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Pathology Research International
Volume 2011 (2011), Article ID 135796, 6 pages
http://dx.doi.org/10.4061/2011/135796
Clinical Study

A Cytohistologic Correlation of Mucoepidermoid Carcinoma: Emphasizing the Rare Oncocytic Variant

Department of Pathology & Laboratory Medicine, University of Pennsylvania Medical Center, 6 Founders Pavilion, 3400 Spruce Street, Philadelphia, PA 19104, USA

Received 7 November 2010; Accepted 13 January 2011

Academic Editor: Darshana Jhala

Copyright © 2011 Timothy V. Wade et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.