A 44-year-old patient was referred by a general practitioner to the Department of Oral and Maxillofacial Surgery for presenting a parotid tumor, which appeared to be a single nodule upon palpation.
With the suspicion of benign tumor aspiration puncture was performed with 23 G needle aspiration in the Pathology Service, fixing the material immediately obtained in 95% alcohol and reserving one of the following:
The samples fixed in alcohol were stained following the Papanicolaou technique, while the air-dried samples were stained with Diff-Quick technique.
Cytologically, a lesion composed of epithelial and ductal cells is observed over a pituitary fundus and myxomatous, in addition to chondroid material and fragments of eosinophilic stroma basilar.
The cytological diagnosis was pleomorphic adenoma (PA), so a total parotidectomy with preservation of the facial nerve was performed.
The surgical specimen was included in 10% formaldehyde, observing macroscopically a 2x2 cm tumor, with blast-elastic consistency and whitish coloration, partially encapsulated, as well as a 1.5 cm thin lymphoid stroma.
After fixation, the whole piece is dried and the paraffin blocks are routinely obtained.
Classical hematoxylin-eosin staining was used for microscopic observation.
The microscopic study shows a well circumscribed main tumor surrounded by a connective pseudocapsule composed of a biphasic cell population of glandular epithelium and myoepithelial cells surrounded by a diagnosis of pleomorphic adenoma that confirms the myxoid.
The other nodules were lymphatic ganglia, but a new small size lesion appeared, highly cystic mixed tumor, of papillary appearance, consisting of a double row of oncocytic cells with adjacent lymphocytic stroma surrounding the cystic spaces.
The definitive histopathological diagnosis was pleomorphic adenoma and synchronic Warthin tumor of the right parotid.
