Salivary duct carcinoma of the parotid gland. Report of a case with cytologic and immunocytochemical findings on fine needle aspiration biopsy.

ABSTRACT

BACKGROUND: Salivary duct carcinoma (SDC) is a rare high grade neoplasm arising from the larger ducts of the major salivary glands, most frequently in the parotid glands in the elderly. It is important to identify some characteristics that allow differentiating SDC from the other salivary gland adenocarcinomas, which have different prognoses. CASE A 63-year-old, white male presented with an indolent swelling in the left parotid gland, the retromandibular angle. Fine needle aspiration biopsy (FNAB) showed polygonal or cuboidal, medium-sized, moderately pleomorphic cells with round to oval nuclei in cytocentrifuge preparations. Small tissue fragments with a prominent cribriform pattern and an area of comedocarcinoma were observed in the cytocentrifuged material. Tumor cells were diffusely immunoreactive for low- and high-molecular-weight cytokeratins, and strong positivity was observed with 115D8 and Ber-EP4 antibodies. Overexpression of c-ERB B-2 was absent, and < 5% of the nuclei were immunoreactive for p53. CONCLUSION: The cytologic and immunocytochemical appearance of SDC are characteristic, and FNAB results provide the surgeon with useful information for planning surgical therapy.