2021 Volume 60 Issue 5 Pages 279-283
Background : Pleomorphic adenoma of the salivary gland associated with necrosis is rare. Findings of fine-needle aspiration (FNA) cytology in one such case is reported.
Case : A male patient in his 40’s presented with the complaints of swelling and pain in the left submandibular gland. Findings of ultrasonography were suggestive of malignancy. FNA showed numerous large cells with nuclear atypia, naked nuclei and multinucleated cells in the background of a large amount of necrosis and inflammation. However, no myxomatous stroma was found. Therefore, malignancy could not be ruled out. Extensive coagulative necrosis and abscess formation were observed at the center of the tumor. In addition, organization and fibrous connective tissue were seen around the tumor. In a part of the margin of the tumor, structures composed of epithelial or myoepithelial cells were observed which showed cord-like, nest-like, glandular or tubular arrangement. Based on the findings, the tumor was diagnosed as a pleomorphic adenoma with a large area of infarct-like necrosis.
Conclusion : In this case, the possibility of malignant tumor could not be ruled out because of the presence of necrosis, and histiocytes/fibroblasts with reactive atypia. Cytologists should be aware of the cytological findings associated with infarct-like changes of a tumor and exercise adequate caution while diagnosing a tumor as benign or malignant.
