Pleomorphic Adenoma Originating from Heterotopic Salivary Tissue of the Upper Neck: A Diagnostic Pitfall

Figure 2

(a) US of thyroid gland (T = trachea) showing the left thyroid nodule, isoechoic to slightly hypoechoic to glandular parenchyma, wide-than-taller shape, hypervascular at color Doppler, with coarse peripheral calcifications (arrowheads). No microcalcifications or perinodular thyroid parenchyma invasion is seen. The thyroid nodule was classified TI-RADS 3 (probably benign nodules, <5% risk of malignancy); however, because of its size, FNAC was performed, showing no signs of malignancy. (b) US of the palpable level IIA lesion revealing a hypoechoic, well-delineated, and polylobulated mass (arrows) in the left anterior neck triangle located along the anterior border of the sternocleidomastoid muscle (asterisk) and submandibular salivary gland (arrowhead). (c) FNAC was performed (original magnification, ×25; Papanicolaou (Pap) stain) and revealed tumor epithelial part (arrows) with squamoid epithelial cells (arrowhead, inset in (c), original magnification, ×100; Pap stain) and myoepithelial cells (arrow, inset in (c)), thus suggesting the diagnosis of pleomorphic adenoma.

(a)

(b)

(c)