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Naso JR, Roden AC. Recent developments in the pathology of primary pulmonary salivary gland-type tumours. Histopathology 2024; 84:102-123. [PMID: 37694812 DOI: 10.1111/his.15039] [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: 06/27/2023] [Revised: 08/08/2023] [Accepted: 08/17/2023] [Indexed: 09/12/2023]
Abstract
Primary pulmonary salivary gland-type tumours are rare neoplasms that are thought to arise from seromucinous glands that are located in the submucosa of large airways. These neoplasms have clinical and pathologic features that are distinct from other pulmonary neoplasms. The majority of primary pulmonary salivary gland-type tumours are malignant, with the most common entities being mucoepidermoid carcinoma, adenoid cystic carcinoma, and epithelial-myoepithelial carcinoma. Less commonly seen are myoepithelial carcinoma, hyalinizing clear cell carcinoma, acinic cell carcinoma, secretory carcinoma, salivary duct carcinoma, intraductal carcinoma, and polymorphous adenocarcinoma. Benign salivary gland-type tumours of the lung include pleomorphic adenoma and sialadenoma papilliferum. Morphologic, immunophenotypic, and molecular features of these neoplasms are largely similar to salivary gland tumours elsewhere, and therefore the exclusion of metastatic disease requires clinical and radiologic correlation. However, the differential diagnostic considerations are different in the lung. The distinction of salivary gland-type tumours from their histologic mimics is important for both prognostication and treatment decisions. Overall, salivary gland type-tumours tend to have a more favourable outcome than other pulmonary carcinomas, although high-grade variants exist for many of these tumour types. Recent advances in our understanding of the spectrum of salivary gland-type tumours reported in the lung and their diversity of molecular and immunohistochemical features have helped to refine the classification of these tumours and have highlighted a few differences between salivary gland-type tumours of the lung and those primary to other sites.
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Affiliation(s)
- Julia R Naso
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, MN, USA
| | - Anja C Roden
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, MN, USA
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2
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Patel S, Barros J, Nwizu NN, Ogbureke KUE. Metastatic renal cell carcinoma to the oral cavity as first sign of disease: A case report. Clin Case Rep 2020; 8:1517-1521. [PMID: 32884786 PMCID: PMC7455456 DOI: 10.1002/ccr3.2923] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 03/25/2020] [Accepted: 04/10/2020] [Indexed: 12/30/2022] Open
Abstract
Renal cell carcinoma metastasis to the oral cavity is rare. Significantly, the oral lesion in this case was the first indication of a malignant disease in the patient. This case underscores the importance of detailed history taking, interpretation of clinical finding, and high index of suspicion for metastatic disease to the oral cavity.
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Affiliation(s)
- Shalizeh Patel
- Department of Restorative Dentistry & ProsthodonticsSchool of Dentistry at HoustonUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Juliana Barros
- Department of Restorative Dentistry & ProsthodonticsSchool of Dentistry at HoustonUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Ngozi N. Nwizu
- Department of Diagnostic & Biomedical SciencesSchool of Dentistry at HoustonUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Kalu U. E. Ogbureke
- Department of Diagnostic & Biomedical SciencesSchool of Dentistry at HoustonUniversity of Texas Health Science Center at HoustonHoustonTXUSA
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3
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Abstract
An 80-year-old male presented with painless blurred vision from the right eye following endoscopic biopsy of a right maxillary sinus mass with the otolaryngology service. The patient admitted to progressive right-sided proptosis over the past few weeks. Past medical history was significant for acinic cell adenocarcinoma of buccal space origin with resection 3 years prior. Orbital CT revealed a large, poorly circumscribed destructive mass in the right masticator space with extension to the paranasal sinuses, inferior and medial orbit, and middle cranial fossa. Histopathology confirmed the mass to represent a recurrent acinic cell carcinoma. The patient was treated with chemotherapy, and at last follow-up 2 years after presentation had stable painless globe dystopia and visual acuity. The authors describe a very rare case of a recurrent minor salivary gland acinic cell carcinoma with secondary orbital extension.
