Fine Needle Aspiration Cytology of Cellular Pleomorphic Adenoma

OBJECTIVE: To study the spectrum of cytologic changes seen in cellular pleomorphic adenoma (CPA) and to determine features that would allow a more specific diagnosis. STUDY DESIGN: We reviewed 11 fine needle aspirates of surgically confirmed salivary gland CPA in addition to three discrepant cases in which CPA was strongly considered in the cytologic diagnosis. RESULTS: Pleomorphic adenoma was considered in the differential diagnosis, but a difinitive cytologic diagnosis was not made in the 11 cases. Acinic cell carcinoma, basal cell adenoma, adenoid cystic carcinoma; myoepithelioma and spindle cell neoplasm accounted for most of the other diagnostic considerations. The three discrepant cases included a malignant myoepithelioma, acinic cell carcinoma and mucoepidermoid carcinoma. CONCLUSION: Familiarity with the variable aspirate appearance of CPA in addition to well-defined cytologic and architectural criteria can help establish the proper diagnosis in the majority of cases. There remain, however, few cases in which a definitive diagnosis is not possible.