Salivary gland tumor pathophysiology: Difference between revisions

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===Malignant tumors===
{| style="border: 0px; font-size: 90%; margin: 3px; width: 800px;" align=center
|valign=top|
|+
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Entity}}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Architecture}}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Morphology}}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Cell borders}}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Cytoplasm}}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Nucleus}}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Other}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Mucoepidermoid carcinoma
| style="padding: 5px 5px; background:  #F5F5F5;"  |Cystic and solid
| style="padding: 5px 5px; background:  #F5F5F5;"  |Epitheloid
| style="padding: 5px 5px; background:  #F5F5F5;"  |Distinct
| style="padding: 5px 5px; background:  #F5F5F5;"  |fuffy, clear, abundant
| style="padding: 5px 5px; background:  #F5F5F5;"  |Nuclei small
| style="padding: 5px 5px; background:  #F5F5F5;"  |SCC (?)
| style="padding: 5px 5px; background:  #F5F5F5;"  |Immunohistochemistry: p63+
|-
| style="padding: 5px 5px; background: #DCDCDC;  font-weight: bold" |Adenoid cystic carcinoma (AdCC)
| style="padding: 5px 5px; background:  #F5F5F5;" |pseudocysts, cribriform, solid, hyaline stroma
| style="padding: 5px 5px; background:  #F5F5F5;" |Epitheloid
| style="padding: 5px 5px; background:  #F5F5F5;" |Subtle
| style="padding: 5px 5px; background:  #F5F5F5;" |Scant, hyperchromatic
| style="padding: 5px 5px; background:  #F5F5F5;" |Small+/-"carrot-shaped"
| style="padding: 5px 5px; background:  #F5F5F5;" |Pleomorphic adenoma, Polymorphous low grade adenocarcinoma (PLGA)
| style="padding: 5px 5px; background:  #F5F5F5;" |Stains: PAS+ (pseudocyst material), CD117+, cyclin D1+
|-
| style="padding: 5px 5px; background:  #DCDCDC;  font-weight: bold"  |Acinic cell carcinoma (AcCC)
| style="padding: 5px 5px; background:  #F5F5F5;"  |Sheets, acinar (islands)
| style="padding: 5px 5px; background:  #F5F5F5;"  |Epithelioid
| style="padding: 5px 5px; background:  #F5F5F5;"  |Clear
| style="padding: 5px 5px; background:  #F5F5F5;"  |Granular abundant
| style="padding: 5px 5px; background:  #F5F5F5;"  |stippled, +/-occasional nucleoli
| style="padding: 5px 5px; background:  #F5F5F5;"  |Adenocarcinoma not otherwise specified, oncocytoma of salivary gland
| style="padding: 5px 5px; background:  #F5F5F5;"  |Stains: PAS +ve, PAS-D +ve; Immunohistochemistry: S-100 -ve, p63 -ve
|-
| style="padding: 5px 5px; background:  #DCDCDC;  font-weight: bold" |Salivary duct carcinoma
| style="padding: 5px 5px; background:  #F5F5F5;"  |Glandular, cribriform
| style="padding: 5px 5px; background:  #F5F5F5;"  |Columnar
| style="padding: 5px 5px; background:  #F5F5F5;"  |Subtle/clear
| style="padding: 5px 5px; background:  #F5F5F5;"  |Hyperchromatic
| style="padding: 5px 5px; background:  #F5F5F5;"  |Columnar
| style="padding: 5px 5px; background:  #F5F5F5;"  |Metastatic breast carcinoma
| style="padding: 5px 5px; background:  #F5F5F5;"  |similar to ductal breast carcinoma; male>female
|-
| style="padding: 5px 5px; background:  #DCDCDC;  font-weight: bold" |Polymorphous low-grade adenocarcinoma
| style="padding: 5px 5px; background:  #F5F5F5;"  |Variable, often small nests, may be targetoid
| style="padding: 5px 5px; background:  #F5F5F5;"  |Epithelioid
| style="padding: 5px 5px; background:  #F5F5F5;"  |Indistinct
| style="padding: 5px 5px; background:  #F5F5F5;"  |Eosinophilic
| style="padding: 5px 5px; background:  #F5F5F5;"  |Ovoid & small with small nucleoli
| style="padding: 5px 5px; background:  #F5F5F5;"  | Adenoid cystic carcinoma (AdCC)
| style="padding: 5px 5px; background:  #F5F5F5;"  |minor salivary gland tumour, often in palate, cytologically monotonous; IHC: S-100+, CK+, vim.+, GFAP+/-, BCL2+/-
|-
| style="padding: 5px 5px; background:  #DCDCDC;  font-weight: bold" |Epithelial-myoepithelial carcinoma
| style="padding: 5px 5px; background:  #F5F5F5;"  |Nests (myoepithelial) with tubules (epithelial)
| style="padding: 5px 5px; background:  #F5F5F5;"  |Epithelioid
| style="padding: 5px 5px; background:  #F5F5F5;"  |Not distinct
| style="padding: 5px 5px; background:  #F5F5F5;"  |Eosinophilic cytoplasm; epithelial: scant; myoepithelial: moderate
| style="padding: 5px 5px; background:  #F5F5F5;"  |Focal clearing
| style="padding: 5px 5px; background:  #F5F5F5;"  | Adenoid cystic carcinoma (AdCC), pleomorphic adenoma
| style="padding: 5px 5px; background:  #F5F5F5;"  |Rare
|-
| style="padding: 5px 5px; background:  #DCDCDC;  font-weight: bold" |Basal cell adenocarcinoma
| style="padding: 5px 5px; background:  #F5F5F5;"  |Variable, islands surrounded by hyaline bands, lesion not encapsulated
| style="padding: 5px 5px; background:  #F5F5F5;"  |Basaloid
| style="padding: 5px 5px; background:  #F5F5F5;"  |Subtle
| style="padding: 5px 5px; background:  #F5F5F5;"  |Scant, hyperchromatic
| style="padding: 5px 5px; background:  #F5F5F5;"  |Granular
| style="padding: 5px 5px; background:  #F5F5F5;"  | Basal cell adenoma
| style="padding: 5px 5px; background:  #F5F5F5;"  |Rare, usually parotid gland, may arise from a basal cell adenoma
|-
|}
==References==
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==References==
==References==

