Acinic cell carcinoma differential diagnosis: Difference between revisions

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Revision as of 12:34, 27 September 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD [2]

Overview

Acinic cell carcinoma is a head and neck tumor happening in the salivary glands. If a patient was observed with related signs, the tumor must be classified as a benign or invasive by the capsule being intact. Differential diagnosis of a malignant tumor in the salivary gland is made after the incision and by histology features which will provide a good chemotherapy regimen for so-called patients.

Differentiating acinic cell carcinoma from other Diseases

Category	Diseases		Benign/ Malignant	Clinical manifestation					Paraclinical findings			Gold standard diagnosis	Associated findings
Category	Diseases		Benign/ Malignant	Demography	History	Symptoms	Signs		Lab findings	Histopathology	Imaging	Gold standard diagnosis	Associated findings
Warthin's tumor^[1]^[2]	Benign	Male to female ratio: 4:1 More common in people aged 60-70 years old	History of swollen salivary gland Jaw pain Tinnitus	−	+	Non tender Mobile Firm Solitary	−	−	Papillae Fibrous capsule Cystic spaces	Neck CT: Cystic lesion posteriorly within the parotid gland MRI: B/L heterogeneous lesions	Biopsy	−
						Pleomorphic adenoma^[3]^[4]	Benign	More common in females Incidence increase with age Incidence: 2-3.5 cases per 100,000 population						History of swelling Dysphagia Hoarseness	−	+	Palpable mass of deep lobe of parotid gland Firm Mobile	−	−	Proliferation of epithelial cells and stromal matrix in the ducts	MRI: Homogenous on T1 Abundant myxochondroid stroma on T2	Biopsy	−
Oncocytoma ^[5]	Benign	Race: Caucasian patients predilection Gender: No gender preference Age: 50–70 years	Growing palpable painless mass Facial swelling Lymphadenopathy (if transformed to malignant)	±	±	Firm, multilobulated Mobile mass	Normal Redness Swelling Skin ulceration	Normal Anemia	Epithelial cells with eosinophilic Granular cytoplasm Rich in mitochondria	CT: Isodense expansive mass Enhancement after intravenous contrast Hypodense areas MRI: Isodensties on T1 Mass is hyperintense on T2 Enhancement on contrast	Incisional biopsy and histopathological examination	-
Monomorphic adenoma ^[6]^[7]^[8]	Benign or malignant	Age: 26-76 years Rare in children Gender: No predilection	Growing palpable painless mass on jaw or in oral cavity Facial swelling Lymphadenopathy (if transformed to malignant) Pain and ulceration (in later stage)	±	±	Nodular Fluctuant swelling	Normal Redness Skin ulceration May have lymphadenopathy	Normal	Straw colored fluid on aspiration	Ultrasound: Used to biopsy the lesion May show cystic an solid components CT: useful for lesions with calcification and venous phleboliths MRI: Test of choice Differentiate benign from malignant Defines tumor extent Shows perineural spread	Incisional biopsy and histopathological examination	-
Mucoepidermoid carcinoma ^[9]	Malignant	Age: Mean age of 59 Female predilection	Painlesss mass Swelling in oral cavity Lymphadenopathy	±	±	Cystic and solid mass	May have lymphadenopathy	−	Gross findings: Firm Tan-white to yellow Bosselated Cystic Microscopic findings: Encapsulated squamous and glandular components	Cystic and solid component with variable appearance on CT and MRI	Incisional biopsy and histopathological examination	Association with CMV

Differentiating acinic cell carcinoma from other diseases on the basis of histology findings

On the basis of histologist findings acinic cell carcinoma must be differentiated from other salivary and head and neck masses such as salivary metastasis of thyroid carcinoma, salivary oncocytoma, mucoepidermoid carcinoma, Mammary analog secretory carcinoma.^[10]^[11]


Diseases	Histological findings
Diseases	Overlapping features	Distinguishing features
Salivary metastasis of thyroid carcinoma^[12]	Empty appearance, grooves, pseudoinclusions	Immunohistochemistry (Thyroglobulin)
salivary oncocytoma^[13]	Eosinophilic, non-serous cells	Hematoxylin
mucoepidermoid carcinoma^[14]	Microcystic, and follicula, inconspicuous mucous/squamoid cells, eosinophilic	Immunohistochemistry for p63
Mammary analoge secretory carcinoma^[15]	Histologically similar	Lack of PAS-positive secretory granules, Vimentin positive, Adipophilin positive

