Fine needle aspiration cytology of lymphoepitheliomalike carcinoma of the parotid gland. A case report

Abstract

Lymphoepitheliomalike carcinoma is a rare primary neoplasm of the salivary gland that has also been reported to occur in other primary sites. In this report we document the clinical, cytomorphologic and histologic findings of a case affecting the parotid gland. The patient was a 48-year-old, white woman with a two-month history of a swelling on the left side of the face and associated pain. Physical examination and computed tomography revealed a left parotid mass with spread to the superior cervical lymph nodes. Fine needle aspiration (FNA) of the parotid and upper cervical nodes revealed multiple, irregular aggregates of epithelial cells with a high nuclear/cytoplasmic ratio and finely granular chromatin. Prominent, single, round nucleoli were present. Multiple chromocenters were also noted. These aggregates were found in a background of abundant, benign, small and large lymphocytes. The patient underwent parotidectomy with radical neck dissection. Histopathologic examination of the parotid showed a poorly differentiated carcinoma in a benign lymphoid background consistent with lymphoepitheliomalike carcinoma, with metastatic tumor involving two lymph nodes of the parotid compartment. To our knowledge, this is the first reported case of FNA biopsy of this unusual entity. The cytomorphologic features of these neoplasms when aspirated from the salivary gland are sufficiently distinctive to allow a specific diagnosis of lymphoepitheliomalike carcinoma.