title: Fine-needle aspiration cytology of mammary analog secretory carcinoma masquerading as low-grade mucoepidermoid carcinoma: case report with a review of the literature.
abstract: OBJECTIVE
  The primary role of fine-needle aspiration cytology (FNAC) of salivary gland masses is to determine the underlying process and guide further management. The objective of our study is to provide a comprehensive review of cytologic features and ancillary studies of mammary analog secretory carcinoma (MASC), discuss differential diagnosis and review recent advances in the understanding of its biologic behavior.
  
  
  METHODS
  A 23-year-old female underwent ultrasound-guided FNA of a slowly enlarging parotid mass. Smears displayed branching clusters of bland vacuolated polygonal cells in a secretory proteinaceous background. Eosinophilic cells with eccentric nuclei and inconspicuous nucleoli were also noted. Based on positive intracellular mucin staining and the lack of extracellular-matrix material, the cytologic diagnosis rendered was 'suspicious for low grade mucoepidermoid carcinoma'. Superficial parotidectomy revealed an MASC confirmed by fluorescence in situ hybridization (FISH) studies for ETV6 translocation.
  
  
  CONCLUSIONS
  MASC should be included in the differential diagnosis of mucinous salivary lesions with cystic changes on FNA. Immunohistochemistry for mammaglobin and S-100 helps in excluding morphologic mimics. FISH helps to confirm the diagnosis. Age alone should not be a deterrent in diagnosing a carcinoma.
authors.affiliation: Department of Pathology, North Shore-LIJ Health System, Lake Success, N.Y., USA.
authors.forename: Jaya
authors.initials: J
authors.lastname: Bajaj
authors.forename: Cecilia
authors.initials: C
authors.lastname: Gimenez
authors.forename: Farah
authors.initials: F
authors.lastname: Slim
authors.forename: Mohamed
authors.initials: M
authors.lastname: Aziz
authors.forename: Kasturi
authors.initials: K
authors.lastname: Das
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics*; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology; D018267:Carcinoma, Acinar Cell / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D018277:Carcinoma, Mucoepidermoid / Q000175:diagnosis / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D010306:Parotid Gland / Q000378:metabolism / Q000473:pathology*; D009418:S100 Proteins / Q000235:genetics*; D012468:Salivary Gland Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D060765:Secretoglobins / Q000235:genetics*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D009418:S100 Proteins; D060765:Secretoglobins