Journal of Pathology and Translational Medicine

Comparison of Cytologic Characteristics between Adenoid Cystic Carcinoma and Adenoid Basal Carcinoma in the Uterine Cervix: Juhyeon Jeong, Seung Yeon Ha, Hyun Yee Cho, Dong Hae Chung, Jungsuk An; J Pathol Transl Med. 2015;49(5):396-402. Published online August 17, 2015; DOI: https://doi.org/10.4132/jptm.2015.07.08

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Background
Adenoid cystic carcinoma (ACC) and adenoid basal carcinoma (ABC) are rare in the uterine cervix. ACC is more aggressive than ABC, thus accurate differential diagnosis is important. In this study, we identified cytologic features useful in distinguishing these two tumors for diagnosis. Methods: Three cases of ACC and five cases of ABC were selected for this study. Cervicovaginal smear slides were reviewed retrospectively, and the area, circumference, major axis, and minor axis of nuclei were measured using an image analyzer. Results: ACC displayed three-dimensional clusters with a small acini pattern. ABC displayed peripheral palisading without an acini pattern. The nuclei of ACC were more irregular and angulated than those of ABC, and the former showed a coarsely granular chromatin pattern. The nucleic area, circumference, major axis, and minor axis were 18.556±8.665 µm², 23.320±11.412 µm, 5.664±1.537 µm, and 4.127±1.107 µm in ACC and 11.017±4.440 µm², 15.920±5.664 µm, 4.612±1.025 µm, and 3.088±0.762 µm in the cases of ABC. All measured values showed statistically significant difference (p < .001). Conclusions: Although the nuclei of both of these tumor types were oval shaped, inferred from the ratio of minor axis to major axis (0.728 in ACC and 0.669 in ABC), the area of nuclei was approximately 1.7 times larger in ACC than in ABC. Distinguishing nucleic features, including area, morphology, and chromatin pattern, may be helpful in making a correct diagnosis.

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Diagnostic Features of Fine Needle Aspiration Cytology of Pleomorphic Adenoma, Adenoid Cystic Carcinoma, and Mucoepidermoid Carcinoma of Salivary Gland.: Eun Sook Nam, Won Bo Jo, Jung Ho Han, Insun Kim; Korean J Cytopathol. 1990;1(1):60-67.

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Abstract PDF: The evaluate the diagnostic findings of salivary gland tumors, we reexamined aspiration cytology smears of 7 cases of pleomorphic adenoma, 3 cases of adenoid cystic carcinoma, and 3 cases of mucoepidermoid carcinoma, performed during April 1986 to March 1990, which were comfurmed by surgical excision and histologic diagnosis. The results obtained are summarized as follows : 1. All cases of pleomorphic adenoma showed branching cellular clusters of epithelial and myoepithelial cells. Acellular elements including myxomatous and chondroid components were observed. There were no cellular pleomorphism and nucleoli. Keratinizing squamous epithelial cells and keratin pearls were noted. 2. The smears of adenoid cystic carcinoma showed cell balls or cell cords containing a central hyaline core. Nuclear atypism and the nucleoli were frequently observed. There were no keratinizing squamous epithelial cells. 3. The smears of mucoepidermoid carcinoma showed mainly sheets or clusters of intermediate cells and some mucin-producing cells. Some nuclear pleomorphism was observed. Mucinous material and many inflammatory cells were present in the background.

Adenoid Cystic Carcinoma of the Breast: A case report.: Eun Ha Jung, Hye Rim Park, Jin Hee Sohn; Korean J Pathol. 1999;33(4):299-302.

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Abstract PDF: Adenoid cystic carcinoma (ACC) of the breast is an uncommon carcinoma accounting for less than 1% of the breast carcinoma. This type of carcinoma has a distinctive histology, such as cylindromatous, cribriform, glandlike space and solid pattern in the variable proportion. Prognosis is favorable with rare recurrence or metastasis and the guideline for therapy is not well established. We experienced a case of ACC of right breast in the 48 year-old woman. Cytologically, it showed numerous three-dimensional, well outlined cell clusters with central core of homogeneous, eosinophilic material. The mass was well demarcated, firm and measured 2.5 2.5 2 cm. Cut surface was yellowish white and granular with focal necrosis. Histologically, the tumor was composed of cylindromatous, adenoid and solid area with marked cellular atypia. Focal invasion was identified in the adipose tissue around the tumor. Histologic and nuclear grade was III by Kleer's grade. Nodal metastasis was not found.

Adenoid Cystic Carcinoma of the Male Breast: A case report.: Mi Kyung Lee, In Chul Hong, Woo Ick Yang, Sang Ho Cho; Korean J Pathol. 1999;33(5):389-392.

