1/20. Unusual choristoma of the parotid gland in a girl. A possible trichoadenoma.An 8-year-old girl had a painless circumscribed nodule in the right parotid gland for 4 weeks. A tumour (1.3 cm diameter) within the salivary gland parenchyma showed small cystic spaces with horn-like material macroscopically. The tumour tissue contained solid squamous cell formations and cystic spaces limited by multilayered squamous epithelium and covered by layers of ortho- and parakeratotic cells. The cystic spaces contained keratotic lamellae. In some areas pin-like epithelial proliferations were seen. All epithelial cells were characterized by uniform nuclei, and no atypical mitoses were seen. Keratinizated masses with partial calcification were occasionally located in the interstitial tissue and replaced by multinucleated giant cells. The tumour was classified as a choristoma and resembled a trichoadenoma. The ectodermally derived oral and salivary gland epithelium may be the source of skin-like or adnexal tumours.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/20. adenolymphoma (Warthin's tumor) with multiple sarcoid-like granulomas.Five cases of adenolymphoma (Warthin's tumor) (AL) with numerous sarcoid-like granulomas within the lymphoid stroma are described. All patients were males, aged from 44 to 71 years (mean 57.3 years); all tumors were localized in the parotid gland. Fine needle aspiration cytology was performed in two cases 7.5 and 2 weeks before operation, respectively. Microscopic examination demonstrated the typical structure of AL. In addition, dispersed throughout the lymphoid stroma there were numerous granulomas formed by both epithelioid and multinucleated giant cells of Langhans type, strongly resembling sarcoidosis. The pathogenesis of the granulomatous change remains speculative. It could be caused by a toxic effect of the cysts' contents but probably not by its direct action; the spread of the fluid via sinuses into the lymphatic tissue seems to be more probable. We presume that the previous FNA may have some triggering effect. Granulomatous transformation of the lymphoid stroma resembling sarcoidosis is rare, but should be included in the spectrum of secondary changes in AL. It is not limited to metaplastic AL; it can be seen in an otherwise typical AL without any additional histologic changes. knowledge of a previous FNA and awareness of the possibility of this peculiar histologic change are necessary to avoid incorrect diagnosis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/20. Extramedullary plasmacytoma of the parotid gland. Report of a case with extensive amyloid deposition masking the cytologic and histopathologic picture.BACKGROUND: Extramedullary plasmacytomas are uncommon. Although approximately 90% occur in the head and neck region, parotid gland localization is extremely rare. CASE: This report describes fine needle aspiration and histopathologic findings in an extramedullary plasmacytoma arising in the left parotid gland of a 62-year-old man. Aspiration smears showed multiple amorphous clumps of material admixed with ductal epithelial cells, multinucleated giant cells and inflammatory cells rich in plasma cells, suggestive of pleomorphic adenoma. In surgical material, excessive amyloid deposition was observed. Six months later the tumor recurred, and in the second surgical specimen clusters of atypical plasma cells among amyloid deposits was noted. Clinical and laboratory examination excluded multiple myeloma. After local recurrence, radiotherapy was applied. Ten months later the patient was well and without systemic involvement. CONCLUSION: Two points are important. First, in the salivary gland region, because of the focal metachromasia of amyloid with Giemsa stain, amyloid can be confused with the chondromyxoid matrix of pleomorphic adenoma. Second, although localized forms of amyloid tumor exist, one should keep in mind that amyloid may be so abundant that it may mask an underlying plasma cell neoplasm, as in our case.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/20. A very rare benign tumour in the parotid region: calcium pyrophosphate dihydrate crystal deposition disease.calcium pyrophosphate dihydrate crystal deposition disease, exhibits several clinical manifestations, from absence of symptoms to severely destructive arthropathy or conditions simulating neoplasm, which is frequently related to the temporomandibular joint. Fifteen of the 31 reported cases of tophaceous pseudogout were found in the head and neck region. A patient presented with a parotid swelling, which initially was suspected to be malignant because of the following findings: radiodensity, progression into the joint, osseous destruction of the major ala of the sphenoid and a fine needle aspirate with crystals, osteoblasts, megakaryocytes and irregular cells of varying size. At surgery there was found a tumour consisting of a white, firm gritty material. It progressed to the skull base where material had to be left, because of the presence of the nerves and vessels. A frozen specimen was reported to be benign. Histological examination showed inflammatory cells, macrophages, a chondroid material with embedded metaplastic chondroid cells and giant cells of foreign body type. Crystal examination of x-ray diffraction revealed calcium pyrophosphate dihydrate.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/20. Combined transcervical transmastoid approach to giant parotid pleomorphic adenoma: a case report.Although rare, giant major salivary gland pleomorphic adenomas are among the most astonishing patient presentations. patients may ignore these slow-growing, benign lesions until significant functional impairment occurs. Complete tumor excision and facial nerve preservation in these cases are challenging requirements and are greatly aided by combined transcervical and transmastoid approaches to these lesions. In the presented case, facial nerve monitoring accurately identified the collateralization between the upper and lower divisions of the facial nerve and allowed the required sacrifice of the lower division without the need for facial nerve grafting or reconstruction. The patient recovered full function of all branches.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
