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Balgobind S, Cheung VKY, Luk P, Low THH, Wykes J, Wu R, Lee J, Ch'ng S, Palme CE, Clark JR, Gupta R. Prognostic and predictive biomarkers in head and neck cancer: something old, something new, something borrowed, something blue and a sixpence in your shoe. Pathology 2024; 56:170-185. [PMID: 38218691 DOI: 10.1016/j.pathol.2023.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 01/15/2024]
Abstract
A biomarker is a measurable indicator of biological or pathological processes or the response to an exposure or intervention and is used to guide management decisions. In head and neck pathology, biomarkers are assessed by histological criteria and immunohistochemical and molecular studies. Surgical resection remains the mainstay of management of many head and neck malignancies. Adjuvant radiotherapy and/or systemic therapy may be administered depending on the presence of adverse prognostic factors identified on histopathological or immunohistochemical examination. In this review, we outline the clinically relevant prognostic and predictive factors in head and neck malignancies including conventionally recognised factors such as tumour size, depth of invasion, lymphovascular and perineural invasion and margin status as well as novel evolving factors such as recurrent genetic rearrangements and assessment of immune checkpoints. Practical issues are discussed to assist with recognising and reporting of these factors. A summary of useful tools such as structured pathology report formats is also included to assist with comprehensive reporting of all clinically relevant parameters, minimise risk and improve workflow efficiencies.
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Affiliation(s)
- Sapna Balgobind
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, NSW, Australia.
| | - Veronica K Y Cheung
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, NSW, Australia
| | - Peter Luk
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, NSW, Australia; Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Tsu-Hui Hubert Low
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia; Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Sydney Facial Nerve Service, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - James Wykes
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Raymond Wu
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia; Department of Radiation Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Jenny Lee
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia; Melanoma Institute Australia, University of Sydney, Sydney, NSW, Australia; Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Sydney Ch'ng
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia; Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Carsten E Palme
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia; Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Jonathan R Clark
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia; Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Sydney Facial Nerve Service, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Ruta Gupta
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, NSW, Australia; Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia
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Ly A, Balassanian R, Alperstein S, Donnelly A, McGrath C, Sohani AR, Stelow EB, Thrall MJ, Zhang ML, Pitman MB. One procedure-one report: the Re-Imagine Cytopathology Task Force position paper on small tissue biopsy triage in anatomic pathology. J Am Soc Cytopathol 2023; 12:395-406. [PMID: 37270328 DOI: 10.1016/j.jasc.2023.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Endoscopic biopsy procedures increasingly generate multiple tissue samples from multiple sites, and frequently retrieve concurrent cytologic specimens and small core needle biopsies. There is currently lack of consensus in subspecialized practices as to whether cytopathologists or surgical pathologists should review such samples, and whether the pathology findings should be reported together or separately. MATERIALS AND METHODS In December 2021, the American Society of Cytopathology convened the Re-Imagine Cytopathology Task Force to examine various workflows that would facilitate unified pathology reporting of concurrently obtained biopsies and improve clinical care. RESULTS AND CONCLUSIONS This position paper summarizes the key points and highlights the advantages, challenges, and resources available to support the implementation of such workflows that result in "one procedure-one report".
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Affiliation(s)
- Amy Ly
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts.
