Acinic cell carcinoma‐papillary cystic variant. Pitfalls of fine needle aspiration diagnosis: study of five cases and review of literature

Abstract

Hypocellular, cyst-like specimens pose a diagnostic problem when using FNA, as they can easily be misinterpreted as a benign cyst of the salivary gland. Our review of cases found certain 'red flags' that should prompt pathologists to further investigate the true acinic origin of hypocellular cystic specimens. On close morphological examination, these specimens revealed the presence of tight cellular clusters, distinct cytoplasmic borders, larger nuclei with distinct nucleoli and binucleated cells.

A case of secretory carcinoma of the parotid gland provides cytological clues for the differential diagnosis of this disease

“…Similarly, cytoplasmic vacuolar size in secretory carcinoma varies considerably . In addition, papillary clusters with capillaries may be observed in PCV‐ACC . Thus, a differential diagnosis between these tumours is difficult based merely on the presence of a vacuolated cytoplasm and the papillary configuration of tumour cells with capillaries.…”

“…Because both secretory carcinoma and PCV‐ACC share similar cytological features in terms of cell cluster characteristics and cytomorphological features, a cytological differential diagnosis between these two neoplasms can be challenging. Cytoplasmic vacuolar size in PCV‐ACC has been reported to vary from fine and uniform to single‐large (targetoid) . Similarly, cytoplasmic vacuolar size in secretory carcinoma varies considerably .…”

Diagnostic challenges and problem cases in salivary gland cytology: A 20‐year experience

“…Naked nuclei and lymphocytes occasionally are observed in the background . Prominent papillary features present in some cases, squamoid and metaplastic oncocytic changes, cystic changes, histiocyte‐like vacuolated cytoplasm, and a lack of single cells may lead to a misdiagnosis of variants of acinic cell carcinoma . Acinic cell carcinoma can be a false‐negative diagnosis as benign acinar cells, sialadenosis, sialadenitis, Warthin tumor, or oncocytoma .…”

“…14 Prominent papillary features present in some cases, squamoid and metaplastic oncocytic changes, cystic changes, 22 histiocyte-like vacuolated cytoplasm, and a lack of single cells may lead to a misdiagnosis of variants of acinic cell carcinoma. 23,24 Acinic cell carcinoma can be a false-negative diagnosis as benign acinar cells, sialadenosis, sialadenitis, 14 Warthin tumor, or oncocytoma. 25 Mucoepidermoid carcinoma, clear cell neoplasm, and sebaceous carcinoma also are part of the differential diagnosis for acinic cell carcinoma.…”

Current aspects of salivary gland tumors – a systematic review of the literature

“…as opposed to a holistic view of salivary gland tumors, and therefore, they need to be summarized and visualized to be easily comparable in terms of the epidemiology, therapy, and prognosis. Some different reviews concerning salivary gland tumors have been published in the last two centuries [1], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18] most of which discuss the entities or diagnostic or prognostic aspects and principal therapeutic strategies in detail. However, there is no research article that described an overview of the gender-specific distribution as well as country-specific differences for those tumors.…”