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Nodular fasciitis of the parotid gland, masquerading as pleomorphic adenoma.

Hwang CS, Lee CH, Kim A, Shin N, Park WY, Park MG, Park do Y - Korean J Pathol (2014)

Bottom Line: Subsequently, parotidectomy was performed and NF was diagnosed based on histologic and immunohistochemical findings.The clinical history of rapid growth and the presence of mitoses and inflammatory cells help to distinguish NF from PA.In addition, immunohistochemical stains for smooth muscle actin and CD68 are useful to confirm the diagnosis of NF.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.

ABSTRACT
It is difficult to distinguish nodular fasciitis (NF) from other neoplasm of the parotid gland, especially pleomorphic adenoma (PA) by fine needle aspiration cytology. A 39-year-old female noticed a mass in the parotid region. The aspirate material showed cohesive parts composed of the cells that had oval or spindle-shaped nuclei and relatively abundant cytoplasm and some cells with plasmacytoid features. The background substance was fibromyxoid. PA was diagnosed based on the cytologic findings. Subsequently, parotidectomy was performed and NF was diagnosed based on histologic and immunohistochemical findings. NF in the parotid region is rare and may be misdiagnosed as other benign or malignant tumors of the parotid gland. The clinical history of rapid growth and the presence of mitoses and inflammatory cells help to distinguish NF from PA. In addition, immunohistochemical stains for smooth muscle actin and CD68 are useful to confirm the diagnosis of NF.

No MeSH data available.


Related in: MedlinePlus

Computed tomography image and gross finding of the parotid mass. (A) Computed tomography scan shows a 1.9×1.3×1.2-cm-sized, heterogeneously enhancing lobulated mass (*). (B) The excised tumor is relatively well demarcated, but not encapsulated. The cut surface of the mass is solid and gray white.
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f1-kjpathol-48-5-366: Computed tomography image and gross finding of the parotid mass. (A) Computed tomography scan shows a 1.9×1.3×1.2-cm-sized, heterogeneously enhancing lobulated mass (*). (B) The excised tumor is relatively well demarcated, but not encapsulated. The cut surface of the mass is solid and gray white.

Mentions: The patient was a 39-year-old female who had a mass in the right parotid region. The mass was found 2 months previously and had subsequently showed a gradual increase in size. No history of trauma or injury was identified. On physical examination, a firm, mobile, well-circumscribed mass was palpable in the subcutaneous tissue of the right cheek. No nerve paralysis or paresthesia was identified. At the same time, the patient was diagnosed with papillary carcinoma in the right thyroid gland by fine needle aspiration cytology (FNAC). Before the patient underwent a right hemithyroidectomy, ultrasonography and FNAC were performed. Ultrasonography showed a 2.3-cm-sized irregular shaped mass in the right parotid gland with ill-defined margins. Subsequently, computed tomography scan showed a 1.9×1.3×1.2-cm-sized, heterogeneously enhancing lobulated mass (Fig. 1A). Laboratory examination data were within normal limits. FNAC was performed for the mass of the right parotid region.


Nodular fasciitis of the parotid gland, masquerading as pleomorphic adenoma.

Hwang CS, Lee CH, Kim A, Shin N, Park WY, Park MG, Park do Y - Korean J Pathol (2014)

Computed tomography image and gross finding of the parotid mass. (A) Computed tomography scan shows a 1.9×1.3×1.2-cm-sized, heterogeneously enhancing lobulated mass (*). (B) The excised tumor is relatively well demarcated, but not encapsulated. The cut surface of the mass is solid and gray white.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4215962&req=5

f1-kjpathol-48-5-366: Computed tomography image and gross finding of the parotid mass. (A) Computed tomography scan shows a 1.9×1.3×1.2-cm-sized, heterogeneously enhancing lobulated mass (*). (B) The excised tumor is relatively well demarcated, but not encapsulated. The cut surface of the mass is solid and gray white.
Mentions: The patient was a 39-year-old female who had a mass in the right parotid region. The mass was found 2 months previously and had subsequently showed a gradual increase in size. No history of trauma or injury was identified. On physical examination, a firm, mobile, well-circumscribed mass was palpable in the subcutaneous tissue of the right cheek. No nerve paralysis or paresthesia was identified. At the same time, the patient was diagnosed with papillary carcinoma in the right thyroid gland by fine needle aspiration cytology (FNAC). Before the patient underwent a right hemithyroidectomy, ultrasonography and FNAC were performed. Ultrasonography showed a 2.3-cm-sized irregular shaped mass in the right parotid gland with ill-defined margins. Subsequently, computed tomography scan showed a 1.9×1.3×1.2-cm-sized, heterogeneously enhancing lobulated mass (Fig. 1A). Laboratory examination data were within normal limits. FNAC was performed for the mass of the right parotid region.

Bottom Line: Subsequently, parotidectomy was performed and NF was diagnosed based on histologic and immunohistochemical findings.The clinical history of rapid growth and the presence of mitoses and inflammatory cells help to distinguish NF from PA.In addition, immunohistochemical stains for smooth muscle actin and CD68 are useful to confirm the diagnosis of NF.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.

ABSTRACT
It is difficult to distinguish nodular fasciitis (NF) from other neoplasm of the parotid gland, especially pleomorphic adenoma (PA) by fine needle aspiration cytology. A 39-year-old female noticed a mass in the parotid region. The aspirate material showed cohesive parts composed of the cells that had oval or spindle-shaped nuclei and relatively abundant cytoplasm and some cells with plasmacytoid features. The background substance was fibromyxoid. PA was diagnosed based on the cytologic findings. Subsequently, parotidectomy was performed and NF was diagnosed based on histologic and immunohistochemical findings. NF in the parotid region is rare and may be misdiagnosed as other benign or malignant tumors of the parotid gland. The clinical history of rapid growth and the presence of mitoses and inflammatory cells help to distinguish NF from PA. In addition, immunohistochemical stains for smooth muscle actin and CD68 are useful to confirm the diagnosis of NF.

No MeSH data available.


Related in: MedlinePlus