Pleomorphic Adenoma Histology — MFDS Part 1 MCQ
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Correct answer: D — Pleomorphic adenoma
The correct answer is D, pleomorphic adenoma. This benign mixed salivary tumour contains epithelial or duct-forming cells together with variably shaped myoepithelial cells in a characteristic myxoid, chondroid or chondromyxoid extracellular matrix. Warthin tumour instead has cystic and papillary spaces lined by bilayered oncocytic epithelium over lymphoid stroma. Adenoid cystic carcinoma typically shows cribriform, tubular or solid architecture with hyaline pseudocystic material and is clinically associated with perineural invasion. Mucoepidermoid carcinoma contains varying proportions of mucous, epidermoid and intermediate cells rather than chondromyxoid stroma. Acinic cell carcinoma demonstrates serous acinar differentiation, often with granular cytoplasm. The epithelial–myoepithelial admixture combined with chondromyxoid stroma is therefore diagnostic of pleomorphic adenoma among these options.
Reference: Rameeza A, Hemalata M. Fine-needle aspiration cytology of salivary gland lesions. Journal of Oral and Maxillofacial Pathology. 2022; Figure 2 and accompanying histomorphology description. https://pubmed.ncbi.nlm.nih.gov/35571296/