postopera-tive course was uneventful, and function of the facial nerve remains intact. Among the benign lesions in the 81 cases, the most commonly diagnosed lesion in our study was Pleomorphic Adenoma, with a frequency of 51.84%, which is similar to the studies by Vaidya et al, 18 and Tahoun and Ezzat. Majority of such masses (78%) are found to be benign [7]. FNAC findings show features of pleomorphic adenoma (Figures 1 and 2). Histopathology Specimens: Clinical, Pathological and Laboratory Aspects, Second Edition will be of educative value and act as a reference tool for the medical undergraduate student, medical trainee in histopathology and the biomedical ... FNAC diagnosed three false -ve and one false +ve cases: one case of monomorphic adenoma FNAC, US-CNB and excision biopsy was performed was diagnosed as pleomorphic adenoma, one case of in all cases. This second edition has 8 new chapters, providing updated information on the use of FNAC for pancreas, gall bladder, soft tissue lesions, and skin and bone with a large number of new microphotographs, making Fine Needle Aspiration Cytology: ... https://radiopaedia.org/articles/pleomorphic-adenoma-of-the-salivary-glands Pleomorphic adenoma was the most common in benign tumor side (45.7%) while SCC is the most common in malignant group (53.6%). Pleomorphic adenoma is the most common salivary gland tumor, accounting for about 60% of all the salivary gland neoplasm’s. Sublingual tumor presents with fullness in the oral mucosal floor. Ectopic pleomorphic adenoma is one of the differential diagnoses to be taken into account when facing any level II cervical mass with well-defined borders at imaging, hypoechoic and hypovascular US features, and with minor but homogeneous contrast enhancement at CT. As FNAC is a fairly accurate preoperative procedure for the Post-operative course was uneventful and the definitive histology confirmed FNAC findings, showing a completely excised unifocal pleomorphic adenoma. This text describes a system of reporting breast fine needle aspiration biopsy that uses five clearly defined categories, each described by a specific term and each with a specific risk of malignancy. Final histopathological report confirmed the diagnosis of pleomorphic adenoma in 18 (90%) cases and Warthin's tumour in 2 (10%). unifocal pleomorphic adenoma, completely removed. [7,8] Sonographic findings are oval heterogeneous hypoechoic mass, cystic component may be seen. Pleomorphic adenomas account for 70-80% of benign salivary gland tumours and are especially common in the parotid gland (see below) 1,2. benign.2,3 Pleomorphic adenoma is a benign mixed tumor which is the ... on these cytomorphological findings, a diagnosis of pleomorphic adenoma arising from the minor salivary glands of the right buccal ... FNAC for the definite diagnosis of many tumors including those Pleomorphic adenoma with atypia was the diagnosis on cytology. Conclusion. Monographs in this series have given the field of cytology an outstanding set of reference works designed to assist the practising cytopathologist in his/her daily diagnostic work. False-negative FNAC findings in carcinoma ex pleomorphic adenoma are reported several times in the literature. On excision a solid, cystic, encapsulated tumour revealed features of basal cell adenoma with tubular, trabecular, solid and membranous areas . The origin of de novo pleomorphic adenoma is probably from displaced or aberrant salivary gland tissue within a lymph node (2). Pleomorphic adenoma, the most common benign tumour of major salivary glands such as parotid and submandibular glands is also known as benign mixed tumour due to presence of both epithelial and stromal components in FNAC as well as histopathology. Basal cell adenoma is a rare benign neoplasm of the salivary glands that derives its name from the basaloid appearance of the tumor cells. Review of the 45 cases diagnosed correctly on FNAC as PA, showed varied frequency of the following morpho-logic features. Discussion. Most of the patients were in the 20-40 year age group and amounted to 57 (46.35%). The final histology revealed the diagnosis of pleomorphic adenoma. Pleomorphic adenoma, the most common benign tumour of major salivary glands such as parotid and submandibular glands is also known as benign mixed tumour due to presence of both epithelial and stromal components in FNAC as well as histopathology. years. All cases of malignancy on FNAC were proven to be malignant on the final pathology. Fine needle aspiration cytology (FNAC) revealed the typical cytologic findings of PA. FNAC showed no false malignant findings, but it was false benign in 5 (2.6%) cases. Found inside – Page iiThis volume describes a uniform international approach for classifying and reporting salivary gland FNA samples. Pleomorphic adenoma in ultrasound. The diagnosis of salivary gland tumors utilize both tissue sampling and radiographic studies. Tissue sampling procedures include fine needle aspiration (FNA) and core needle biopsy (bigger needle comparing to FNA). Both of these procedures can be done in an outpatient setting. By offering a clear understanding of the science behind the evidence, the book fills a void for radiologists, neurologists, neurosurgeons, pediatricians, primary care physicians, and other clinicians with an interest in neuroimaging and a ... Mucoepidermoid carcinoma (MEC) was the only malignant lesion seen in our study. It