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Said-Al-Naief N, Carlos R, Vance GH, Miller C, Edwards PC. Combined DOG1 and Mammaglobin Immunohistochemistry Is Comparable to ETV6-breakapart Analysis for Differentiating Between Papillary Cystic Variants of Acinic Cell Carcinoma and Mammary Analogue Secretory Carcinoma. Int J Surg Pathol 2017; 25:127-140. [PMID: 27670353 DOI: 10.1177/1066896916670005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
Abstract
BACKGROUND We investigated the reliability of combined DOG1 and mammaglobin immunohistochemistry compared with ETV6 fluorescence in situ hybridization (FISH) in the assessment of salivary tumors previously diagnosed as acinic cell carcinoma (ACC). Ultrastructural features of cases reclassified as mammary analogue secretory carcinoma (MASC) were assessed by transmission electron microscopy (TEM). METHODS Immunohistochemical (IHC) reactivity to DOG1 and mammaglobin was validated against FISH targeting the ETV6 gene in all 14 cases. RESULTS Three cases with papillary cystic histomorphology previously diagnosed as ACC were revised to MASC. TEM features of the ETV6 rearrangement-positive MASC cases showed large numbers of secretory granules with extrusion into the intercellular spaces, well-developed endoplasmic reticulum, lipid-laden vacuoles, well-formed microvilli, and large lining cystic spaces. CONCLUSIONS Combined DOG1 and mammaglobin immunohistochemistry is comparable to ETV6 -breakapart analysis for differentiating between papillary cystic variants of ACC and MASC.
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Affiliation(s)
| | - Roman Carlos
- 2 Centro Clínico de Cabeza y Cuello/Hospital Herrera Llerandi, Guatemala City, Guatemala
| | - Gail H Vance
- 3 Department of Medical and Molecular Genetics Indiana University School of Medicine Indianapolis, IN, USA
| | - Caroline Miller
- 4 Department of Anatomy and Cell Biology Indiana University School of Medicine Indianapolis, IN, USA
| | - Paul C Edwards
- 5 Department of Oral Pathology, Medicine and Radiology Indiana University School of DentistryIndianapolis, IN, USA
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5
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Hsieh MS, Jeng YM, Jhuang YL, Chou YH, Lin CY. Carbonic anhydrase VI: a novel marker for salivary serous acinar differentiation and its application to discriminate acinic cell carcinoma from mammary analogue secretory carcinoma of the salivary gland. Histopathology 2015. [DOI: 10.1111/his.12792] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Min-Shu Hsieh
- Department of Pathology; National Taiwan University Hospital and National Taiwan University College of Medicine; Taipei Taiwan
- Graduate Institute of Pathology; National Taiwan University College of Medicine; Taipei Taiwan
| | - Yung-Ming Jeng
- Department of Pathology; National Taiwan University Hospital and National Taiwan University College of Medicine; Taipei Taiwan
- Graduate Institute of Pathology; National Taiwan University College of Medicine; Taipei Taiwan
| | - Yu-Lin Jhuang
- Graduate Institute of Pathology; National Taiwan University College of Medicine; Taipei Taiwan
| | - Yueh-Hung Chou
- Department of Anatomical Pathology; Far Eastern Memorial Hospital; New Taipei City Taiwan
| | - Chiao-Ying Lin
- Department of Dentistry; Taipei Medical University; Taipei Taiwan
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6
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Atta IS, Al Qahtani FN. DOG1, alpha-amylase and p63 expression in acinic cell carcinoma of salivary gland; immunohistochemical, clinical and radiological study. Histol Histopathol 2015. [DOI: 10.7243/2055-091x-2-13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Zhu S, Schuerch C, Hunt J. Review and Updates of Immunohistochemistry in Selected Salivary Gland and Head and Neck Tumors. Arch Pathol Lab Med 2015; 139:55-66. [DOI: 10.5858/arpa.2014-0167-ra] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context
Immunohistochemistry is a useful tool for diagnosing salivary gland and head and neck tumors.
Objective
To review immunohistochemical markers, which can aid in the diagnosis of selected salivary gland and head and neck tumors.
Data Sources
Literature review and authors' personal practice experience.
Conclusions
Salivary gland and head and neck tumors include a large diverse group of tumors with complex and overlapping histologic features. Immunohistochemistry plays an important role in resolving the differential diagnosis of some salivary gland and head and neck tumors and can provide information for the prognosis of certain tumors.
