Acinic cell carcinoma with extensive neuroendocrine differentiation: a diagnostic challenge.
Primary salivary gland carcinoma with neuroendocrine differentiation is of rare occurrence, especially so in the parotid gland. Amongst the various reported primary tumors with neuroendocrine differentiation, acinic cell carcinoma (ACC) one such tumor. A 48 year old lady presented with a gradually increasing right infra-auricular swelling for a period of 1 year which enlarged suddenly in a short period. Contrast Enhanced Computed Tomography (CECT) suggested diagnosis of Pleomorphic Adenoma. Fine Needle Aspiration Cytology (FANC) yielded a cystic fluid suggesting a possibility of Warthin's tumor or Oncocytic lesion. Intraoperative findings were suggestive of a Warthin's tumor. Initial histopathological examination of the tumor was suggestive of neuroendocrine carcinoma. However, extensive sectioning revealed peripheral islands of ACC. Immunoexpression of S-100, Neuron specific Enolase (NSE), Chromogranin A and Synaptophysin confirmed the diagnosis. The possibility of neuroendocrine differentiation in a primary salivary gland tumor should be kept in mind whenever a salivary gland tumor shows only neuroendocrine histology.
Roy
Somak
S
Department of Pathology, Maulana Azad Medical College, New Delhi, India.
Dhingra
Kajal Kiran
KK
Gupta
Parul
P
Khurana
Nita
N
Gupta
Bulbul
B
Meher
Ravi
R
D000235:Adenolymphoma / Q000473:pathology; D044963:Biopsy, Fine-Needle; D018267:Carcinoma, Acinar Cell / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D010307:Parotid Neoplasms / Q000473:pathology* / Q000601:surgery