Summary
Clinical Summary:
A 24 year old male previously healthy presents with an enlarging right angle of the mandible mass present for 9 months. He has no history of tobacco use. Ultrasound shows a 2 cm mass by his angle of the mandible, possibly a parotid mass. A fine needle aspiration of the mass is performed.
Cytology Description:
Smears and cell block slide show cellular aspirates with small groups and loosely cohesive clusters as well as single cells. Cells are large but morphologically resemble normal acinar cells with round nuclei and tiny nucleoli, abundant finely vacuolated to granular cytoplasm
immunostaining show the tumor is positive for DOG-1. Special staining show the tumor is positive for PAS and PAS/diastase with diffuse cytoplasmic staining
Discussion:
Acinic cell carcinoma is a rare low-grade salivary gland tumor that most commonly occurs in the parotid gland. It has serous acinar differentiation. Cytology usually shows thick masses of cells that sometimes appear to cluster around blood vessels. The aggregates are larger and more loosely aggregated than the tight grape-like clusters of normal acini. The neoplastic cells have bland round nuclei with abundant granular to vacuolated cytoplasm. The granules represent the zymogen granules, which stain metachromatically with D.Quick. Bare nuclei are present in the background.
Mayah Hijazi M.D, Wafaa Elatre M.D.