Revision as of 07:11, 8 November 2015

Salivary gland tumor Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

The pathophysiology of salivary gland tumors depends on the histological subtype.

Pathophysiology
Entity Architecture Morphology Cell borders Cytoplasm Nucleus Differential Diagnosis Other
Pleomorphic adenoma Variable mixed proportion; must include:
  • myoepithelium
  • mesenchymal stroma
  • epithelium (ductal cells) or
  • chondromyxoid stroma
 Variable Variable Plasmacytoid Adenoid cystic carcinoma Occasionally encapsulated, mixed proportion of glandular, myoepithelial and mesenchymal cells
Warthin tumor Papillary, bilayer Cuboid (basal), columnar (apical) Clearly seen Eosinophilic, abundant Unremarkable Sebaceous lymphadenoma AKA papillary cystadenoma lymphomatosum
Basal cell adenoma variable, islands surrounded by hyaline bands, lesion encapsulated Basaloid Subtle Scant, hyperchromatic Granular Basal cell adenocarcinoma
Canalicular adenoma Chains of cells Cuboid or columnar Subtle Scant, hyperchromatic Granular Basal cell adenoma Exclusively oral cavity, 80% in upper lip; immunohistochemistry: p63-
Sialoblastoma variable, islands surrounded by loose fibrous stroma Basaloid Subtle Scant, hyperchromatic Granular Adenoid cystic carcinoma Basal cell adenocarcinoma

Malignant tumors
Entity Architecture Morphology Cell borders Cytoplasm Nucleus Differential Diagnosis Other
Mucoepidermoid carcinoma Cystic and solid Epitheloid Distinct fuffy, clear, abundant Nuclei small SCC (?) Immunohistochemistry: p63+
Adenoid cystic carcinoma (AdCC) pseudocysts, cribriform, solid, hyaline stroma Epitheloid Subtle Scant, hyperchromatic Small+/-"carrot-shaped" Pleomorphic adenoma, Polymorphous low grade adenocarcinoma (PLGA) Stains: PAS+ (pseudocyst material), CD117+, cyclin D1+
Acinic cell carcinoma (AcCC) Sheets, acinar (islands) Epithelioid Clear Granular abundant stippled, +/-occasional nucleoli Adenocarcinoma not otherwise specified, oncocytoma of salivary gland Stains: PAS +ve, PAS-D +ve; Immunohistochemistry: S-100 -ve, p63 -ve
Salivary duct carcinoma Glandular, cribriform Columnar Subtle/clear Hyperchromatic Columnar Metastatic breast carcinoma similar to ductal breast carcinoma; male>female
Polymorphous low-grade adenocarcinoma Variable, often small nests, may be targetoid Epithelioid Indistinct Eosinophilic Ovoid & small with small nucleoli Adenoid cystic carcinoma (AdCC) minor salivary gland tumour, often in palate, cytologically monotonous; IHC: S-100+, CK+, vim.+, GFAP+/-, BCL2+/-
Epithelial-myoepithelial carcinoma Nests (myoepithelial) with tubules (epithelial) Epithelioid Not distinct Eosinophilic cytoplasm; epithelial: scant; myoepithelial: moderate Focal clearing Adenoid cystic carcinoma (AdCC), pleomorphic adenoma Rare
Basal cell adenocarcinoma Variable, islands surrounded by hyaline bands, lesion not encapsulated Basaloid Subtle Scant, hyperchromatic Granular Basal cell adenoma Rare, usually parotid gland, may arise from a basal cell adenoma

References

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References

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