Hyalinizing clear-cell carcinoma of salivary glands in fine-needle aspiration

Hyalinizing clear-cell carcinoma (HCCC) is a recently described distinctive salivary gland neoplasm. Because of its cytoplasmic clearing and the bland nuclear features, HCCC resembles other tumors. The authors describe the cy tomorphologic features of four cases of HCCC in fine-needle aspirates (FNA) and discuss the differential diagnosis. Fine-needle aspirates from 4 patients with primary HCCC of minor salivary g lands were reviewed. Smears were stained with Diff-Quik and Papanicolaou st ains. The cytologic features of the epithelial and the stromal components w ere analyzed. Cell blocks were prepared, and findings were correlated with prior or subsequent surgical specimens in each case. The smears contained numerous cohesive small and large epithelial cell grou ps and sheets which had sharp outlines and showed focal nuclear overlapping . The cells had uniform round to ovoid nuclei, granular chromatin, and smal l nucleoli. The abundant, well-defined cytoplasm was clear in many cells bu r denser in others. No myoepithelial cells or hyaline globules were identif ied. HCCC seems to have characteristic cytomorphologic findings on FNA smears. B ecause these cytologic features are not specific, and overlap with those of a number of salivary gland neoplasms that contain clear cells, a high leve l of suspicion, clinico-pathologic correlation, and examination of cell blo cks are necessary to suggest the diagnosis. A diagnosis of HCCC by FNA was suspected in 3 of the 4 cases reported here. Diagn. Cytopathol. 2000;23:333 -337. (C) 2000 Wiley-Liss, Inc.