{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T20:27:35Z","timestamp":1789244855581,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Salivary duct carcinoma (SDC) is an aggressive malignancy of the salivary gland. The rare mucin\u2010rich variant is characterized by the presence of nests of malignant cells floating in pools of extracellular mucin. We present an unusual case of SDC with abundant mucocytes but complete absence of extracellular mucin, initially misdiagnosed as mucoepidermoid carcinoma (MEC) on fine needle aspiration (FNA). The patient, an 85\u2010year\u2010old woman, presented with a 3.2\u2009cm heterogeneous, partially cystic, right parotid mass causing facial nerve paralysis. FNA revealed mixed pleomorphic and hyperchromatic epithelial cells with abundant mucocytes. The tumor cells were focally positive for p63 and androgen receptor (AR). The patient was diagnosed with intermediate\u2010grade MEC. Subsequent parotidectomy revealed high\u2010grade duct\u2010forming carcinoma with extensive perineural invasion, frequent mitosis, and comedonecrosis arising from a pleomorphic adenoma. This was remarkable for numerous mucocytes and the absence of extracellular mucin. Immunohistochemically, the tumor cells expressed AR, CK7, GATA3, and GCDFP\u201015, confirming the diagnosis of SDC. Whole exome sequencing revealed <jats:italic>RAD50<\/jats:italic> p.Lys973Arg and <jats:italic>POLE<\/jats:italic> p.Arg52Trp mutations, suggesting that the DNA damage repair pathway was affected. Given the potential for variability in individual marker expression, including aberrant phenotypes, such as p63\u2010positive SDC or AR\u2010positive MEC, employing a comprehensive panel of markers for accurate diagnosis is crucial. Markers such as GATA3 and GCDFP\u201015 can be useful in detecting highly aggressive SDC.<\/jats:p>","DOI":"10.1002\/dc.25483","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T10:19:20Z","timestamp":1746440360000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Mucocyte\u2010Rich\/Extracellular Mucin\u2010Poor Salivary Duct Carcinoma: An Unusual Morphological Variant Mimicking Mucoepidermoid Carcinoma"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2029-0167","authenticated-orcid":false,"given":"Azadeh","family":"Samiei","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harvey","family":"Cramer","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila","family":"Segura","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector","family":"Mesa","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tieying","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Indiana University School of Medicine  Indianapolis Indiana 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