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Abstract PDF: A 65 year-old male patient presented with a large palpable mass beneath the areola of the right breast for 7 years. The resected breast tissue was almost totally replaced by a round large solid mass (9 6 cm) with a pink-gray to yellow firm, partly nodular cut surface. Microscopically, the tumor revealed the diagnostic biphasic cellular pattern of adenoid cystic carcinoma, which consisted of both cribriform pattern of myoepithelial cells and tubular pattern of epithelial cells. On immunohistochemistry, the tumor revealed immunoreactivities for alpha-smooth muscle actin and S-100 protein in the myoepithelial cells and for AE1/AE3 in the epithelial cells. Mitoses were scarce. Multifocal lymphatic permeation and foci of perineural invasion were also found. Underlying resection margins and overlying skin were invaded by the tumor. We diagnosed this tumor as grade II adenoid cystic carcinoma according to the system utilized for the salivary gland tumors.

Metastatic Adenoid Cystic Carcinoma of the Lung Diagnosed by Fine Needle Aspiration Biopsy.: So Yeon Park, Kwang Gil Lee; Korean J Cytopathol. 1990;1(2):175-178.

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Abstract PDF: A case of metastatic adenoid cystic carcinoma of the lung, originated from the trachea, was diagnosed by fine needle aspiration. Although the cytologic features of adenoid cystic carcinoma have been well described, it is easy to confuse adenoid cystic carcinoma with more common primary small cell neoplasms of the lung, i.e., small cell carcinoma, well differentiated adenocarcinoma, and carcinoid tumor of the lung. The features distinguishing adenoid cystic carcinoma from these neoplasms include 1) tight, globular, honeycomb pattern of cells, 2) acellular basement membrane material in the lumen, and 3) cells lacking true nuclear molding and having bland chromatin pattern. The morphologic feature of metastatic adenoid cystic carcinoma in this case was so distinctive as to permit a definite diagnosis by aspiration cytology.

Cytopathologic Features of Primary Bronchial Adenoid Cystic Carcinoma: A Case Report.: Ji Shin Lee, Jong Soon Kim, Bok Sook Yang, Min Cheol Lee, Chang Soo Park, Sang Woo Juhng; Korean J Cytopathol. 1995;6(1):67-70.

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Abstract PDF: Adenoid cystic carcinoma arising from the submucosal glands of the trachea and bronchial tree is rare. The histopathology and natural history of bronchial adenoid cystic carcinoma have been well documented, but detailed descriptions of its cytomor- phology are few. We report a case of primary bronchial adenoid cystic carcinoma in a 20-year-old female, diagnosed by bronchial brushing cytology. The cytologic specimens showed large clusters of small cells arranged around cystlike spaces containing globular basophilic material.

Cytopathologic Features of Adenoid Cystic of Trachea Carcinoma: Report of 2 Cases.: Young Mee Cho, So Young Park, In Chul Lee; Korean J Cytopathol. 1995;6(2):214-218.

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Abstract PDF: Cytopathologic findings of two cases of adenoid cystic carcinoma of the trachea are reported. The carcinomas grew as a intratracheal mass. By bronchial washing, brushing and/ or post-bronchoscopic sputum cytology, large cohesive sheets, lobulated clusters, or three dimensional ball-like structures were obtained. They had numerous cyst-like spaces containing characteristic globular basophilic material. The tumor cells were uniform and had a small amount of cytoplasm. Nuclei were small and hyperchromatic. Nucleoli were occasionally observed. The cytological diagnosis was confirmed by bronchoscopic biopsies.

The Cytologic Features of Adenoid Cystic Carcinoma of the Uterine Cervix: A Case Report .: Seung Yeon Ha, Hyuni Cho, Young Ha Oh, Geun Shin Lyu; Korean J Cytopathol. 1998;9(2):207-212.

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Abstract PDF: Adenoid cystic carcinoma of the uterine cervix is a rare tumor accounting for less than 1% of all cervical adenocarcinoma. This tumor is characterized by aggressive biological behavior with frequent local recurrence or metastatic spread, postmenopausal onset, and occasional association with conventional squamous cell carcinoma. The cytologic diagnosis of adenoid cystic carcinoma in the uterine cervix is often difficult because of negative smear due to intact overlying mucosa, cytologic findings mimicking endometrial cells, and masquerade as squamous cell carcinoma. Recently we have experienced a case of adenoid cystic carcinoma arising in the uterine cervix, which was identified on the routine Papanicolaou smear and was histologically confirmed by the consequent biopsy. The smear showed abundant cellularity composed of relatively uniform cells. The tumor cells were arranged in small clusters, acini, naked cells, and loose sheets with abortive cribriform pattern. There were scattered globoid basement membrane-like materials and tumor diathesis. The nuclei were pleomorphic and showed hyperchromatic and coarsely granular choromatin with inconspicuous nucleoli. The punch biopsy of the uterine cervix showed typical histologic findings of adenoid cystic carcinoma characterized by tumor nests composed of hyperchromatic uniform basaloid cells, cribriform pattern, and cylindrical hyaline bodies.

Fine Needle Aspiration Cytology of Solid Type Adenoid Cystic Carcinoma of Buccal Mucosa: A Case Report .: Jeana Kim, Kyoung Mee Kim, Young Sill Kim, Anhi Lee, Sang In Shim, Byung Kee Kim; Korean J Cytopathol. 2000;11(2):89-92.

