Journal of Pathology and Translational Medicine

Original Article

Comprehensive Cytomorphologic Analysis of Pulmonary Adenoid Cystic Carcinoma: Comparison to Small Cell Carcinoma and Non-pulmonary Adenoid Cystic Carcinoma: Seokhwi Kim, Jinah Chu, Hojoong Kim, Joungho Han; J Pathol Transl Med. 2015;49(6):511-519. Published online October 19, 2015; DOI: https://doi.org/10.4132/jptm.2015.09.07

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Background
Cytologic diagnosis of pulmonary adenoid cystic carcinoma (AdCC) is frequently challenging and differential diagnosis with small cell carcinoma is often difficult. Methods: Eleven cytologically diagnosed cases of pulmonary AdCC were collected and reviewed according to fifteen cytomorphologic characteristics: small cell size, cellular uniformity, coarse chromatin, hyperchromasia, distinct nucleolus, frequent nuclear molding, granular cytoplasm, organoid cluster, sheet formation, irregular border of cluster, hyaline globule, hyaline basement membrane material, individual cell necrosis or apoptotic body, and necrotic background. Twenty cases of small cell carcinoma and fifteen cases of non-pulmonary AdCC were also reviewed for the comparison. Results: Statistically significant differences were identified between pulmonary AdCC and small cell carcinoma in fourteen of the fifteen cytomorphologic criteria (differences in sheet formation were not statistically significant). Cellular uniformity, distinct nucleolus, granular cytoplasm, distinct cell border, organoid cluster, hyaline globule, and hyaline basement membrane material were characteristic features of AdCC. Frequent nuclear molding, individual cell necrosis, and necrotic background were almost exclusively identified in small cell carcinoma. Although coarse chromatin and irregular cluster border were observed in both, they favored the diagnosis of small cell carcinoma. Hyaline globules were more frequently seen in non-pulmonary AdCC cases. Conclusions: Using the fifteen cytomorphologic criteria described by this study, pulmonary AdCC could be successfully distinguished from small cell carcinoma. Such a comprehensive approach to an individual case is recommended for the cytologic diagnosis of pulmonary AdCC.

Citations

Citations to this article as recorded by

Recent developments in the pathology of primary pulmonary salivary gland‐type tumours
Julia R Naso, Anja C Roden
Histopathology.2024; 84(1): 102. CrossRef
Bronchial cytology of pulmonary adenoid cystic carcinoma – A multi-institute series with emphasis on immunocytochemistry
Joanna K.M. Ng, Ka Pang Chan, Gary M. Tse, Joshua J.X. Li
Annals of Diagnostic Pathology.2023; 64: 152132. CrossRef
Pulmonary adenoid cystic carcinoma: molecular characteristics and literature review
Zhixin Chen, Jiapeng Jiang, Ying Fan, Hongyang Lu
Diagnostic Pathology.2023;[Epub] CrossRef
Recent updates in salivary gland tumors of the lung
Anja C. Roden
Seminars in Diagnostic Pathology.2021; 38(5): 98. CrossRef
Cytology of Primary Salivary Gland-Type Tumors of the Lower Respiratory Tract: Report of 15 Cases and Review of the Literature
Chiara Saglietti, Marco Volante, Stefano La Rosa, Igor Letovanec, Marc Pusztaszeri, Gaia Gatti, Massimo Bongiovanni
Frontiers in Medicine.2017;[Epub] CrossRef

Case Report

Bronchial Brushing Cytologic Finding of Primary Pulmonary Adenoid Cystic Carcinoma Misinterpretated as Small Cell Carcinoma: A Case Report with Literature Review.: Hyun Jung Kim, Sangbong Choi, Jieun Kwon, Jeong Yeon Kim, Kyeongmee Park; Korean J Pathol. 2011;45(4):441-444.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.441

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Abstract PDF

An adenoid cystic carcinoma is a very rare primary pulmonary neoplasm. Bronchial washing and brushing cytological findings of pulmonary adenoid cystic carcinoma have rarely been described. Here, we report the bronchial brushing cytological findings of an adenoid cystic carcinoma, finally diagnosed in a 71-year-old female patient. The low-power view showed moderate cellularity and cohesive clusters of small to medium-sized cells. The high-power view revealed distinct nuclear moldings, a coarse chromatin pattern, and inconspicuous nucleoli, which was favorable to a diagnosis of small cell carcinoma. However, apoptotic bodies, nuclear debris, and mitoses were not seen frequently. The bronchial biopsy showed solid, trabecular, and cribriform patterns in small cells. Periodic acid Schiff staining disclosed globular basement membrane-like materials, and the immunohistochemical staining revealed the presence of myoepithelial cell components, strongly suggestive of a salivary gland type tumor, compatible with an adenoid cystic carcinoma. In this report, we describe the exfoliative cytological features of a pulmonary adenoid cystic carcinoma with emphasis on some diagnostic pitfalls.

Citations

Citations to this article as recorded by

Bronchial cytology of pulmonary adenoid cystic carcinoma – A multi-institute series with emphasis on immunocytochemistry
Joanna K.M. Ng, Ka Pang Chan, Gary M. Tse, Joshua J.X. Li
Annals of Diagnostic Pathology.2023; 64: 152132. CrossRef
Comprehensive Cytomorphologic Analysis of Pulmonary Adenoid Cystic Carcinoma: Comparison to Small Cell Carcinoma and Non-pulmonary Adenoid Cystic Carcinoma
Seokhwi Kim, Jinah Chu, Hojoong Kim, Joungho Han
Journal of Pathology and Translational Medicine.2015; 49(6): 511. CrossRef

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