男、43岁、左上腭肿块2年余，左上腭肿块大小约2cmx1.5xcm1.5cm，余氏持笔式持续性负压穿刺针穿刺，针吸物为少许血性小颗粒物。液基制片，HE染色

该例目前尚无组织切片结果。

 腺样囊性癌,具有典型的黏液球团状细胞,考虑来源于小涎腺

 This is a beautiful aspirate and I basically agree with most of the posts that it most likely represent an adenoid cystic carcinoma.

What size of the needle you used to do the aspiration? few photos really show a microbiopsy-like picture. I have one more question for those who are interested in FNA, can you see 黏液球团状细胞 in other salivary gland neoplam?

谢谢陈博士的回帖，此例的组织学结果就是腺样囊性癌。我们医院使用的是北京友谊医院余小蒙大夫发明的持笔式持续式负压穿刺器，外径0.8mm的针头，我们已经使用了12年了，感到外径0.8mm的针头比0.7mm的针头容易获得微小活检样的图像。在其他的涎腺新生物的穿刺物里我们基本没有见到过黏液球团状细胞，不过经您提醒我今后会关注这个问题的。

黏液球团状细胞 can be seen in the following salivary gland neoplasms: 1)Pleomorphic adenoma; 2) Basal cell adenoma; 3) Adenoid cystic carcinoma; 4) Myoepithelioma or carcinoma; 5) Polymorphous low-grade adenocarcinoma. So, it is not that specific, you have to look at the whole slide and the cells carefully, before you render the diagnosis.

I am trying to post a nice paper addressing this issue.oops! I can only post the abstract and not the pdf file of the whole paper. Maybe somebody can help me?

Cytologic diagnosis of adenoid cystic carcinoma of salivary glands.

Nagel H, Hotze HJ, Laskawi R, Chilla R, Droese M.

Department of Cytopathology, Georg-August-University of Göttingen, Germany. hnagel@med.uni-goettingen.de

The cytomorphologic features in fine-needle aspiration (FNA) biopsies from 31 primary and 33 recurrent adenoid cystic carcinomas (ACC) were investigated. The correct FNA diagnosis was established in 24 of 31 primary ACC (77%). The diagnostic clue in aspirates from ACC are large globules of extracellular matrix, partially surrounded by basaloid tumor cells. In FNAs with predominance of basaloid tumor cells, but lacking characteristic globules, all other benign and malignant salivary gland tumors of epithelial-myoepithelial differentiation should be considered in the cytologic diagnosis. Pleomorphic adenoma is most frequently confused with ACC, and therefore, the cytologic findings in FNAs from 50 pleomorphic adenomas were compared with those diagnosed as ACC. Furthermore, rare neoplasms of salivary glands with epithelial-myoepithelial cell differentiation, including basal-cell adenoma and carcinoma, epithelial-myoepithelial carcinoma, and polymorphous low-grade adenocarcinoma, as well as some nonsalivary gland neoplasms presenting an adenoid cystic pattern, must be considered. The cytologic features of these entities are discussed in detail with respect to the cytologic diagnostic criteria of ACC.