| | - Ronald Balassanian
- Department of Pathology, University of California San Francisco, San Francisco, California
| | - Susan Alperstein
- Department of Pathology, Weill Cornell Medical College, New York, New York
| | - Amber Donnelly
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, Nebraska
| | - Cindy McGrath
- Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Aliyah R Sohani
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
| | - Edward B Stelow
- Department of Pathology, University of Virginia, Charlottesville, Virginia
| | - Michael J Thrall
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - M Lisa Zhang
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
| | - Martha B Pitman
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
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Fuoco J, Dong M, MacMillan C, Kak I, Perez-Ordonez B, Bradley G, Xu W, Magalhaes M. A 10-Year Review of Intraoral Salivary Gland Tumor Diagnoses: Diagnostic Challenges and Inter-Observer Agreement. Head Neck Pathol 2023; 17:193-203. [PMID: 36171535 PMCID: PMC10063724 DOI: 10.1007/s12105-022-01487-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Salivary gland tumors (SGT) are a diverse group of neoplasms arising from the major and minor glands. The oral cavity is the most common site for minor SGT (IMSGT), and these lesions frequently pose a challenge to the pathologist due to overlapping histopathological features and limited material for analysis. Our objective was to determine specific clinical and histopathological features associated with challenges in IMSGT diagnoses and pathologists' agreement. METHODS We conducted a retrospective analysis of 248 IMSGT received between 2010 and 2019. We evaluated the diagnostic challenge of the cases by stratifying according to whether a definitive, favored, or indeterminate (challenging) diagnosis was provided. Inter-observer agreement and concordance of biopsy diagnoses with the final diagnoses after tumor resection were evaluated. RESULTS Of the 248 biopsies, 191 had a definitive diagnosis, 38 favored diagnoses, and 19 were indeterminate. The predominant diagnoses considered for the indeterminate category were pleomorphic adenoma/myoepithelioma (PA), polymorphous adenocarcinoma (PAC), adenoid cystic carcinoma (AdCC), and low-grade adenocarcinoma. Using multivariate analysis of clinical features, younger patient age, smaller tumor size, and larger biopsy size increased the likelihood of a definitive diagnosis (p = 0.014, p = 0.037, p = 0.012). The inter-observer agreement for 68 representative cases was moderate overall (Fleiss's Kappa 0.575) and good for the 40 cases with a definitive diagnosis (Fleiss's Kappa 0.66). Sixty-five biopsy diagnoses were matched with corresponding tumor resection diagnoses and found to show a good concordance (Cramer's V test 0.76). The discordant diagnoses predominantly involved PA, carcinoma exPA, PAC, AdCC, and adenocarcinoma NOS. CONCLUSION Diagnostic challenges in IMSGT incisional biopsies were infrequent, especially if multiple pathologists were consulted. PA, PAC, AdCC, and adenocarcinoma NOS were the histologic types more commonly posing diagnostic challenges. Younger patient age, smaller tumor size, and larger biopsy are associated with a definitive diagnosis. This data highlights the importance of appropriate sampling in IMSGT.
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Affiliation(s)
- Jessie Fuoco
- Oral & Maxillofacial Pathology & Oral Medicine, University of Toronto, 457-124 Edward Street, M5G 1G6, Toronto, ON, Canada
| | - Mei Dong
- Department of Biostatistics, University Health Network, Princess Margaret Hospital, Toronto, ON, Canada
| | - Christina MacMillan
- Department of Laboratory Medicine & Pathobiology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Ipshita Kak
- Department of Laboratory Medicine & Pathobiology, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Bayardo Perez-Ordonez
- Department of Laboratory Medicine & Pathobiology, University Health Network, Toronto, ON, Canada
| | - Grace Bradley
- Oral & Maxillofacial Pathology & Oral Medicine, University of Toronto, 457-124 Edward Street, M5G 1G6, Toronto, ON, Canada
- Department of Dental and Maxillofacial Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Wei Xu
- Department of Biostatistics, University Health Network, Princess Margaret Hospital, Toronto, ON, Canada
| | - Marco Magalhaes
- Oral & Maxillofacial Pathology & Oral Medicine, University of Toronto, 457-124 Edward Street, M5G 1G6, Toronto, ON, Canada.
