Amylase crystalloids on fine-needle aspiration of the salivary gland

Abstract

Amylase crystalloids is one of the several types of crystalline structures that can be seen in non-neoplastic and neoplastic salivary gland lesions. Here, a 60-year-old woman with an infraauricular mass existing for two years is presented. On ultrasound a cystic mass, 1 cm in diameter was detected in the tail of right parotid gland. Clear and mucoid fluid was obtained from the mass by fine-needle aspiration. Smears showed numerous rhomboid, rectangular or rod-shaped, non-birefringent crystalloid structures and a few acinar cell groups in a mucoid background rich in polymorphonuclear leucocytes and lymphoctes. It was reported as cystic sialadenitis with amylase crystalloids. In the four-month follow-up, there was no recurrence of the mass.Since encountered only in benign salivary gland lesions in the literature as in our case, observation of amylase crystalloids on fine-needle aspiration smears indicates a benign lesion and avoids unnecessary surgery.

Αlfa-Amylase Crystalloid Granuloma in the Parotis Salivary Gland: Case Report

“…5 Bu yapılar histokimyasal olarak Papanicolau boyası ile canlı turuncu, Giemsa boyası ile derin mavi renkte boyanma özel-liğindedir. 7,8 Bizim olgumuzda da dilate duktusun içinde bazıları yabancı cisim tipi dev hücrelerce fagosite edilmiş, eozinofilik, yuvarlak-köşeli ya da romboid karakterde farklı şekillerde çok sayıda kristaloid görülmüştür. Bu kristaloidler histokimyasal olarak PAS (-), Mason Trikrom ile kırmızı, Papanicolau boyası ile turuncu, Giemsa boyası ile ise derin mavi renkte boyanmıştır.…”

Crystalloids in Submandibular Sialadenitis

“…Detecting crystalloid structures in salivary gland aspirates is a rare observation, which is described in the present case study. Several types of crystalloids may be found in fine-needle aspiration cytology of salivary gland lesions [1,2]. Since the first report of ''tyrosine crystals'' in a parotid mixed tumor by Bullock in 1953, several types of crystalloids have been described in association with mixed tumor and related neoplastic and nonneoplastic entities.…”

“…They show a variety of geometric shapes, including needles, rods, and polyhedral forms; they are of variable sizes; generally singly dispersed but may aggregate; they are generally eosinophilic and refractile. Amylase crystalloids are non birefringent and are often associated with benign lesions, especially those with oncocytic metaplasia, sialadenitis, and sialolithiasis, oncocytic neoplasms (e.g., Warthin, oncocytoma, oncocytic cystadenoma, and mixed tumor with oncocytic features) [2]. Amylase crystalloids were first described by Takeda and Ishikawa in 1983 where they confirmed the nature of the substance by scanning electron microscopy and electron probe X-ray microanalysis [5].…”

Amylase crystalloids in nonneoplastic salivary gland: A distinct finding

“…Tyrosine and amylase crystalloids are the most common types encountered in FNA specimens . Literature review indicates amylase crystalloids in salivary gland FNAs are often associated with sialadenitis and sialolithiasis; while they have also been reported associated with simple, lymphoepithelial, and oncocytic cysts as well as neoplasia, including Warthins tumor and cellular benign mixed tumor . Patients tend to be older, present with swelling or a mass, and may or may not respond to antibiotic treatment.…”