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Affiliation(s)
- Shaobo Zhu
- From the Department of Laboratory Medicine, Geisinger Medical Center, Danville, Pennsylvania (Drs Zhu and Schuerch)
| | - Conrad Schuerch
- From the Department of Laboratory Medicine, Geisinger Medical Center, Danville, Pennsylvania (Drs Zhu and Schuerch)
| | - Jennifer Hunt
- and the Department of Pathology, University of Arkansas for Medical Sciences, Little Rock (Dr Hunt)
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Nagao T, Sato E, Inoue R, Oshiro H, H. Takahashi R, Nagai T, Yoshida M, Suzuki F, Obikane H, Yamashina M, Matsubayashi J. Immunohistochemical analysis of salivary gland tumors: application for surgical pathology practice. Acta Histochem Cytochem 2012; 45:269-82. [PMID: 23209336 PMCID: PMC3496863 DOI: 10.1267/ahc.12019] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 07/04/2012] [Indexed: 01/05/2023] Open
Abstract
Salivary gland tumors are relatively uncommon and there exists a considerable diagnostic difficulty owing to their diverse histological features in individual lesions and the presence of a number of types and variants, in addition to overlapping histological patterns similar to those observed in different tumor entities. The classification is complex, but is closely relevant to the prognostic and therapeutic aspects. Although hematoxylin-eosin staining is still the gold standard method used for the diagnosis, immunohistochemistry (IHC) can enhance the accuracy and be a helpful tool when in cases to investigate the subjects that cannot be assessed by histological examination, such as the cell nature and differentiation status, cell proliferation, and tumor protein expression. This review depicts on the practical diagnostic utility of IHC in salivary gland tumor pathology under the following issues: assessment of cell differentiation, focusing on neoplastic myoepithelial cells; discrimination of histologically mimic tumor groups; diagnosis of specific tumor types, e.g., pleomorphic adenoma, adenoid cystic carcinoma, and salivary duct carcinoma; and evaluation of malignancy and prognostic factors. IHC plays a limited, even though important, role in the diagnosis of salivary gland tumors, but is often useful to support the histological assessment. However, unfortunately few tumor type-specific markers are still currently available. For these reasons, IHC should be considered a method that can be used to assist the final diagnosis, and its results themselves do not directly indicate a definitive diagnosis.
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Affiliation(s)
- Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Eiichi Sato
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Rie Inoue
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Hisashi Oshiro
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Reisuke H. Takahashi
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Takeshi Nagai
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Maki Yoshida
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Fumie Suzuki
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Hiyo Obikane
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Mitsumasa Yamashina
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
| | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Anatomic Pathology, Tokyo Medical University
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Chênevert J, Duvvuri U, Chiosea S, Dacic S, Cieply K, Kim J, Shiwarski D, Seethala RR. DOG1: a novel marker of salivary acinar and intercalated duct differentiation. Mod Pathol 2012; 25:919-29. [PMID: 22460810 DOI: 10.1038/modpathol.2012.57] [Citation(s) in RCA: 161] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Anoctamin-1 (ANO1) (DOG1, TMEM16a) is a calcium-activated chloride channel initially described in gastrointestinal stromal tumors, but now known to be expressed in a variety of normal and tumor tissues including salivary tissue in murine models. We herein perform a comprehensive survey of DOG1 expression in 156 cases containing non-neoplastic human salivary tissues and tumors. ANO1 mRNA levels were significantly higher (8-fold increase, P<0.0001) in normal parotid tissue (n=6) as compared with squamous mucosa (n=15). By immunohistochemistry, DOG1 showed a diffuse moderate (2+) apical membranous staining pattern in normal serous acini, 1+ apical membranous pattern in mucous acini, and variable 1-2+ apical staining of distal intercalated ducts. Myoepithelial cells, striated and excretory ducts were invariably negative. All acinic cell carcinomas (n=28) were DOG1 positive demonstrating a complex mixture of intense (3+) apical membranous, cytoplasmic and complete membranous staining. Most ductal tumor types were negative or only showed a subset of positive cases. Within the biphasic tumor category, adenoid cystic carcinomas (18/24 cases) and epithelial-myoepithelial carcinomas (8/15 cases) were frequently positive, often showing a distinctive combined apical ductal and membranous/cytoplasmic myoepithelial staining profile. Thus, DOG1 staining is a marker of salivary acinar and to a lesser extent intercalated duct differentiation. Strong staining can be used to support the diagnosis of acinic cell carcinoma. DOG1 may also be a marker of a 'transformed' myoepithelial phenotype in a subset of biphasic salivary gland malignancies.
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Affiliation(s)
- Jacinthe Chênevert
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Löning T, Jäkel KT. [Salivary gland tumors--tumor typing and grading]. DER PATHOLOGE 2004; 25:38-45. [PMID: 14767611 DOI: 10.1007/s00292-003-0671-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In addition to staging, histological typing and grading provide important information for prognosis and adequate treatment of salivary gland cancers. Current classification and grading systems for mucoepidermoid carcinoma, adenoid cystic carcinoma, and malignant mixed tumor (carcinoma ex pleomorphic adenoma) are discussed.
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Affiliation(s)
- T Löning
- Institut für Oralpathologie, Zentrum klinisch-theoretische Medizin I, Universitätsklinikum Eppendorf, Hamburg.
