Application of immunohistochemistry to the diagnosis of salivary gland tumors

Differential Diagnosis between Oral Metastasis of Renal Cell Carcinoma and Salivary Gland Cancer

Renal cell carcinoma, which has clear cells in 70% of cases, has a high frequency of hematogenous distant metastases to lung, bone, liver, and other areas. Metastatic cancer accounts for 1 to 3% of malignant tumors in the stomatognathic region, and the metastasis of renal cell carcinoma to the oral mucosal tissue, though extremely rare, does occur. In addition, clear cells have been observed in some salivary gland cancers in the oral cavity. Therefore, the differential diagnosis of metastatic renal cell carcinoma and salivary gland cancer is important. This review discusses the differential diagnosis between metastatic renal cell carcinoma and malignant tumors of the salivary gland.

Stromal and epithelial syndecan-1 expression in benign and malignant salivary gland tumors: which is more reflective of behavior?

INTRODUCTION

Salivary gland tumors are a diverse group of lesions, with various origins and extremely different behaviors, leading to a variety of outcomes for patients. Therefore, the need to discover novel markers with the ability to predict the behavior of benign and malignant salivary gland neoplasms is crucial. Syndecan-1 is a cell-surface protein with significant roles in various aspects of tumor function. Its expression in salivary gland neoplasms, especially their stromal component, has not been investigated.

OBJECTIVES

We aimed to assess the immunopositivity of syndecan-1 in epithelial and stromal components of salivary gland neoplasms and to compare it between benign and malignant subtypes in addition to evaluating its correlation with clinicopathologic parameters.

METHODS

133 salivary gland tumors were immunohistochemically stained with syndecan-1 and the intensity and percentage of this protein was determined, compared between the tumors and correlated with clinicopathologic factors.

RESULTS

Statistical analysis of lesions with a sufficient sample size showed significant differences in percentage and intensity between both epithelial and stromal components of all tumors (p<0.05). Pairwise-comparisons demonstrated significantly higher staining-percentage of epithelial cells (p=0.02) in Warthin's tumor compared to pleomorphic adenoma and adenoid cystic carcinoma. Similarly, significantly higher staining intensities and/or percentages was observed in mucoepidermoid carcinoma and adenoid cystic carcinoma compared to pleomorphic adenoma and Warthin's tumor (p<0.05). Of the clinicopathologic factors, there was only a significant negative correlation between stromal percentage of mucoepidermoid carcinoma and age and a significant difference between stromal intensity+percentage of adenoid cystic carcinoma and gender (p<0.05).

CONCLUSIONS

According to our findings we postulate that stromal syndecan-1 correlates with the behavior of salivary gland tumors, with malignant neoplasms demonstrating a higher expression, indicating a role for syndecan-1 in invasion and metastasis.

Immunohistochemical evaluation of salivary gland tumors differentiation and proliferation by using calponin and telomerase

Background

Salivary gland tumors are a heterogeneous group of lesions with diverse histological features. Hence they are considered as a diagnostic challenge for the pathologist. Myoepithelial cells are considered as a key in the morphogenetic process, with diverse differentiation in various salivary gland tumors. Calponin is an actin filament- associated protein that represents a sensitive marker of myoepithelial cells. Telomerase is a ribonucleoprotein that adds telomere repeats at the end of chromosomes in order to prevent replicative senescence. It has a key role in cellular immortality and tumorgenesis of various tumors. This study evaluates the immunohistochemical expression of calponin and telomerase in various salivary gland tumors.

Methods

This retrospective study involved 30 formalin fixed paraffin embedded blocks of salivary gland tumors. The immunohistochemical staining and evaluation of subcellular localization, pattern, intensity, and distribution for calponin and immune scoring for telomerase were done. The statistical analyses of data were conducted by Chi-square and ANOVA-test, a P-value of <0.05 was considered significant.

Results

Calponin showed expression at the periphery of acini and intercalated ducts in the normal salivary gland. It revealed cytoplasmic expression in 83.3% of benign tumors. The pleomorphic adenoma showed a diffuse pattern of staining (85.7%), strong intensity (64.3%), and mixed distributions (57.1%). The diffuse pattern of calponin was seen in all cases of mucoepidermoid, polymorphous low-grade adenocarcinoma and epithelial-myoepithelial carcinoma (100%). Telomerase revealed negative expression in the normal salivary gland. Pleomorphic adenoma illustrated high telomerase expression in score 2 and score 3 (93.3%). Telomerase immune scoring is significantly related to the benign tumors as P value was 0.03. Both polymorphous low grade and epithelial-myoepithelial carcinoma were detected only in score 3. Finally, the mean level of telomerase activity was slightly higher in malignant tumors than benign ones with non-significant relation as P value was 0.6.

