Background:Pleomorphic adenoma (PA) is the most common benign tumor of the salivary glands. Histologically it is characterized by presenting epithelial as well as mesenchymal elements and may contain various metaplastic changes. Case presentation: In this article, a case of PA with extensive mucinous metaplasia and histologically very similar to mucoepidermoid carcinoma (MEC) is presented. Discussion and Conclusions:Pleomorphic adenoma with extensive mucinous and squamous differentiation can potentially be misdiagnosed as MEC. Immunohistochemistry was not effective in the differential diagnosis and the diagnosis was confirmed by the absence of MAML2 translocation.
Rosai‐Dorfman disease (RDD) is a rare benign histiocytosis usually characterized by massive cervical lymphadenopathy and systemic manifestations. Extranodal, especially spinal involvement, is extremely rare. Our case was deemed worthy of presentation because it was the first reported isolated case of spinal RDD related to IgG4 and mimicked meningioma clinically and radiologically. A case with an intradural extramedullary mass causing neurological compression findings in the thoracic spinal region and radiologically mimicking meningioma is presented. In the histomorphological examination of the resection material, polymorphonuclear leukocytes in the dura, histiocytes showing emperipolesis, an increase in collagenized fibrous connective tissue, and intense lymphoplasmacytic cell infiltration accompanied by obliterative phlebitis were observed. Immunohistochemically, the histiocytic cells were found to be S‐100 protein, CD68, and CD163 positive and CD1a and langerin negative, and more than half of the plasma cells were immunoglobulin‐G4 (IgG4) positive. Although rare, RDD or IgG4‐related meningeal disease should be considered in the differential diagnosis of dural‐based spinal masses that radiologically suggest meningioma. The pathologist should be aware that these two histopathological entities may coexist. To our knowledge, this is the first case of “isolated spinal RDD related to IgG4” reported in the literature.
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