Pleomorphic adenoma pathophysiology: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
===Pathogenesis=== | ===Pathogenesis=== | ||
*The exact pathogenesis of | *The exact pathogenesis of pleomorphic adenoma is not completely understood. | ||
===Genetics=== | ===Genetics=== | ||
Revision as of 16:21, 16 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
The exact pathogenesis of [disease name] is not fully understood.
OR
It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
OR
[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
OR
Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
OR
[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
OR
The progression to [disease name] usually involves the [molecular pathway].
OR
The pathophysiology of [disease/malignancy] depends on the histological subtype.
Pathophysiology
Pathogenesis
- The exact pathogenesis of pleomorphic adenoma is not completely understood.
Genetics
- PLAG1 and HMGA2 chromosomal rearrangments is specific to Pleomorphic adenoma.[1]
- Some clonal chromosomal abnormalities involving 8q12 and 12q15 have also been described.[2]
Gross Pathology
- The gross pathological features of Pleomorphic adenoma are as follows:
- Firm
- Mobile
- Well demarcated
- Encapsulated(mostly, but the Myxoid and Stroma rich subtype sometimes show focal absences of capsule) [3]
- Tan-white in appearance
Pleomorphic adenoma gross appearance,Calicut Medical College [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)
Microscopic Pathology
On microscopic histopathological analysis, the characteristic findings of pleomorphic adenoma include:
- Pleomorphic adenoma has a highly variable appearance on microscopy, hence the name.
- It is characterized by both polygonal epithelial and spindle-shaped myoepithelial cells in a variable stroma matrix which can be either epithelomucoid, myxoid, cartilaginous,or hyaline.
- Epithelial elements are usually polygonal,spindle, or stellate shaped cells which may be arranged into duct-like structures, sheets, clumps or interlacing strands.[4]
- The ducts and tubules exhibiting an outer lining in addition to an inner cuboidal epithelial cell layer are seen.
- This is outer myoepithelial cell layer which merges into the surrounding stroma which also contains dispersed or clumped myoepithelial element cells.[4]
- Some areas of squamous metaplasia and epithelial pearls are also seen.
Librepath [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], from Wikimedia Commons
On immunohistochemical analysis, the characteristic findings of pleomorphic ademona include:
- Positive S-100 protein[5]
- Positive GFAP mainly in myxomatous and early chondromatous differentiation.[6]
- BMP-6 protein overexpression.[7]
References
- ↑ Mendoza, Pia R.; Jakobiec, Frederick A.; Krane, Jeffrey F. (2013). "Immunohistochemical Features of Lacrimal Gland Epithelial Tumors". American Journal of Ophthalmology. 156 (6): 1147–1158.e1. doi:10.1016/j.ajo.2013.06.034. ISSN 0002-9394.
- ↑ Debnath SC, Adhyapok AK (June 2010). "Pleomorphic adenoma (benign mixed tumour) of the minor salivary glands of the upper lip". J Maxillofac Oral Surg. 9 (2): 205–8. doi:10.1007/s12663-010-0052-5. PMC 3244097. PMID 22190789.
- ↑ Zhan KY, Khaja SF, Flack AB, Day TA (April 2016). "Benign Parotid Tumors". Otolaryngol. Clin. North Am. 49 (2): 327–42. doi:10.1016/j.otc.2015.10.005. PMID 27040584.
- ↑ 4.0 4.1 Bokhari MR, Greene J. PMID 28613579. Missing or empty
|title=(help) - ↑ Furuse, Cristiane; de Sousa, Suzana O. Machado; Nunes, Fabio Daumas; de Magalhaes, Marina Helena Cury Gallottini; de Arauijo, Vera Cavalcanti (2016). "Myoepithelial Cell Markers in Salivary Gland Neoplasms". International Journal of Surgical Pathology. 13 (1): 57–65. doi:10.1177/106689690501300108. ISSN 1066-8969.
- ↑ Nishimura T, Furukawa M, Kawahara E, Miwa A (December 1991). "Differential diagnosis of pleomorphic adenoma by immunohistochemical means". J Laryngol Otol. 105 (12): 1057–60. PMID 1664847.
- ↑ Kusafuka K, Yamaguchi A, Kayano T, Takemura T (December 1999). "Immunohistochemical localization of the bone morphogenetic protein-6 in salivary pleomorphic adenomas". Pathol. Int. 49 (12): 1023–7. PMID 10632922.