- Department of Dental and Maxillofacial Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
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Colombo E, Van Lierde C, Zlate A, Jensen A, Gatta G, Didonè F, Licitra LF, Grégoire V, Vander Poorten V, Locati LD. Salivary gland cancers in elderly patients: challenges and therapeutic strategies. Front Oncol 2022; 12:1032471. [PMID: 36505842 PMCID: PMC9733538 DOI: 10.3389/fonc.2022.1032471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/31/2022] [Indexed: 11/26/2022] Open
Abstract
Salivary gland carcinomas (SGCs) are the most heterogeneous subgroup of head and neck malignant tumors, accounting for more than 20 subtypes. The median age of SGC diagnosis is expected to rise in the following decades, leading to crucial clinical challenges in geriatric oncology. Elderly patients, in comparison with patients aged below 65 years, are generally considered less amenable to receiving state-of-the-art curative treatments for localized disease, such as surgery and radiation/particle therapy. In the advanced setting, chemotherapy regimens are often dampened by the consideration of cardiovascular and renal comorbidities. Nevertheless, the elderly population encompasses a broad spectrum of functionalities. In the last decades, some screening tools (e.g. the G8 questionnaire) have been developed to identify those subjects who should receive a multidimensional geriatric assessment, to answer the question about the feasibility of complex treatments. In the present article, we discuss the most frequent SGC histologies diagnosed in the elderly population and the relative 5-years survival outcomes based on the most recent data from the Surveillance, Epidemiology, and End Results (SEER) Program. Moreover, we review the therapeutic strategies currently available for locoregionally advanced and metastatic disease, taking into account the recent advances in precision oncology. The synergy between the Multidisciplinary Tumor Board and the Geriatrician aims to shape the most appropriate treatment pathway for each elderly patient, focusing on global functionality instead of the sole chronological age.
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Affiliation(s)
- Elena Colombo
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Charlotte Van Lierde
- Otorhinolaryngology-Head and Neck Surgery, Leuven Cancer Institute, University Hospitals Leuven and Department of Oncology, section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Alexandra Zlate
- Department of Radiation Oncology, Centre Leon Berard, Lyon, France
| | - Alexandra Jensen
- Department of Radiation Oncology, University Hospitals Giessen and Marburg (UKGM), Marburg, Germany
| | - Gemma Gatta
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fabio Didonè
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lisa F. Licitra
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Hematology, University of Milan, Milan, Italy
| | - Vincent Grégoire
- Department of Radiation Oncology, Centre Leon Berard, Lyon, France
| | - Vander Vander Poorten
- Otorhinolaryngology-Head and Neck Surgery, Leuven Cancer Institute, University Hospitals Leuven and Department of Oncology, section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Laura D. Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Felicelli C, Reznicek J, Chornenkyy Y, Jager L, Johnson D. Validation of the Milan system for reporting salivary gland cytopathology: a single institution's 10-year experience. J Am Soc Cytopathol 2022; 11:264-273. [PMID: 35660360 DOI: 10.1016/j.jasc.2022.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/20/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Fine needle aspiration cytology is often used for the initial diagnosis and management of patients with salivary gland tumors. Because of its global usage, a consensus classification schema was devised in 2018 to initiate universal reporting of salivary gland cytology specimens, termed the Milan system for reporting salivary gland cytopathology (MSRSGC) and composed of distinct diagnostic categories. Few retrospective studies have been undertaken to review the MSRSGC within institutions. MATERIALS AND METHODS We analyzed salivary gland fine needle aspirations during a 10-year span from 2011 to 2021, categorized each cytology case to fit the MSRSGC, and subsequently reviewed the corresponding surgical resections, if indicated, to determine the rate of malignancy (ROM) and rate of neoplasia. RESULTS Our ROM was higher (>10%) for the following MSRSGC categories: non-neoplastic, atypia of undetermined significance, and suspicious for malignancy. Also, our data correlated well with the following MSRSGC categories: nondiagnostic, neoplasm-benign, salivary gland neoplasm of uncertain malignant, and malignant. CONCLUSIONS Although the data were indicative of the ROM for surgically resected salivary gland lesions, the ROM for non-neoplastic lesions could truly be lower given that most lesions in this category will not undergo surgical resection. Additionally, determination of the rate of neoplasia could a tool that could be used to further guide our clinical colleagues.
