ABSTRACT
We present a patient suffering from salivary duct carcinoma in the mobile portion of the tongue, arising from a minor salivary gland; this condition is extremely rare. The patient was a 64-year-old woman who presented with a nonpainful, hard mass in her tongue. An aspiration smear showed cells with very scant cytoplasm and pale oval nuclei containing small, single nucleoli. Scattered clusters of small cells had darkly stained nuclei. Neither necrosis nor cribriform areas were seen. The smears suggested a salivary gland neoplasm; however, definitive diagnosis of salivary duct carcinoma remained difficult. Partial glossectomy was performed with a wide margin. Macroscopic examination revealed an unencapsulated, submucosal tumour infiltrating underlying muscle. Microscopic examination revealed a salivary duct carcinoma with comedonecrosis and relatively few cribriform and papillary areas. This case suggests that it may not be easy to establish a definitive diagnosis of salivary duct carcinoma from an aspiration smear if the salivary duct carcinoma is composed of comedonecrosis surrounded by solid tissue in a noncribriform pattern.
Subject(s)
Salivary Ducts/pathology , Salivary Gland Neoplasms/pathology , Tongue Neoplasms/pathology , Tongue/pathology , Carcinoma, Ductal/pathology , Carcinoma, Ductal/surgery , Female , Humans , Middle Aged , Necrosis , Salivary Gland Neoplasms/surgery , Salivary Glands, Minor/pathology , Tongue/surgery , Tongue Neoplasms/surgery , Treatment OutcomeSubject(s)
Mesothelioma/pathology , Peritoneal Neoplasms/pathology , Aged , Biopsy , Diagnosis, Differential , Female , Humans , Peritoneum/pathology , Peritonitis/diagnosisABSTRACT
A retroperitoneal cystic mass compressing the right psoas muscle was found incidentally by ultrasonography in a 67-year-old woman. The radiological findings and a history of costal caries led us to suspect a psoas cold abscess. Ultrasound-guided needle aspiration was done to establish the diagnosis and to drain the content, but only a small amount of sterile fluid was obtained. The patient complained of neuralgia in her right leg at the time of puncture. Under the preoperative diagnosis of a neurogenic tumor, the mass was surgically resected, and found to be filled with old blood. The solid region consisted of a proliferation of fusiform cells, leading to a diagnosis of benign schwannoma. Retroperitoneal schwannoma is often misdiagnosed as an adjacent anatomical structure. Thus, we conclude that both microbiological and cytological examination of an aspiration specimen is important when psoas abscess is considered in a differential diagnosis.
