Cytomorphologic characteristics and differential diagnoses of lymphoepithelial carcinoma of the parotid

• Published in: Journal of the American Society of Cytopathology JASC Vol. 5; no. 2; pp. 93 - 99
• Main Authors: Hipp, Jennifer A., MD, PhD, Jing, Xin, MD, Zarka, Matthew A., MD, Schmitt, Alessandra C., MD, Siddiqui, Momin T., MD, Wakely, Paul, MD, Bishop, Justin, MD, Ali, Syed Z., MD, FRCPath, FIAC
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2016
• Subjects: Ancillary studies; Cytomorphology of lymphoepithelial carcinoma; Fine needle aspiration; Lymphoepithelial-like carcinoma; Pathology; Salivary glands lesions; Salivary glands lesions; Lymphoepithelial-like carcinoma; Cytomorphology of lymphoepithelial carcinoma; Ancillary studies; Fine needle aspiration
• ISSN: 2213-2945; 2213-2945
• DOI: 10.1016/j.jasc.2015.09.216

Introduction Lymphoepithelial carcinoma of the salivary gland is an extremely rare neoplasm and is challenging to diagnose by fine needle aspiration (FNA). There are rare reports on the cytopathologic features of lymphoepithelial carcinoma, which may be mistaken for other high-grade salivary gland neoplasm or a metastasis to the salivary gland. Materials and methods A retrospective review was undertaken of 7 cases of lymphoepithelial carcinoma of the parotid diagnosed on FNA with histologic confirmation from 4 major medical centers. Results Cytomorphologic features of lymphoepithelial carcinoma include smears with moderate cellularity displaying a rich nonneoplastic population of lymphoplasmacytic cells admixed with tissue fragments of high grade, malignant undifferentiated epithelial cells with high nuclear to cytoplasm ratio, hyperchromasia, prominent nucleoli, and scant to abundant, indistinct cytoplasm. Discussion Diagnostic pitfalls of lymphoepithelial carcinoma include metastatic squamous cell carcinoma, metastatic nasopharyngeal carcinoma, and other high grade primary salivary gland neoplasms. Recognizing this lesion may help guide clinicians to perform additional imaging studies to exclude a primary from other sites.