References

↑ Chulam TC, Noronha Francisco AL, Goncalves Filho J, Pinto Alves CA, Kowalski LP (December 2013). "Warthin's tumour of the parotid gland: our experience". Acta Otorhinolaryngol Ital. 33 (6): 393–7. PMID 24376295.
↑ "Warthin tumor | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program".
↑ 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.
↑ Kato H, Kawaguchi M, Ando T, Mizuta K, Aoki M, Matsuo M (August 2018). "Pleomorphic adenoma of salivary glands: common and uncommon CT and MR imaging features". Jpn J Radiol. 36 (8): 463–471. doi:10.1007/s11604-018-0747-y. PMID 29845358.
↑ Chen B, Hentzelman JI, Walker RJ, Lai JP (2016). "Oncocytoma of the Submandibular Gland: Diagnosis and Treatment Based on Clinicopathology". Case Rep Otolaryngol. 2016: 8719030. doi:10.1155/2016/8719030. PMC 5045990. PMID 27722003.
↑ Kim KH, Sung MW, Kim JW, Koo JW (July 2000). "Pleomorphic adenoma of the trachea". Otolaryngol Head Neck Surg. 123 (1 Pt 1): 147–8. doi:10.1067/mhn.2000.102809. PMID 10889498.
↑ Pramod Krishna B (June 2013). "Pleomorphic Adenoma of Minor Salivary Gland in a 14 year Old Child". J Maxillofac Oral Surg. 12 (2): 228–31. doi:10.1007/s12663-010-0125-5. PMC 3681990. PMID 24431845.
↑ Kessler AT, Bhatt AA (2018). "Review of the Major and Minor Salivary Glands, Part 2: Neoplasms and Tumor-like Lesions". J Clin Imaging Sci. 8: 48. doi:10.4103/jcis.JCIS_46_18. PMC 6251244. PMID 30546932.
↑ Chenevert J, Barnes LE, Chiosea SI (February 2011). "Mucoepidermoid carcinoma: a five-decade journey". Virchows Arch. 458 (2): 133–40. doi:10.1007/s00428-011-1040-y. PMID 21243374.
↑ "Tumors of the Salivary Glands, Atlas of Tumor Pathology: Third Series, Fascicle 17 G. L. Ellis and P. L. Auclair. Armed Forces Institute of Pathology, Washington D.C. ISBN: 1 881041 26 3 (Printed). 1996. Price: $69.00. ISBN: 1 881041 41 7 (CD-ROM). 1998. Price: $65.00". The Journal of Pathology. 192 (4): 564–565. 2000. doi:10.1002/1096-9896(200012)192:4<564::AID-PATH737>3.0.CO;2-M. ISSN 0022-3417.
↑ Kumar, Uma (2017). "Acinic Cell Carcinoma Papillary-Cystic Variant: Diagnostic Pitfalls in Fine Needle Aspiration Cytology". JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. doi:10.7860/JCDR/2017/21347.9772. ISSN 2249-782X.
↑ Sams, Ralph N.; Gnepp, Douglas R. (2012). "P63 Expression Can Be Used in Differential Diagnosis of Salivary Gland Acinic Cell and Mucoepidermoid Carcinomas". Head and Neck Pathology. 7 (1): 64–68. doi:10.1007/s12105-012-0403-2. ISSN 1936-055X.
↑ Schwartz, Lauren E.; Begum, Shahnaz; Westra, William H.; Bishop, Justin A. (2013). "GATA3 Immunohistochemical Expression in Salivary Gland Neoplasms". Head and Neck Pathology. 7 (4): 311–315. doi:10.1007/s12105-013-0442-3. ISSN 1936-055X.
↑ Patel, Kalyani R.; Solomon, Isaac H.; El-Mofty, Samir K.; Lewis, James S.; Chernock, Rebecca D. (2013). "Mammaglobin and S-100 immunoreactivity in salivary gland carcinomas other than mammary analogue secretory carcinoma". Human Pathology. 44 (11): 2501–2508. doi:10.1016/j.humpath.2013.06.010. ISSN 0046-8177.
↑ Castle JT, Thompson LD, Frommelt RA, Wenig BM, Kessler HP (1999). "Polymorphous low grade adenocarcinoma: a clinicopathologic study of 164 cases". Cancer. 86 (2): 207–19. PMID 10421256.

