Indian Journal of Pathology and Microbiology

: 2011  |  Volume : 54  |  Issue : 2  |  Page : 424--425

Fine-needle aspiration biopsy of adenoid cystic carcinoma of the palatine tonsil

N Azarpira1, MJ Ashraf1, M Shishegar2,  
1 Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Iran
2 Department of Otolaryngology, Shiraz Medical School, Shiraz University of Medical Sciences, Iran

Correspondence Address:
N Azarpira
Pathology Department, Nemazi Hospital, Transplant Research Center, Shiraz University of Medical Sciences, Shiraz

How to cite this article:
Azarpira N, Ashraf M J, Shishegar M. Fine-needle aspiration biopsy of adenoid cystic carcinoma of the palatine tonsil.Indian J Pathol Microbiol 2011;54:424-425

How to cite this URL:
Azarpira N, Ashraf M J, Shishegar M. Fine-needle aspiration biopsy of adenoid cystic carcinoma of the palatine tonsil. Indian J Pathol Microbiol [serial online] 2011 [cited 2020 Sep 27 ];54:424-425
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Minor salivary gland tumors are most commonly located in the oral cavity, particularly the hard palate, and less commonly in the paranasal sinuses, pharynx and larynx. [1] In contrast to major salivary gland tumors, which are mainly benign, tumors that arise from submucosal seromucinous minor salivary glands are more commonly malignant. The most common malignant minor salivary gland tumors are adenoid cystic carcinoma (ACC). [2] Because it grows very slowly, it is often diagnosed at a late stage. The combination of a delayed diagnosis and the tumor's propensity for early perineural and hematologic spread increases the risk of local recurrence and systemic metastasis. [2]

Here we describe the cytological features of ACC in the palatine tonsil. A 70-year-old man presented with a three-month history of a slowly growing mass in the right palatine tonsil. On examination of his throat, the tonsil was unusually large and contained a large ulcerative tender mass [Figure 1]. Fine-needle aspiration (FNA) showed cellular smears containing tissue fragments of cohesive, uniform cells that encircled hyaline-like material that was magenta color on Wright Giemsa [Figure 2]. The cytoplasm of the epithelial cells was scant and with slightly hyperchromatic round to oval nuclei. Mitotic figure was not found. These findings was in favor of ACC. [2],[3] Histologic examination of the tumor showed a classic ACC pattern, with solid sheets of medium-sized tumor cells demonstrating moderate nuclear pleomorphism and prominent nucleoli. The tumor cells surrounded multiple cystic spaces containing eosinophilic hyaline-like basement membrane material [Figure 3]. The surface epithelium of palatine tonsil show sloughing with surface ulceration. {Figure 1}{Figure 2}{Figure 3}

In the review of literature, ACC was reported as parapharyngeal mass. [4],[5] Another salivary gland tumors such as pleomorphic adenoma, malignant mixed tumor and polymorphous low-grade adenocarcinoma were also reported in this area. [6],[7],[8] Therefore, this is the first report of ACC in the palatine tonsil. Adenoid cystic carcinoma has non-specific symptoms and tends to grow quite slowly with a protracted clinical course. [7] The long-term prognosis of ACC depends on primary surgical treatment. The present case highlights the need for the clinician and pathologist to be aware of unusual lesions that may be found in the palatine tonsil.


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