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Affiliation(s)
- Christopher Felicelli
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| | - Joseph Reznicek
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Yevgen Chornenkyy
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lucy Jager
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Daniel Johnson
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Skalova A, Leivo I, Hellquist H, Simpson RHW, Vander Poorten V, Willems SM, Mosaieby E, Slouka D, Ferlito A. Clear Cell Neoplasms of Salivary Glands: A Diagnostic Challenge. Adv Anat Pathol 2022; 29:217-226. [PMID: 35249992 DOI: 10.1097/pap.0000000000000339] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This review focuses on the heterogenous group of clear cell neoplasms of salivary glands and attempts to identify major differential diagnostic features. Within the head and neck region, clear cells are found most commonly in salivary gland tumors, but may also be seen in tumors of squamous or odontogenic epithelial origin, primary or metastatic carcinomas, benign or malignant melanocytic lesions, or benign or malignant mesenchymal tumors. Clear cells occur fairly commonly among a wide variety of salivary gland neoplasms, but mostly they constitute only a minor component of the tumor cell population. Clear cells represent a major diagnostic feature in two salivary gland neoplasms, epithelial-myoepithelial carcinoma and hyalinizing clear cell carcinoma. In addition, salivary gland neoplasms composed predominantly of clear cells could also include clear cell variants of other salivary neoplasms, such as mucoepidermoid carcinoma and myoepithelial carcinoma, but their tumor type-specific histologic features may only be available in limited nonclear cell areas of the tumor. Diagnosing predominantly clear cell salivary gland tumors is difficult because the immunoprofiles and morphologic features may overlap and the same tumor entity may also have a wide range of other histologic presentations. Many salivary gland tumors are characterized by tumor type-specific genomic alterations, particularly gene fusions of the ETV6 gene in secretory carcinoma, the MYB and MYBL1 genes in adenoid cystic carcinoma, the MAML2 gene in mucoepidermoid carcinoma, the EWSR1 gene in hyalinizing clear cell carcinoma, and others. Thus, along with conventional histopathologic examination and immunoprofiling, molecular and genetic tests may be important in the diagnosis of salivary gland clear cell tumors by demonstrating genetic alterations specific to them.
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Affiliation(s)
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku and Department of Pathology, Turku University Hospital, Turku, Finland
| | - Henrik Hellquist
- Epigenetics and Human Disease Laboratory, Department of Biomedical Sciences and Medicine, Algarve Biomedical Center (ABC), University of Algarve, Faro, Portugal
| | - Roderick H W Simpson
- Department of Anatomical Pathology, University of Calgary, Calgary, Alberta, Canada
| | - Vincent Vander Poorten
- Department of Oncology, Section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Stefan M Willems
- Department of Pathology and Medical Biology, University of Groningen, Groningen, The Netherlands
| | - Elaheh Mosaieby
- Departments of Pathology
- Molecular and Genetic Laboratory, Bioptic Laboratory Ltd, Plzen, Czech Republic
| | - David Slouka
- Otorhinolaryngology, Faculty of Medicine in Plzen, Charles University
| | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
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Alena S, Hyrcza MD, Vaneček T, Baněčková M, Leivo I. Fusion-Positive Salivary Gland Carcinomas. Genes Chromosomes Cancer 2021; 61:228-243. [PMID: 34913211 DOI: 10.1002/gcc.23020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/05/2021] [Accepted: 12/06/2021] [Indexed: 11/07/2022] Open
Abstract
Salivary gland tumors are a rare, heterogeneous group of neoplasms that pose significant diagnostic challenges for the histopathologist. Histopathological diagnosis relies primarily on morphological assessment, with ancillary special stains and immunohistochemistry. In recent years, new defining genomic alterations have been characterized in these tumors. In particular, they include gene fusions which have shown to be tightly tumor-type specific, and thus valuable for use in diagnostically challenging cases. These discoveries also help in refining tumor classification. Furthermore, such genetic alterations may have prognostic as well as potentially therapeutic implications in the era of personalized medicine. This review aims at providing a summary of the most recent updates in this field.