preferentially occurs in the parotid gland during the sixth and seventh decades of life. On sectioning, degenerative and cystic changes can be seen. Common salivary gland swellings are: a) Pleomorphic adenoma. Around 70-80 percent of pleomorphic adenoma occur in the superficial lobe of the parotid gland, although the lesion may occur in any area of the parotid gland. Pleomorphic adenoma (PA) is the most common benign neoplasm of the salivary glands. The final histology revealed the diagnosis of pleomorphic adenoma. Adenoid cystic carcinoma is a close differential of pleomorphic adenoma and basal cell adenoma. The sensitivity of FNAC in detecting malignant tumors was 73% and the specificity was 97%. Color medical images are included. This second edition features new chapters on soft tissue methods and laboratory management. Annotation (c)2003 Book News, Inc., Portland, OR (booknews.com). CONCLUSION: This case illustrates that together with clinical and radiologic findings, primary PA of the EAC can confidently be diagnosed by FNAC. a pleomorphic adenoma in ESGT (Figure 4). One case of pleomorphic adenoma, which was diagnosed preoperatively, was found to be carcinoma ex-pleomorphic adenoma postoperatively on HPE. FNAC was performed on 40 patients with palpable parotid swelling. The incidence of pleomorphic adenoma (PA) of the minor salivary glands is reported to be 10%, and while the histological findings in PA can be diverse, keratin-filled cysts lined by squamous epithelium are rarely reported. Sensitivity, specificity and diagnostic accuracy of FNAC was 66.6%, 95.8% and 93% in case of neoplastic lesions and 100% in non neoplastic lesions. Written by more than 20 acknowledged experts, this volume is the most comprehensive and authoritative reference on diagnostic surgical pathology of the head and neck. Pleomorphic adenoma (PA) was the most common neoplasm identified (found in 63% of cases), followed by other benign neoplasms and, less commonly, malignancies. Features new to this edition include chapters on structure and ultrastructure of cells, current status of molecular biology and its application to diagnostic cytology, cell response to injury, cytology of cancer, AIDS, and flow cytometry; ... Altogether 171 (88%) tumors were classified as true salivary gland neoplasms. Pleomorphic adenoma on gross examination presents a single, well-circumscribed mobile mass. FNAC is a fairly accurate pre-operative procedure for the diagnosis of pleomorphic adenomas. Adenoid cystic carcinoma is a close differential of pleomorphic adenoma and basal cell adenoma. In the parotid, BCA is occasionally difficult to distinguish from pleomorphic adenoma due to its overlapping clinical and cytological features. We report a case of BCA which was initially treated as a case of pleomorphic adenoma, review literature and discuss the differential diagnosis of similar case. The condition can, however, present with cyst formation in some cases. References 1. Case #392. This book is in the series commonly referred to as the "Blue Book" series. and the smears demonstrated features indicative of pleomorphic adenoma admixed with findings indicative of a poorly differentiated carcinoma. Parapharyngeal masses are rather rare in occurrence, comprising only 0.5% of all the tumors arising in the head neck region. Found insideThis issue of Oral and Maxillofacial Surgery Clinics of North America is devoted to Advances in Oral and Maxillofacial Surgery and is edited by Drs. Jose M. Marchena, Jonathan Shum and Jonathon S. Jundt. Divided into two parts, this book covers everything from advances in oncogenesis and its relationship to orbital tumors, to medical genetics and the role of imaging in diagnosis of orbital tumors. The other two cases with false negative diagnosis were that of mucoepidermoid and adenoid cystic carcinoma which were inaccurately diagnosed on FNAC as pleomorphic adenoma. It can be as small as a few millimeters or can be large or giant. Pleomorphic adenomas are easily identified on cytology, because of their characteristic biphasic pattern comprising of epithelial/myoepithelial cells and fibromyxochondroid stroma. New edition presenting latest advances in oral medicine. Includes multiple choice questions for revision and a free book called Basic Oral Radiology (9789351523215). Previous edition published in 2008. These guide books fit into the lab coat pocket, ideal for portability and quick reference. Each volume is heavily illustrated with a full color art program, while the text follows a user-friendly outline format. The great majority (78%) of pleomorphic adenomas are found in the superficial portion of the parotid glands, most of the tumors arise in the superficial portion of the parotid gland. Organized by major organs and body systems, the text offers comprehensive, abundantly illustrated guidance to enable both the radiologist and clinical oncologist to better appreciate and overcome the challenges of tumor imaging. Sensitivity, specificity and diagnostic accuracy of FNAC was 66.6%, 95.8% and 93% in case of neoplastic lesions and 100% in non neoplastic lesions. Pleomorphic adenoma, being the most common salivary gland tumor constitutes 45-74% cases of all the salivary gland neoplasms and 53-77% occurring in the parotid gland. The results as observed in FNA smears and histologic sections are shown in Table II. 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