Cribriform Adenocarcinoma of Minor Salivary Glands Presented as a Nasopharyngeal Tumor: a Case Report Highlighting the Significance of Cytology.

Abstract

Abstract Cribriform adenocarcinoma of minor salivary gland (CAMSG) is a rare malignancy presenting cytologic features resembling papillary thyroid carcinoma, localized in oral cavity and oropharynx. Despite cervical lymph node (LN) metastases as a frequent manifestation of CMSG, there are a scant number of publications evaluating its cytology. The aim of this report was to present a CAMSG in an unusual location in the light of cytological features, thus enriching the spectrum of fine-needle aspiration biopsy (FNAB) differential diagnosis. We report a case of a 76 year-old female presenting an enlarged submandibular LN on physical examination. Computed tomography revealed a submucosal lesion situated predominantly in the nasopharynx. FNAB and subsequently an open biopsy of submandibular LN were conducted. In cytological smear cribriform, dense clusters of monomorphic round-oval tumor cells with scant cytoplasm were observed. Histologically, the tumor was composed of oval, overlapping cells with bright nuclear chromatin and nuclear grooves forming cribriform, papillary and solid structures. Immunohistochemistry panel revealed: TTF-1 (-), thyroglobulin (-), S100 (+), p63 (+), Gal-3 (+), CK19 (+) focally. The diagnosis of CAMSG should be considered when dealing with nasopharyngeal mass. Commonly nodal metastases are observed in this tumor, therefore appropriate evaluation of cytological smear is crucial for patient management.