Type of Preparation:
Direct Smear
Magnification:
Intermediate Magnification
Clinical History:
39-year old female with "Swelling of jaw"
Interpretation:
Fig. 3.9b Non-Neoplastic: Granulomatous Sialadenitis
Cytomorphologic Criteria:
• Hypocellular (scant acinar and ductal cells)
• Groups of epithelioid histiocytes
• Variable amounts of acute and chronic inflammatory cells
• ± Multinucleated giant cells
• ± Necrotic background debris
Explanatory Notes:
The diagnosis relies on identifying groups of epithelioid histiocytes Obstructive sialadenopathy with extravasation of ductal contents is the most common cause of a granulomatous reaction, which can result from calculi or less often tumors. In cases with more marked granulomas, care should be taken to avoid misinterpreting the epithelioid histiocytes with their moderate amounts of eosinophilic cytoplasm and curved nuclei as an epithelial neoplasm. Mycobacterial infection (tuberculous or nontuberculous) is the most common etiology for infectious granulomatous sialadenitis, although special stains (AFB) infrequently reveal diagnostic acid fast bacteria.