Fine Needle Aspiration Cytology of Cellular Pleomorphic Adenoma

To study the spectrum of cytologic changes seen in cellular pleomorphic adenoma (CPA) and to determine features that would allow a more specific diagnosis. We reviewed 11 fine needle aspirates of surgically confirmed salivary gland CPA in addition to three discrepant cases in which CPA was strongly considered in the cytologic diagnosis. Pleomorphic adenoma was considered in the differential diagnosis, but a difinitive cytologic diagnosis was not made in the 11 cases. Acinic cell carcinoma, basal cell adenoma, adenoid cystic carcinoma; myoepithelioma and spindle cell neoplasm accounted for most of the other diagnostic considerations. The three discrepant cases included a malignant myoepithelioma, acinic cell carcinoma and mucoepidermoid carcinoma. Familiarity with the variable aspirate appearance of CPA in addition to well-defined cytologic and architectural criteria can help establish the proper diagnosis in the majority of cases. There remain, however, few cases in which a definitive diagnosis is not possible.