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Fine-needle aspiration cytology of mammary analog secretory carcinoma masquerading as low-grade mucoepidermoid carcinoma: case report with a review of the literature.

AbstractBACKGROUND/AIM:
The primary role of fine-needle aspiration cytology (FNAC) of salivary gland masses is to determine the underlying process and guide further management. The objective of our study is to provide a comprehensive review of cytologic features and ancillary studies of mammary analog secretory carcinoma (MASC), discuss differential diagnosis and review recent advances in the understanding of its biologic behavior.
CASE:
A 23-year-old female underwent ultrasound-guided FNA of a slowly enlarging parotid mass. Smears displayed branching clusters of bland vacuolated polygonal cells in a secretory proteinaceous background. Eosinophilic cells with eccentric nuclei and inconspicuous nucleoli were also noted. Based on positive intracellular mucin staining and the lack of extracellular-matrix material, the cytologic diagnosis rendered was 'suspicious for low grade mucoepidermoid carcinoma'. Superficial parotidectomy revealed an MASC confirmed by fluorescence in situ hybridization (FISH) studies for ETV6 translocation.
CONCLUSION:
MASC should be included in the differential diagnosis of mucinous salivary lesions with cystic changes on FNA. Immunohistochemistry for mammaglobin and S-100 helps in excluding morphologic mimics. FISH helps to confirm the diagnosis. Age alone should not be a deterrent in diagnosing a carcinoma.
AuthorsJaya Bajaj, Cecilia Gimenez, Farah Slim, Mohamed Aziz, Kasturi Das
JournalActa cytologica (Acta Cytol) Vol. 58 Issue 5 Pg. 501-10 ( 2014) ISSN: 0001-5547 [Print] Switzerland
PMID25342157 (Publication Type: Case Reports, Journal Article)
Copyright© 2014 S. Karger AG, Basel.
Chemical References
  • Biomarkers, Tumor
  • S100 Proteins
  • Secretoglobins
Topics
  • Biomarkers, Tumor (genetics)
  • Biopsy, Fine-Needle
  • Breast Neoplasms (diagnosis, pathology)
  • Carcinoma (diagnosis, pathology)
  • Carcinoma, Acinar Cell (diagnosis, genetics, pathology)
  • Carcinoma, Mucoepidermoid (diagnosis, pathology)
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization, Fluorescence
  • Parotid Gland (metabolism, pathology)
  • S100 Proteins (genetics)
  • Salivary Gland Neoplasms (diagnosis, genetics, pathology)
  • Secretoglobins (genetics)
  • Young Adult

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