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Ihrler S, Blasenbreu-Vogt S, Sendelhofert A, Lang S, Zietz C, Löhrs U. Differential diagnosis of salivary acinic cell carcinoma and adenocarcinoma (NOS). A comparison of (immuno-)histochemical markers. Pathol Res Pract 2003; 198:777-83. [PMID: 12608654 DOI: 10.1078/0344-0338-00336] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A correct histologic differential diagnosis between salivary acinic cell carcinoma (ACC) and adenocarcinoma not otherwise specified (AC-NOS) is highly relevant because of the strikingly different biologic behavior and related therapeutical strategies. The distinction between both tumor types can be difficult because of an enormous variation in histologic appearance, with either type showing partially overlapping morphologic features. Owing to a lack of approved markers, the expression of PAS-staining, alpha-Amylase, alpha-1 Anti-trypsin, cytokeratin (CK)-subtypes 7/18 and Ki-67 was evaluated in 16 cases of ACC and 16 cases of AC-NOS. CK 7 is identified as the most reliable marker with strong positivity in AC-NOS, and complete or preponderant negativity in ACC. The characteristic membranous staining pattern of CK 18 in ACC, in contrast to a diffuse cytoplasmic pattern in AC-NOS, proved to be an additional valuable criterion. PAS and alpha-Amylase are only of little value when ACC is diagnosed, as many cases are only faintly positive or completely negative. The proliferation index (Ki-67) proved to be significantly higher in AC-NOS; however, the diagnostic usefulness is limited by a relevant overlap. In conclusion, we recommend CK 7 and 18 as the most valuable markers in cases with difficult differential diagnosis between ACC and AC-NOS.
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Affiliation(s)
- Stephan Ihrler
- Institute of Pathology, Ludwig-Maximilians-University, Munich, Germany.
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Hirokawa M, Sugihara K, Sai T, Monobe Y, Kudo H, Sano N, Sano T. Secretory carcinoma of the breast: a tumour analogous to salivary gland acinic cell carcinoma? Histopathology 2002; 40:223-9. [PMID: 11895487 DOI: 10.1046/j.1365-2559.2002.01346.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS Acinic cell-like breast carcinoma is a newly recognized entity, and few acinic cell-like breast carcinoma cases have been reported. All reported acinic cell-like breast carcinomas were counterparts of the solid type of acinic cell carcinoma of the salivary gland. We report here three cases of secretory breast carcinoma with acinic cell differentiation, and discuss the similarity between secretory breast carcinoma and acinic cell carcinoma of the salivary gland. METHODS AND RESULTS The cases were histologically identical to acinic cell carcinoma of the salivary gland: papillary-cystic type in case 1, a mixture of papillary-cystic, microcystic and follicular type in case 2, and microfollicular type in case 3. Immunohistochemically, the tumour cells were positive for salivary-type amylase, lysozyme, S100 protein and alpha 1-antitrypsin, and negative or less reactive for gross cystic disease fluid protein-15 and oestrogen receptor. All three cases did not reveal metastasis or recurrence. CONCLUSIONS These cases were typical of secretory breast carcinoma, and were clinically, histologically and immunohistochemically analogous to acinic cell carcinoma of the salivary gland. We emphasize that secretory breast carcinoma and acinic cell carcinoma of the salivary gland may be identical lesions.
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Affiliation(s)
- M Hirokawa
- Department of Pathology, University of Tokushima School of Medicine, Tokushima, Japan.
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Kobayashi I, Kiyoshima T, Ozeki S, Shima K, Shigemura N, Matsuo K, Sakai H. Immunohistochemical and ultrastructural study of a papillary cystadenocarcinoma arising from the sublingual gland. J Oral Pathol Med 1999; 28:282-6. [PMID: 10426203 DOI: 10.1111/j.1600-0714.1999.tb02040.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Immunohistochemical and ultrastructural findings in a rare case of papillary cystadenocarcinoma arising from the left sublingual gland of a 55-year-old Japanese man are reported. Histologically, the tumor tissue was found to be composed of various-sized cystic cavities in which papillary epithelial projections with thin fibrovascular cores were observed. The papillary projections consisted of a single layer to several layers of high columnar epithelial cells. Invasion to the surrounding fibrous tissue and into the lymphatics was observed, thus suggesting an aggressive potential in the present case. The possibility of the involvement of myoepithelial cells could be excluded based on the immunohistochemical and ultrastructural findings. The immunohistochemical and ultrastructural findings also suggested that this type of salivary gland tumor, at least the present case, may arise from striated or excretory ducts. There was positive immunostaining for tumor markers CA19-9 and CA125. However, the biological role of these carbohydrate antigens in salivary gland tumors is unclear at present. Further investigations are, therefore, called for to solve this issue.
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Affiliation(s)
- I Kobayashi
- Department of Oral Pathology, Faculty of Dentistry, Kyushu University, Fukuoka, Japan
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