Template:WH Template:WS

[pmid24376295-1] Chulam TC, Noronha Francisco AL, Goncalves Filho J, Pinto Alves CA, Kowalski LP (December 2013). "Warthin's tumour of the parotid gland: our experience". Acta Otorhinolaryngol Ital. 33 (6): 393–7. PMID 24376295.

[urlWarthin_tumor_|_Genetic_and_Rare_Diseases_Information_Center_(GARD)_–_an_NCATS_Program-2] "Warthin tumor | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program".

[pmid22190789-3] 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.

[pmid29845358-4] Kato H, Kawaguchi M, Ando T, Mizuta K, Aoki M, Matsuo M (August 2018). "Pleomorphic adenoma of salivary glands: common and uncommon CT and MR imaging features". Jpn J Radiol. 36 (8): 463–471. doi:10.1007/s11604-018-0747-y. PMID 29845358.

[pmid277220032-5] Chen B, Hentzelman JI, Walker RJ, Lai JP (2016). "Oncocytoma of the Submandibular Gland: Diagnosis and Treatment Based on Clinicopathology". Case Rep Otolaryngol. 2016: 8719030. doi:10.1155/2016/8719030. PMC 5045990. PMID 27722003.

[pmid10889498-6] Kim KH, Sung MW, Kim JW, Koo JW (July 2000). "Pleomorphic adenoma of the trachea". Otolaryngol Head Neck Surg. 123 (1 Pt 1): 147–8. doi:10.1067/mhn.2000.102809. PMID 10889498.

[pmid24431845-7] Pramod Krishna B (June 2013). "Pleomorphic Adenoma of Minor Salivary Gland in a 14 year Old Child". J Maxillofac Oral Surg. 12 (2): 228–31. doi:10.1007/s12663-010-0125-5. PMC 3681990. PMID 24431845.

[pmid30546932-8] Kessler AT, Bhatt AA (2018). "Review of the Major and Minor Salivary Glands, Part 2: Neoplasms and Tumor-like Lesions". J Clin Imaging Sci. 8: 48. doi:10.4103/jcis.JCIS_46_18. PMC 6251244. PMID 30546932.

[pmid21243374-9] Chenevert J, Barnes LE, Chiosea SI (February 2011). "Mucoepidermoid carcinoma: a five-decade journey". Virchows Arch. 458 (2): 133–40. doi:10.1007/s00428-011-1040-y. PMID 21243374.

[10] "Tumors of the Salivary Glands, Atlas of Tumor Pathology: Third Series, Fascicle 17 G. L. Ellis and P. L. Auclair. Armed Forces Institute of Pathology, Washington D.C. ISBN: 1 881041 26 3 (Printed). 1996. Price: $69.00. ISBN: 1 881041 41 7 (CD-ROM). 1998. Price: $65.00". The Journal of Pathology. 192 (4): 564–565. 2000. doi:10.1002/1096-9896(200012)192:4<564::AID-PATH737>3.0.CO;2-M. ISSN 0022-3417.

[Kumar2017-11] Kumar, Uma (2017). "Acinic Cell Carcinoma Papillary-Cystic Variant: Diagnostic Pitfalls in Fine Needle Aspiration Cytology". JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. doi:10.7860/JCDR/2017/21347.9772. ISSN 2249-782X.

[SamsGnepp2012-12] Sams, Ralph N.; Gnepp, Douglas R. (2012). "P63 Expression Can Be Used in Differential Diagnosis of Salivary Gland Acinic Cell and Mucoepidermoid Carcinomas". Head and Neck Pathology. 7 (1): 64–68. doi:10.1007/s12105-012-0403-2. ISSN 1936-055X.

[SchwartzBegum2013-13] Schwartz, Lauren E.; Begum, Shahnaz; Westra, William H.; Bishop, Justin A. (2013). "GATA3 Immunohistochemical Expression in Salivary Gland Neoplasms". Head and Neck Pathology. 7 (4): 311–315. doi:10.1007/s12105-013-0442-3. ISSN 1936-055X.