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Affiliation(s)
- Skálová Alena
- Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, Czech Republic.,Bioptic Laboratory, Ltd, Plzen, Czech Republic
| | - Martin D Hyrcza
- Department of Pathology and Laboratory Medicine, University of Calgary, Arnie Charboneau Cancer Institute, Calgary, Canada
| | - Tomáš Vaneček
- Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, Czech Republic.,Molecular and Genetic Laboratory, Bioptic Laboratory, Ltd, Plzen, Czech Republic
| | - Martina Baněčková
- Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, Czech Republic.,Bioptic Laboratory, Ltd, Plzen, Czech Republic
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku, Turku University Hospital, Turku, Finland
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Gotoh S, Nakasone T, Matayoshi A, Makishi S, Hirano F, Ntege EH, Shimizu Y, Nakamura H. Mucoepidermoid carcinoma of the anterior lingual salivary gland: A rare case report. Mol Clin Oncol 2021; 16:7. [PMID: 34881027 PMCID: PMC8647187 DOI: 10.3892/mco.2021.2444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/26/2021] [Indexed: 11/25/2022] Open
Abstract
Mucoepidermoid carcinomas (MECs) are rare head and neck malignant tumours that were originally considered to be benign. It has been estimated that ~20% of MECs in the major salivary glands, such as the parotid gland, and 50% in the several minor salivary glands found in the oral cavity, are malignant. The diagnosis of MECs is mainly based on ancillary and immunohistochemistry testing. However, owing to the difficulty in harvesting adequate material for histological examination, the histopathological diagnosis of intraoral MECs may be particularly challenging. We herein report a rare case of an 82-year-old patient who presented to the Department of Oral and Maxillofacial Surgery of Ryukyu University Hospital with complaints of a progressive swelling and pain in the ventral surface of the apex of the tongue. The patient had previously undergone needle biopsy and the histopathological analysis of the tumour suggested a diagnosis of irritation fibroma. To ensure a more accurate histopathological assessment, an incisional biopsy was performed, in addition to the haematological and radiological assessments. Examination of the obtained surgical specimen confirmed low-grade MEC of the anterior lingual gland. The tumour was surgically excised, the patient healed uneventfully and no recurrence was detected on the regular 3-year follow-up. Although MECs are relatively more common in the minor salivary glands of the oral cavity, they are a rare occurrence in the anterior lingual gland. Therefore, adequate histological material should be surgically harvested to perform a complete evaluation of the morphology and cytology of the tumour and ensure the accuracy of diagnosis.
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Affiliation(s)
- Shimpei Gotoh
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
| | - Toshiyuki Nakasone
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
| | - Akira Matayoshi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
| | - Shoko Makishi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
| | - Fusahiro Hirano
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
| | - Edward H Ntege
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan.,Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
| | - Yusuke Shimizu
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
| | - Hiroyuki Nakamura
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Ryukyu University, Nishihara, Okinawa 903-0215, Japan
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Serinelli S, Mirchia K, Gitto L, Khurana KK, Zaccarini DJ. PAX-8 Expression in Salivary Duct Carcinoma. Appl Immunohistochem Mol Morphol 2021; 29:680-684. [PMID: 34081633 DOI: 10.1097/pai.0000000000000951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/04/2021] [Indexed: 11/26/2022]
Abstract
Salivary duct carcinoma (SDC) is a high-grade adenocarcinoma resembling breast ductal carcinoma. It accounts for ~10% of malignant tumors of the salivary glands. Most cases show expression of CK7 and androgen receptor. PAX-8 is a transcription factor, with expression reported in renal, Müllerian, and thyroid carcinomas. Previous studies have described an absence of PAX-8 immunostaining in most primary salivary gland neoplasms, including SDCs. However, PAX-8 expression is frequently found in neoplasms that can metastasize to salivary glands, suggesting the possibility that this protein can be used to differentiate SDC from secondary neoplastic involvement of the salivary gland. We evaluated the expression of PAX-8 in 14 cases of SDC from our institution. One case showed diffuse moderate to strong PAX-8 positivity, while 2 tumors showed focal weak staining. Therefore, we conclude that although the majority of SDC are negative for PAX-8, rare diffuse positivity can be seen in these primary salivary gland tumors. This could potentially pose difficulty in ruling out metastatic disease from another PAX-8-positive primary neoplasm.
