Pleomorphic adenoma pathophysiology: Difference between revisions
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====On microscopic histopathological analysis, the characteristic findings of pleomorphic adenoma include:==== | ====On microscopic histopathological analysis, the characteristic findings of pleomorphic adenoma include:==== | ||
*Pleomorphic adenoma has a highly variable appearance on microscopy, hence the name. | *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. | *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.<ref name="pmid28613579">{{cite journal |vauthors=Bokhari MR, Greene J |title= |journal= |volume= |issue= |pages= |date= |pmid=28613579 |doi= |url=}}</ref> | *Epithelial elements are usually polygonal,spindle, or [[stellate shaped cells]] which may be arranged into duct-like structures, sheets, clumps or interlacing strands.<ref name="pmid28613579">{{cite journal |vauthors=Bokhari MR, Greene J |title= |journal= |volume= |issue= |pages= |date= |pmid=28613579 |doi= |url=}}</ref> | ||
*The ducts and tubules exhibiting an outer lining in addition to an inner cuboidal epithelial cell layer are seen. | *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.<ref name="pmid28613579">{{cite journal |vauthors=Bokhari MR, Greene J |title= |journal= |volume= |issue= |pages= |date= |pmid=28613579 |doi= |url=}}</ref> | *This is outer myoepithelial cell layer which merges into the surrounding stroma which also contains dispersed or clumped myoepithelial element cells.<ref name="pmid28613579">{{cite journal |vauthors=Bokhari MR, Greene J |title= |journal= |volume= |issue= |pages= |date= |pmid=28613579 |doi= |url=}}</ref> | ||
Revision as of 17:03, 18 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 pleomorphic adenoma is not fully understood. Chromosomal abnormalities involving 8q12 and 12q15 have been described. The gross features of pleomorphic adenoma are firm, well demarcated, encapsulated, and mobile. On microscopic histopathology they are a mixture of both epithelial and stomal matrix.
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.