6/20. sarcoidosis with giant parotomegaly.We report the case of a 63-year-old man with bilateral parotid gland sarcoidosis. Giant, elastic, hard, subcutaneous tumors had been present on the right parotic and submaxillary regions for 11 years and on the left for 1 year. The patient had had diabetes mellitus for 8 years. Noncaseating epithelioid cell granulomata were revealed histopathologically in the periductal area of the parotid gland. Bilateral hilar lymphadenopathy was noted on chest x-ray studies. serum levels of lysozyme were increased. Levels of serum angiotensin-converting enzyme were within normal limits. tuberculin skin reaction was positive. The tumors gradually improved after treatment with oral minocycline. Giant parotomegaly, as it occurred in this case, is very rare.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
7/20. Cytomorphologic features of papillary cystadenocarcinoma of the parotid.The fine-needle aspiration cytology findings in four cases of recently classified cystadenocarcinoma of the parotid gland are reported. In three cases a recurrent tumor was aspirated. Smear preparations in all four cases were cellular, with numerous papillary projections, single cells, and sheets of cells in varying proportion in a proteinaceous to mucoid background. The background mucin was in varying proportions. The cells were cuboidal to tall columnar with basal nuclei and mild pleomorphism. The cytoplasm was dense in three cases with variable amounts of mucin. In one case (Case 4) the epithelial cells resembled mucin-secreting goblet cells, while in another case (Case 1) the cytoplasm showed multiple vacuolations. mitosis was rare. lymphoid tissue was seen in one case while macrophages and giant cells were seen in two cases. Epidermoid differentiation was absent in all four cases. Pathologic evaluation of the resected tumor confirmed the cytologic diagnosis. Clinical and radiologic evaluation failed to reveal any other potential primary site. Papillary cystadenocarcinomas of the parotid are rare but can be accurately diagnosed on FNAC. However, they need to be differentiated from mucoepidermoid and papillary acinic cell tumors.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/20. A case of giant cell tumor of the parotid gland.In this study, we report a recent patient with a giant cell tumor located in the parotid gland. This condition appears to be very rare; there have been only a few reports of similar patients. The origin of the tumor has remained unclear in previous patients, as well as in our present patient, and awaits further investigation.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
9/20. Testicular seminoma metastasizing to the parotid gland: report of a case.BACKGROUND: Among salivary glands, the parotid gland is the most common site for secondary neoplastic involvement, and carcinomas and melanomas are the two most common secondary tumors. methods: We present a case of testicular seminoma metastasizing to the parotid gland. The patient, who had a remote history of testicular seminoma, was initially seen with a parotid mass. A primary parotid lesion was anticipated, and excisional biopsy was performed. The diagnosis of testicular seminoma metastasizing to the parotid gland was established on the basis of histologic findings and was confirmed by immunohistochemical analysis. RESULTS: Metastatic and primary seminomas have the same morphologic features and cellular composition, and granulomatous reaction is often present in both neoplasms. Extragonadal seminoma often occurs in the midline (presacral, retroperitoneal, anterior mediastinal, and pineal regions); when present in any other locations, the tumor should be considered to be metastatic. placenta alkaline phosphatase is a useful immunohistochemical stain to confirm the diagnosis, and cytokeratin immunohistonegativity rules out carcinomas or epithelioid sarcomas. CONCLUSIONS: To our knowledge, this is the first published case of metastatic testicular seminoma to the parotid gland. Cytomorphologic features of seminoma and the presence of granulomatous giant cells are important diagnostic clues. Two other neoplasms with granulomatous reactions, nasopharyngeal carcinoma and epithelioid sarcoma, should be considered in the differential diagnosis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/20. Giant pleomorphic adenoma of the parotid gland with malignant transformation.A 72-year-old female is described who was admitted to the hospital with a giant mixed tumor of the left parotid gland that had grown to a weight of 6051 g within 20 years and ultimately underwent resection of the mass. Histopathological examination revealed adenocarcinoma cells with hyperchromatic nuclei and mitotic figures proliferated in pleomorphic adenoma. Many authors have reported giant tumors weighing more than a few kilograms of the parotid glands, and most were benign. The present tumor was the sixth largest among all the parotid tumors, including both benign and malignant, which were reported. Furthermore, our case was the largest one confirmed as malignant recorded in the world literature. The tumor was successfully resected with no marked facial nerve paralysis.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
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