A Rare Case of Nodular Fasciitis Presenting as a Parotid Tumor: Clues to Cytodiagnosis

Abstract A 14-year-old boy presented with left preauricular painless swelling of 10 months' duration. Local examination revealed a 3 × 2-cm, firm, nodular, nonmobile mass in the area, just front tragus. Fine needle aspiration yielded paucicellular smears comprising singly scattered histiocyte/myofibroblast-like spindle cells and occasional giant cells. It was reported as benign mesenchymal lesion on cytology. Left superficial parotidectomy performed. Histopathological immunohistochemical analysis confirmed diagnosis nodular fasciitis (NF). an ill-circumscribed cellular neoplasm, abutting focally infiltrating into otherwise normal parotid gland. The tumor comprised arranged short bundles storiform pattern interspersed osteoclast-like cells, foam extravasated red blood (RBCs), focal areas keloidal collagenization. were positive for smooth muscle actin negative CD34, beta-catenin, S100, pan-cytokeratin. Final NF rendered. can rarely involve gland or present enlargement pose diagnostic challenge, especially However, appropriate clinical context, subtle cytomorphological clues such presence myofibroblasts fibrocollagenous stromal fragments help ruling out commonly occurring salivary neoplasms offering definitive cytodiagnosis which will be helpful deciding further course management.