Limits...
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

The cytologic findings of the parotid mass. (A) On low power, the aspirate shows moderately increased cellular areas and rather fibrous stroma. (B) The cells in the loose fibrocellular part have oval or spindle-shaped nuclei with abundant cytoplasm and are arranged in short loose bundles with myxoid background. (C) Some cells seem to have plasmacytoid features and many inflammatory cells are present (arrows). One mitotic cell is also found (*). (D) The cells in some areas consist of tight fascicles (A–D, Papanicolaou stain).
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4215962&req=5

f2-kjpathol-48-5-366: The cytologic findings of the parotid mass. (A) On low power, the aspirate shows moderately increased cellular areas and rather fibrous stroma. (B) The cells in the loose fibrocellular part have oval or spindle-shaped nuclei with abundant cytoplasm and are arranged in short loose bundles with myxoid background. (C) Some cells seem to have plasmacytoid features and many inflammatory cells are present (arrows). One mitotic cell is also found (*). (D) The cells in some areas consist of tight fascicles (A–D, Papanicolaou stain).

Mentions: Papanicolaou staining from the aspirate showed moderately increased cellularity and was composed of isolated and cohesive cells with loose fibrous stroma. In cohesive parts, the cells consisted of short bundles or fascicles that did not form a characteristic pattern of arrangement. Most of the cells had oval or spindle-shaped nuclei and relatively abundant cytoplasm with rather indistinct cytoplasmic outline. Some cells had plasmacytoid features. Cellular pleomorphism was minimal. Inflammatory cells were also diffusely scattered (Fig. 2). Neither necrosis nor brisk mitotic activity was seen. Giemsa staining revealed that the mucoid-like stromal materials were metachromatic, which was reminiscent of the fibromyxoid matrix that is commonly seen in PA. Therefore, PA was initially diagnosed based on the cytologic findings.


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)

The cytologic findings of the parotid mass. (A) On low power, the aspirate shows moderately increased cellular areas and rather fibrous stroma. (B) The cells in the loose fibrocellular part have oval or spindle-shaped nuclei with abundant cytoplasm and are arranged in short loose bundles with myxoid background. (C) Some cells seem to have plasmacytoid features and many inflammatory cells are present (arrows). One mitotic cell is also found (*). (D) The cells in some areas consist of tight fascicles (A–D, Papanicolaou stain).
© Copyright Policy
Related In: Results  -  Collection

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

f2-kjpathol-48-5-366: The cytologic findings of the parotid mass. (A) On low power, the aspirate shows moderately increased cellular areas and rather fibrous stroma. (B) The cells in the loose fibrocellular part have oval or spindle-shaped nuclei with abundant cytoplasm and are arranged in short loose bundles with myxoid background. (C) Some cells seem to have plasmacytoid features and many inflammatory cells are present (arrows). One mitotic cell is also found (*). (D) The cells in some areas consist of tight fascicles (A–D, Papanicolaou stain).
Mentions: Papanicolaou staining from the aspirate showed moderately increased cellularity and was composed of isolated and cohesive cells with loose fibrous stroma. In cohesive parts, the cells consisted of short bundles or fascicles that did not form a characteristic pattern of arrangement. Most of the cells had oval or spindle-shaped nuclei and relatively abundant cytoplasm with rather indistinct cytoplasmic outline. Some cells had plasmacytoid features. Cellular pleomorphism was minimal. Inflammatory cells were also diffusely scattered (Fig. 2). Neither necrosis nor brisk mitotic activity was seen. Giemsa staining revealed that the mucoid-like stromal materials were metachromatic, which was reminiscent of the fibromyxoid matrix that is commonly seen in PA. Therefore, PA was initially diagnosed based on the cytologic findings.

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