Type of Preparation:
Direct Smear
Magnification:
Low Magnification
Clinical History:
52-year old female parotid lesion
Interpretation:
Fig. 3.8a Non-Neoplastic: Chronic Sialadenitis with Amylase Crystals
Cytomorphologic Criteria:
• Hypocellular sample with tan crystalline material
• Small groups of ductal cells, may be basaloid or metaplastic
• Absent or scant acinar cells
• Chronic inflammation (including lymphocytes and plasma cells)
Explanatory Notes:
In addition to stone fragments and inflammatory cells, a subset of chronic sialadenitis cases and benign inflamed cysts can have amylase crystalloids, which are non-birefringent crystalline structures with rectangular, needlelike, and rhomboid geometric shapes. Amylase crystalloids are primarily associated with benign, non-neoplastic conditions, although they have occasionally been reported in Warthin tumor and pleomorphic adenoma (PA). It is important that inflamed cases with amylase crystalloids include a comment in the diagnosis that clinical and radiologic correlations are needed to help exclude a neoplastic condition. Other crystalloids that