BASAL-CELL CARCINOMA METASTATIC TO THE SALIVARY-GLANDS - DIFFERENTIAL-DIAGNOSIS IN FINE-NEEDLE ASPIRATION CYTOLOGY

A disparate group of salivary gland neoplasms is characterized by smal l, uniform hyperchromatic, basaloid cells. This ''small blue cell'' pa ttern is most common in non-Warthin's types of monomorphic adenoma, or in adenoid cystic carcinoma. Small cell anaplastic carcinoma (primary or metastatic), metastatic basaloid squamous cell carcinoma, basal ce ll adenocarcinoma, and metastatic nasopharyngeal carcinoma are rarely encountered but may present a cytologically similar appearance. We rep ort one female and two male patients (median age = 84 yr) with cutaneo us-type basal cell carcinoma (BCC) aspirated from metastatic deposits in the parotid (2 cases) or the submandibular (I case) gland One was c orrectly classified at the time of aspiration, based on a previous his tory of multiple facial BCC. One was interpreted as carcinoma, the pre vious history being unavailable at the time of FNA. Smears in these tw o cases show necrosis and rare keratotic cells. The third case was mis taken for pleomorphic adenoma (PA); the smears showed metachromatic fr agments of collagenous tumor stroma that were misinterpreted as the ma trix material typical of PA. Similar material was identified in the ot her two cases. When the ''small blue cell'' pattern is encountered in salivary gland cytology, one should consider BCC, especially tf necros is is identified The desmoplastic tumor stroma of BCC may mimic the ch ondroid matrix of PA. Careful consideration of previous history is ver y important. (C) 1997 Wiley-Liss, Inc.