A case report of spindle cell myoepithelioma with extensive lipomatous metaplasia and thick collagen bundles in the submandibular gland.
Spindle cell myoepithelioma with extensive lipomatous metaplasia and thick collagen bundles has not yet been described, and there are no published reports on its cytological appearance in fine-needle aspiration (FNA). A 49-year-old man presented with a painless mass in the right submandibular area that had been gradually enlarging for a period of 5 years. The cytologic smears showed fascicles of cohesive spindle cells as well as individual bland cells with bipolar naked nuclei in a fibrillary background. Brightly eosinophilic bundles were intermingled with spindle cells and fat-like vacuoles. The FNA results were suggestive of neurogenic tumor. Patient underwent submandibular gland resection. Grossly, the cut surface showed a well-encapsulated, yellowish-white, soft, elastic mass, measuring 2.8 × 1.9 × 1.5 cm. The tumor consisted of uniform bland spindle cells arranged in short fascicles admixed with adipocyte-like cells and transversing thick collagen bundles, which demonstrated immunoreactivity for myoepithelial markers and ultrastructural features characteristic of myoepithelial cells, suggesting the presence of lipomatous metaplasia. The FNA cytology of spindle cell myoepithelioma with extensive lipometaplasia mimicked that of neurogenic tumor or lipomatous mesenchymal tumor. This case represents the first description of submandibular gland myoepithelioma with lipometaplasia, which is characterized by the coexistence of spindle cells, collagen bundles, and fat-like vacuoles in a fibrillary background. Diagn. Cytopathol. 2016;44:764-769. © 2016 Wiley Periodicals, Inc.
Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi-Do, Republic of Korea.
Mi Jung
MJ
Kwon
Department of Radiology, Hallym University Kangnam Sacred Heart Hospital, Singil-ro, Yeongdeungpo-gu, Seoul, Republic of Korea.
Hye Jeong
HJ
Kim
Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi-Do, Republic of Korea.
Bumjung
B
Park
Department of Pathology, Kangdong Sacred Heart Hospital, Hallym University, College of Medicine, Seoul, Republic of Korea.
Seong Jin
SJ
Cho
Department of Pathology, Kangdong Sacred Heart Hospital, Hallym University, College of Medicine, Seoul, Republic of Korea.
Hyung Sik
HS
Shin
Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi-Do, Republic of Korea.
Hye-Rim
HR
Park
Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi-Do, Republic of Korea.
Soo Kee
SK
Min
Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi-Do, Republic of Korea.
Jinwon
J
Seo
Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi-Do, Republic of Korea.
Kyueng-Whan
KW
Min
Department of Pathology, Kangdong Sacred Heart Hospital, Hallym University, College of Medicine, Seoul, Republic of Korea.
Eun Sook
ES
Nam
D044963:Biopsy, Fine-Needle; D003094:Collagen / Q000378:metabolism*; D006801:Humans; D008067:Lipoma / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D009208:Myoepithelioma / Q000378:metabolism / Q000473:pathology*; D013363:Submandibular Gland / Q000378:metabolism / Q000473:pathology*; D013365:Submandibular Gland Neoplasms / Q000473:pathology*
D003094:Collagen
collagen; cytology; electron microscopy; lipometaplasia; myoepithelioma