[PatelSolomon20132-14] Patel, Kalyani R.; Solomon, Isaac H.; El-Mofty, Samir K.; Lewis, James S.; Chernock, Rebecca D. (2013). "Mammaglobin and S-100 immunoreactivity in salivary gland carcinomas other than mammary analogue secretory carcinoma". Human Pathology. 44 (11): 2501–2508. doi:10.1016/j.humpath.2013.06.010. ISSN 0046-8177.

[pmid10421256-15] Castle JT, Thompson LD, Frommelt RA, Wenig BM, Kessler HP (1999). "Polymorphous low grade adenocarcinoma: a clinicopathologic study of 164 cases". Cancer. 86 (2): 207–19. PMID 10421256.

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@@ Line 10: / Line 10: @@
 {|
-! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
-! colspan="2" rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
+! colspan="2" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
-! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Benign/
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Benign/
 Malignant
 ! colspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Clinical manifestation
 ! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Paraclinical findings
-! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard diagnosis
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard diagnosis
-! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
 |-
-! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Demography
-! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
 !Symptoms
 ! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Signs
-! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab findings
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab findings
-! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
-! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
 |-
-! align="center" style="background:#DCDCDC;" |[[Pleomorphic adenoma]]<ref name="pmid22190789">{{cite journal |vauthors=Debnath SC, Adhyapok AK |title=Pleomorphic adenoma (benign mixed tumour) of the minor salivary glands of the upper lip |journal=J Maxillofac Oral Surg |volume=9 |issue=2 |pages=205–8 |date=June 2010 |pmid=22190789 |pmc=3244097 |doi=10.1007/s12663-010-0052-5 |url=}}</ref><ref name="pmid29845358">{{cite journal |vauthors=Kato H, Kawaguchi M, Ando T, Mizuta K, Aoki M, Matsuo M |title=Pleomorphic adenoma of salivary glands: common and uncommon CT and MR imaging features |journal=Jpn J Radiol |volume=36 |issue=8 |pages=463–471 |date=August 2018 |pmid=29845358 |doi=10.1007/s11604-018-0747-y |url=}}</ref>
+! align="center" style="background:#DCDCDC;" |[[Warthin's tumor]]<ref name="pmid24376295">{{cite journal |vauthors=Chulam TC, Noronha Francisco AL, Goncalves Filho J, Pinto Alves CA, Kowalski LP |title=Warthin's tumour of the parotid gland: our experience |journal=Acta Otorhinolaryngol Ital |volume=33 |issue=6 |pages=393–7 |date=December 2013 |pmid=24376295 |doi= |url=}}</ref><ref name="urlWarthin tumor | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program">{{cite web |url=https://rarediseases.info.nih.gov/diseases/8569/warthin-tumor |title=Warthin tumor &#124; Genetic and Rare Diseases Information Center (GARD) – an NCATS Program |format= |work= |accessdate=}}</ref>
 | align="left" style="background:#F5F5F5;" |
 * [[Benign]]
 | align="left" style="background:#F5F5F5;" |
-* More common in females
+*[[Male]] to female ratio: 4:1
-* [[Incidence]] increase with [[age]]
+* More common in people aged 60-70 years old
-* [[Incidence]]: 2-3.5 cases per 100,000 [[population]]
 | align="left" style="background:#F5F5F5;" |
-* History of [[swelling]]
+* History of [[Swelling|swollen]] [[salivary gland]]
-* [[Dysphagia]]
+* [[Jaw]] pain
-* [[Hoarseness]]
+* [[Tinnitus]]
 | align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | +
+| align="center" style="background:#F5F5F5;" |  +