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Abstract PDF: Adenoid cystic carcinoma constitutes 4 percent of all benign and malignant epithelial salivary gland tumors and is a highly malignant tumor of the salivary glands. The cytologic presentation in aspirates is usually characteristic with spherical clusters(balls) of small tumor cells filled with hyaline material. But in case of the poorly differentiated variety(solid type), it is difficult to differentiate from other tumors because sheets of small, fairly monotonous malignant cells, with somewhat larger and more conspicuous nuclei are only seen. The cytologic findings of fine needle aspiration of solid type adenoid cystic carcinoma of buccal mucosa in a 51-year-old man are presented. On cytologic findings, solid sheets of monotonous tumor cells with focal necrosis was noted on a hemorrhagic background and the characteristic cytologic features of adenoid cystic carcinoma was absent.

Ceruminous Gland Tumors: 5 cases report.: Yun Kyung Kang, Je G Chi; Korean J Pathol. 1994;28(4):414-419.

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Abstract PDF: Tumors of the ceruminous gland are rare. However, careful histologic evaluation and classification are necessary for the proper treatment and ultimate prognosis. We present 5 cases of ceruminous gland tumors. Case l (73/M) and case 2 (52/M) were adenoid cystic carcinoma. They presented with protuding masses in the left external auditory canal for several months. Case 3 (76/M) was a mucoepidermoid carcinoma of auditory canal, who presented with right ear swelling. The mass recurred 3 years after the surgical resection and combined radiation therapy. Case 4 (60/F) and case 5 (2l/F) were ceruminous adenoma, which showed diffuse or focal areas of glandular structures with one-or two-layer of eosinophilic columnar to cuboidal cells and sometimes with myoepithelial cells. These tumors showed non-infil-trative growth pattern and lack of mitosis, and had no capsule.

Adenoid Cystic Carcinoma of the Lung: Report of 2 cases.: Jae Soo Koh, Chang Won Ha, Na Hye Myong, Kyung Ja Cho, Mi Kyung Kim, Ja June Jang; Korean J Pathol. 1992;26(2):175-179.

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Abstract PDF: Adenoid cystic carcinoma of the lung is histologically and ultrastructurally identical to the salivary gland tumor of the same name and is characterized by infiltrative growth, local recurrence, and usually a prolonged clinical course. We have recently experienced two cases of adenoid cystic carcinoma arising in the lung. Case 1 was a 59 year-old male who presented with cough, fever, and chill of 1.5 months' duration, and case 2 was a 61 year-old male who was incidentally found to have a 3 to 4 cm sized lobulated mass in the right upper lobe. After being worked up, both patients underwent right pneumonectomy. In case 1, a 3x2 cm sized tumor was located in the lower bronchus, partly elevating toward the lumen and partly infiltrating into regional lymph nodes and lung parenchyma showing grayish-white and solid cut surface. Case 2 was a 3.5x3.5 cm sized upper bronchial tumor resembling the former in appearance. Histologically, the tumors were composed of small round hyperchromatic cells, forming solid, cribriform, acinar, or tubular structures. Luminal spaces in tumor cell nests contained PAS-positive mucinous or hyaline material. Among the tumor cells, scattered islands of normal submucosal gland were noticed.

Adenoid Cystic Carcinoma of the Esophagus: Report of a case with brief review of the literature.: Eun Suk Koh, In Sook Kim, Tae Jung Kwon, Dong Wha Lee, Chan Sup Shim, Kihl Rho Lee; Korean J Pathol. 1990;24(4):482-488.

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Abstract PDF: Adenoid cystic carcinoma of the esophagus is a rare tumor and has been considered to be counterpart of the salivery gland. The patient we experienced was a 60-year-old female who had a tumor in the lower third of the esophagus. The tumor was located in the submucosa and showed histologic features similar to those of the salivary gland. Electron micrsopic examination revealed ductal structures invested by basal lamina, and clusters of basaloid cells with tonofilaments and desmosomes. No myoepithelial cells were identified. Immunohistochemical studies for S-100 protein, cytokeratin and vimentin were performed. A few cells showed positive reaction to the S-100 protein. These findings suggest that the esophageal adenoid cystic carcinoma arises from the duct of submucosal gland.

Adenoid Cystic Carcinoma of Skin: A case report.: Eun Duk Chang, Young Hee Jee, Sun Moo Kim; Korean J Pathol. 1989;23(3):378-381.

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Abstract: A primary skin adenoid cystic carcinoma first described by Boggio in 1975, is one of the rarest type of eccrine sweat gland carcinoma. Histologically, a tumor with typical morphologic features closely resembles adenoid cystic carcinoma was found in other tissues but in the skin must be distinguished from aggressive basal cell carcinoma. The natural history of this tumor is not yet fully determined but suggests a long indolent and progressive course. We report a case of a 77-year-old male with a small skin nodule in the abdomen.

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