Oncocytic mucoepidermoid carcinoma of the parotid gland: report of a case with DNA ploidy analysis and review of the literature.

Department of Pathology, Gülhane Military Medical Academy and School of Medicine, Ankara, Turkey.
Pathology International (Impact Factor: 1.72). 12/2000; 50(11):905-9. DOI: 10.1046/j.1440-1827.2000.01129.x
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ABSTRACT A 44-year-old female presented with a painful mass in the left parotid gland. Histologic examination revealed the characteristic picture of oncocytic mucoepidermoid carcinoma (OMEC) composed mainly of sheets of oncocytic cells with uniform nuclei and eosinophilic cytoplasm, focally smaller epidermoid cells surrounding poorly formed glandular spaces, and a few cystic structures lined by well-differentiated mucous cells with intracytoplasmic mucin. Immunohistochemical staining with antimitochondrial antibody showed granular cytoplasmic positivity in oncocytic cells. The resulting histogram for DNA ploidy analysis was of diploid type. OMEC of the parotid gland is a recently described rare neoplasm. Only six cases have been previously reported in the literature. For an accurate approach in the management of patients, OMEC should be considered in the differential diagnosis of oncocytic lesions of the parotid gland, most of which are benign.

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    ABSTRACT: It is well-known that the morphological variability of mucoepidermoid carcinoma (MEC) of the salivary glands may lead to interpretative difficulties on fine-needle aspiration (FNA) diagnosis. In this study we identify morphologic features that may be useful in the FNA diagnosis of MEC. The cohort included 23 cases of MEC; cytology and histology slides were reviewed and assessed for % cystic component, extracellular mucin, mucous and intermediate cells, oncocytes, cells with foamy/clear cytoplasm, keratinized cells and lymphocytes. On FNA 12/23 (52%) cases were diagnosed as consistent with or suggestive of MEC; 6/23 (26%) as salivary gland neoplasm and 5/23 (22%) as no tumor seen. The cystic component was ≥50% in 18/23 (78%) and <50% in 5 cases. The features prevalent in FNA and histology were: mucous cells (96% and 91%), extracellular mucin (91% both), intermediate cells (100 and 83%), lymphocytes (96 and 78%) and cells with foamy/clear cytoplasm (74% both). Oncocytes were seen in 43 and 22% and keratinized cells in 48 and 13% cases. Cases with oncocytes and lymphocytes were interpreted as favor Warthin's tumor on FNA. Presence of mucous cells, cells with foamy/clear cytoplasm, intermediate cells and lymphocytes in a mucinous background are diagnostic indicators of MEC; presence of oncocytes should not refrain from diagnosing MEC in FNA specimens.
    Pathology research international. 01/2011; 2011:135796.
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    02/2012; , ISBN: 978-953-51-0104-8