Benign metastasizing tumor or benign epithelial inclusion in the node: A diagnostic dilemma

Generally metastasis implies malignancy, but there are some benign tumours which can also metastasize to lymph nodes, bone, and kidney. The benign tumours which can metastasize includes pleomorphic adenoma, leiomyoma, giant cell tumour of bone and meningioma. A 27 years old female presented to the cytology clinic with the submandibular swelling for past 3 months. Patient is a known case of pleomorphic adenoma post-surgery in the same region 6 years back. On examination two nodular swelling each measuring 1 x 1 which is firm mobile near scar site and left level III lymph node region. A non-guided fine needle aspiration cytology was performed from both the swelling. The Papanicolaou- and May-Grünwald Giemsa-stained smears from both sites showed features of pleomorphic adenoma. The interesting aspect of this article is cytological diagnosis of benign pleomorphic adenoma metastasizing to lymph nodes which is a rare entity.