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Iyer J, Hariharan A, Cao UMN, Mai CTT, Wang A, Khayambashi P, Nguyen BH, Safi L, Tran SD. An Overview on the Histogenesis and Morphogenesis of Salivary Gland Neoplasms and Evolving Diagnostic Approaches. Cancers (Basel) 2021; 13:cancers13153910. [PMID: 34359811 PMCID: PMC8345412 DOI: 10.3390/cancers13153910] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/21/2021] [Accepted: 07/29/2021] [Indexed: 01/08/2023] Open
Abstract
Simple Summary Diagnosing salivary gland neoplasms (SGN) remain a challenge, given their underlying biological nature and overlapping features. Evolving techniques in molecular pathology have uncovered genetic mutations resulting in these tumors. This review delves into the molecular etiopatho-genesis of SGN, highlighting advanced diagnostic protocols that may facilitate the identification and therapy of a variety of SGN. Abstract Salivary gland neoplasms (SGN) remain a diagnostic dilemma due to their heterogenic complex behavior. Their diverse histomorphological appearance is attributed to the underlying cellular mechanisms and differentiation into various histopathological subtypes with overlapping fea-tures. Diagnostic tools such as fine needle aspiration biopsy, computerized tomography, magnetic resonance imaging, and positron emission tomography help evaluate the structure and assess the staging of SGN. Advances in molecular pathology have uncovered genetic patterns and oncogenes by immunohistochemistry, fluorescent in situ hybridization, and next–generation sequencing, that may potentially contribute to innovating diagnostic approaches in identifying various SGN. Surgical resection is the principal treatment for most SGN. Other modalities such as radiotherapy, chemotherapy, targeted therapy (agents like tyrosine kinase inhibitors, monoclonal antibodies, and proteasome inhibitors), and potential hormone therapy may be applied, depending on the clinical behaviors, histopathologic grading, tumor stage and location, and the extent of tissue invasion. This review delves into the molecular pathways of salivary gland tumorigenesis, highlighting recent diagnostic protocols that may facilitate the identification and management of SGN.
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Affiliation(s)
- Janaki Iyer
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (J.I.); (A.H.); (U.M.N.C.); (C.T.T.M.); (A.W.); (P.K.); (L.S.)
| | - Arvind Hariharan
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (J.I.); (A.H.); (U.M.N.C.); (C.T.T.M.); (A.W.); (P.K.); (L.S.)
| | - Uyen Minh Nha Cao
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (J.I.); (A.H.); (U.M.N.C.); (C.T.T.M.); (A.W.); (P.K.); (L.S.)
- Department of Orthodontics, Faculty of Dentistry, Ho Chi Minh University of Medicine and Pharmacy, Ho Chi Minh City 700000, Vietnam
| | - Crystal To Tam Mai
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (J.I.); (A.H.); (U.M.N.C.); (C.T.T.M.); (A.W.); (P.K.); (L.S.)
| | - Athena Wang
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (J.I.); (A.H.); (U.M.N.C.); (C.T.T.M.); (A.W.); (P.K.); (L.S.)
| | - Parisa Khayambashi
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (J.I.); (A.H.); (U.M.N.C.); (C.T.T.M.); (A.W.); (P.K.); (L.S.)
| | | | - Lydia Safi
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (J.I.); (A.H.); (U.M.N.C.); (C.T.T.M.); (A.W.); (P.K.); (L.S.)
| | - Simon D. Tran
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (J.I.); (A.H.); (U.M.N.C.); (C.T.T.M.); (A.W.); (P.K.); (L.S.)
- Correspondence:
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Salivary gland tumours: diagnostic challenges and an update on the latest WHO classification. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.mpdhp.2020.01.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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