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

Publication Date

2014

Journal Title

Acta Cytologica

Abstract

BACKGROUND/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.

Volume Number

58

Issue Number

5

Pages

501-10

Document Type

Article

EPub Date

2014/10/25

Status

Faculty, Northwell Researcher

Facility

School of Medicine; Northwell Health

Primary Department

Pathology and Laboratory Medicine

PMID

25342157

DOI

10.1159/000368070

Comments

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