International Journal of Research & Review (www.ijrrjournal.com) 9 Vol.5; Issue: 11; November 2018 International Journal of Research and Review www.ijrrjournal.com E-ISSN: 2349-9788; P-ISSN: 2454-2237 Case Report Crystalloids in Cytology Smears of Parotid Lesions: A Diagnostic Challenge Shanthi Vissa 1 , Kande Srinivasulu 2 , Nandam Mohan Rao 1 , Byna Shyam Sundara Rao 2 , Bhavana Grandhi 3 1 Professor, 3 Associate Professor, Department of Pathology, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India. 2 Associate Professor, Department of Pathology, Rajiv Gandhi Institute of Medical Sciences, Ongole, Andhra Pradesh, India Corresponding Author: Shanthi Vissa ABSTRACT Cystic lesions in neck region yield fluid on fine needle aspiration cytology and are frequently reported as non-specific as they lack cellularity. Non cellular structures like crystalloids in the fluid give clue to the diagnosis. We report a case of 43 year old male patient presenting with swelling in the right parotid region at the angle of the mandible which on cytology was diagnosed as retention cyst. Key words: Crystalloids, Salivary glands, cytology. INTRODUCTION Crystalloids may be found in various salivary gland lesions. They are more common in non-neoplastic salivary gland lesions but can be encountered rarely in malignant lesions. Various crystalline structures described in non-neoplastic and neoplastic salivary gland lesions are tyrosine, amylase, oxalate, collagenase and intramural crystalloids. [1] We present a case of cystic lesions in the parotid gland containing amylase crystalloids. CASE REPORT A 43 year old male presented with tender swelling at the angle of the mandible on the right side. There was no history of fever, hearing loss or weight loss. On clinical examination firm tender swelling measuring 2x3cms is present at the right parotid region. Ultrasonography revealed homogeneous hypoechoic lesion in the right parotid gland suggesting benign cystic lesion. Fine needle aspiration was performed and 2ml of clear fluid was aspirated. After aspiration swelling subsided. Fine needle aspiration smears were prepared and stained with Haematoxylin & Eosin. Smears revealed numerous rhomboid & rectangular shaped crystalloids with parallel sides (Figure 1 ). Some of them showed pointed ends. Few foci showed epithelioid cell clusters ( Figure 2 ) & multinucleated foreign body giant cells (Figure 3 ). Figure 1: Smears with numerous rectangular shaped crystalloids with parallel sides (H&E, X100)