A white man in his 40s presented with a slowly enlarging, nontender, left-sided neck mass at the angle of the mandible that had been present for 4 years. Fine-needle aspiration was performed twice, each time with inconclusive results. Computed tomography (CT) of the neck showed a heterogeneous mass located immediately adjacent to the tail of the left parotid. No other masses were noted. He underwent a left superficial parotidectomy with en bloc removal of the mass. Pathologic findings revealed a 3.0 × 2.9 × 1.9-cm, encapsulated, tan, soft nodule within the specimen. The nodule had peripheral cystic spaces as well as focal areas of hemorrhage and a 0.5 × 0.4 × 0.4-cm area of calcification within the periphery. The entire tumor was confined within a periparotid lymph node, almost completely replacing it. Histopathologic findings (Figure) showed a mixture of dark, granular, basophilic acinar cells and eosinophilic intercalated ductal cells. The acinar cells contained periodic acid–Schiff–positive, diastase-resistant intracytoplasmic granules, whereas the ductal cells were both fusiform and cuboidal forming small ductlike structures. The neoplasm also exhibited focal areas of hyaline sclerosis without necrosis.
Chase T, Dingle I, Ridley MB. Slowly Enlarging Neck Mass. JAMA Otolaryngol Head Neck Surg. 2017;143(6):629–630. doi:10.1001/jamaoto.2016.3707
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