Contributed by Rayan Rammal, MD, and Raja Seethala, MD
A female in her early 50s presented with a parotid mass. The patient underwent excision of the parotid lesion (at an outside institution).
Gross examination consisted of a 2.7x1.8x1.3 cm portion of salivary tissue (4 grams) and revealed a 1.5 cm multilocular cystic lesion containing mucoid material.
Slides were received in consultation and reviewed. Microscopic examination revealed a multilocular cystic lesion (Fig. 1). The cysts demonstrated an attenuated single to double layer of oncocytic cells with surrounding pericystic sclerosis and stromal lymphoplasmacytic infiltrate (Fig 2A). Mucous cells were present and prominent in some areas (Fig 2B). Foci of architectural complexity were also focally noted, consisting of daughter cysts (Fig 2C) as well as papillary tufting with nuclear stratification, somewhat interestingly with rare cilia (Fig 2D). The case showed no perineural or angiolymphatic invasion, nor was there necrosis or mitotic activity.
Figure 1. (click each image to enlarge)