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Adenoid Cystic CA

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This image shows variable-sized, smooth contoured lobules or islands of uniform basaloid cells punctuated by round rigid gland-like spaces. These spaces are not true glandular lumens but represent stromal invaginations (pseudocysts). They are filled with basophilic myxoid mucinous material (Alcian blue positive). A few true glandular structures lined by low cuboidal cells with eosinophilic cytoplasm are also present.

Basaloid cells are the dominant cell population and can overshadow the epithelial component in some cases. They have hyperchromatic round or angulated nuclei, scanty cytoplasm and indistinct borders. There is minimal cytologic atypia and mitotic activity is not increased.

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