 | align="left" style="background:#F5F5F5;" |
-* Palpable [[mass]] of deep [[lobe]] of [[parotid gland]]
+* Non tender
+* Mobile
 * Firm
-* Mobile
+*[[Solitary]]
 | align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | −
 | align="left" style="background:#F5F5F5;" |
-* Proliferation of [[epithelial cells]] and [[stromal]] [[matrix]] in the [[ducts]]
+*[[Papillae]]
-| align="left" style="background:#F5F5F5;" |
+*[[Fibrous]] [[capsule]]
-* [[MRI]]: Homogenous on T1
+*[[Cystic]] spaces
-* Abundant myxochondroid [[stroma]] on T2
+| align="left" style="background:#F5F5F5;" |
+*[[CT|Neck CT]]: [[Cystic]] lesion posteriorly within the [[parotid gland]]
+*[[MRI]]: B/L heterogeneous lesions
 | align="left" style="background:#F5F5F5;" |
 * [[Biopsy]]
 | align="center" style="background:#F5F5F5;" | −
 |-
-! align="center" style="background:#DCDCDC;" |[[Warthin's tumor]]<ref name="pmid24376295">{{cite journal |vauthors=Chulam TC, Noronha Francisco AL, Goncalves Filho J, Pinto Alves CA, Kowalski LP |title=Warthin's tumour of the parotid gland: our experience |journal=Acta Otorhinolaryngol Ital |volume=33 |issue=6 |pages=393–7 |date=December 2013 |pmid=24376295 |doi= |url=}}</ref><ref name="urlWarthin tumor | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program">{{cite web |url=https://rarediseases.info.nih.gov/diseases/8569/warthin-tumor |title=Warthin tumor &#124; Genetic and Rare Diseases Information Center (GARD) – an NCATS Program |format= |work= |accessdate=}}</ref>
+| colspan="6" |
+! align="center" style="background:#DCDCDC;" |[[Pleomorphic adenoma]]<ref name="pmid22190789">{{cite journal |vauthors=Debnath SC, Adhyapok AK |title=Pleomorphic adenoma (benign mixed tumour) of the minor salivary glands of the upper lip |journal=J Maxillofac Oral Surg |volume=9 |issue=2 |pages=205–8 |date=June 2010 |pmid=22190789 |pmc=3244097 |doi=10.1007/s12663-010-0052-5 |url=}}</ref><ref name="pmid29845358">{{cite journal |vauthors=Kato H, Kawaguchi M, Ando T, Mizuta K, Aoki M, Matsuo M |title=Pleomorphic adenoma of salivary glands: common and uncommon CT and MR imaging features |journal=Jpn J Radiol |volume=36 |issue=8 |pages=463–471 |date=August 2018 |pmid=29845358 |doi=10.1007/s11604-018-0747-y |url=}}</ref>
 | align="left" style="background:#F5F5F5;" |
-* [[Benign]]
+*[[Benign]]
 | align="left" style="background:#F5F5F5;" |
-* [[Male]] to female ratio: 4:1
+* More common in females
-* More common in people aged 60-70 years old
+*[[Incidence]] increase with [[age]]
+*[[Incidence]]: 2-3.5 cases per 100,000 [[population]]
+| colspan="5" |
 | align="left" style="background:#F5F5F5;" |
-* History of [[Swelling|swollen]] [[salivary gland]]
+* History of [[swelling]]
-* [[Jaw]] pain
+*[[Dysphagia]]
-* [[Tinnitus]]
+*[[Hoarseness]]
 | align="center" style="background:#F5F5F5;" | −
-| align="center" style="background:#F5F5F5;" | +
+| align="center" style="background:#F5F5F5;" |  +
 | align="left" style="background:#F5F5F5;" |
-* Non tender
+* Palpable [[mass]] of deep [[lobe]] of [[parotid gland]]
+* Firm
 * Mobile
-* Firm
-* [[Solitary]]
 | align="center" style="background:#F5F5F5;" | −
 | align="center" style="background:#F5F5F5;" | −
 | align="left" style="background:#F5F5F5;" |
-* [[Papillae]]
+* Proliferation of [[epithelial cells]] and [[stromal]] [[matrix]] in the [[ducts]]
-* [[Fibrous]] [[capsule]]
+| align="left" style="background:#F5F5F5;" |
-* [[Cystic]] spaces
+*[[MRI]]: Homogenous on T1
-| align="left" style="background:#F5F5F5;" |
+* Abundant myxochondroid [[stroma]] on T2
-*[[CT|Neck CT]]: [[Cystic]] lesion posteriorly within the [[parotid gland]]
-*[[MRI]]: B/L heterogeneous lesions
 | align="left" style="background:#F5F5F5;" |
-* [[Biopsy]]
+*[[Biopsy]]
 | align="center" style="background:#F5F5F5;" | −
 |-