Conclusions

Calponin showed high diffuse staining with altered distribution in salivary gland tumors, which might give an additional role for this marker in the identification of luminal immuno-modified neoplastic cells. Telomerase is considered as a useful marker in identifying proliferation capacity of salivary gland tumors and is remarkably more detected in malignant salivary gland tumors.

Comparison of p63/p40 Expression With Myoepithelial Markers in Minor Salivary Gland Tumors

The present study aimed to compare the expression of p63/p40 with smooth muscle actin (SMA) and vimentin (VIM) by myoepithelial cells in minor salivary gland tumors. Fifty-two formalin-fixed paraffin-embedded samples of minor salivary gland tumors derived from intercalated duct (pleomorphic adenoma [PA], adenoid cystic carcinoma [ACC], epithelial-myoepithelial carcinoma [EMC], polymorphous adenocarcinoma [PAC], and secretory carcinoma [SC]) and 3 samples of minor salivary gland tumors derived from excretory duct (mucoepidermoid carcinoma [MEC]) were evaluated by means of immunohistochemistry. The data were analyzed qualitatively. The results indicated that p63 and p40 expression were detected in myoepithelial cells present in PA, ACC, and EMC. However, both proteins were also observed in squamous areas of PA and all cases of MEC. SMA were noticed in some myoepithelial cells of PA, ACC, and EMC. Expression of SMA was negative in the other salivary gland tumors evaluated. VIM was constantly expressed by myoepithelial cells in PA, ACC, and EMC. VIM was also observed in cells of PAC and SC, but not in squamous areas of PA and MEC. In conclusion, p63 expression is almost comparable with VIM in detecting myoepithelial cells, an immunolabeling pattern not followed by p40, and consequently, caution has to be taken during the interpretation of salivary gland tumor exhibiting an p63/p40 phenotype in order to avoid a misdiagnosis.

Phenotype and cell proliferation activity of duct-like structures in human sublingual glands: a histological and immunohistochemical study

There are several age-related microscopic changes in the salivary glands, including the increase in the number of duct-like structures (DLS). However, the true origin and the phenotype of the DLS are not known.

Mucoepidermoid Carcinoma of the Palatine Tonsil

Mucoepidermoid carcinoma (MEC) is the most common primary salivary gland malignancy in both adults and children. It has a slight female predilection and usually presents as a painless, rubber-like or soft mass, which may be fixed or mobile. Histologically, MEC is comprised of a mixture of cell types including mucous, epidermoid, and intermediate cells that can be arranged in solid nests or cystic structures. In the oral cavity, it most frequently occurs at the palate or buccal mucosa. The present paper aimed to describe an unusual case of MEC arising in the palatine tonsil.

Canalicular adenoma: a clinicopathologic and immunohistochemical analysis of 67 cases with a review of the literature

There is a lack of a comprehensive immunohistochemical (IHC) analysis of canalicular adenoma (CanAd), especially when combined with a description of the unique histologic features. Given the usual small biopsies, IHC may be useful in distinguishing CanAd from other tumors in the differential diagnosis. Retrospective. The patients included 54 females and 13 males (4.2:1), aged 43-90 years, with a mean age at presentation of 69.9 years. Clinical presentation was generally a mass (n = 61) slowly increasing in size (mean 38.5 months), affecting the upper lip (n = 46), buccal mucosa (n = 17) or palate (n = 4), involving the right (n = 29), left (n = 24) or midline (n = 9), without any major salivary gland tumors. The tumors ranged in size from 0.2 to 3 cm (mean 1.2 cm). Most tumors were multilobular or bosselated (76 %), often surrounded by a capsule. Histologically, the tumors were characterized by cystic spaces, tumor cords with beading, tubule formation, and by the presence of luminal squamous balls (n = 41). The cells were cuboidal to columnar with stippled chromatin. Mitoses were inconspicuous. A myxoid stroma (n = 64), sclerosis (n = 42), luminal hemorrhage (n = 51), and luminal microliths (calcifications) (n = 33) were characteristic. Nine (13.4 %) were multifocal. CanAd showed the following characteristic immunohistochemistry findings: CK-pan and S100 protein (strong, diffuse reaction); peripheral or luminal GFAP reaction; CK5/6 and p16 luminal squamous ball reaction; SOX10 nuclear reaction; cytoplasmic p63 reaction. CanAd are unique minor salivary gland tumors showing a distinct architecture and phenotype. They predilect to older women, with the majority multilobulated and affecting the upper lip, multifocal in 13 %; no major salivary gland tumors were identified. S100 protein, CK-pan, GFAP and SOX10 are positive, with luminal squamous balls highlighted by CK5/6 or p16.

Development and characterization of salivary adenoid cystic carcinoma cell line

OBJECTIVE

To develop in vitro adenoid cystic carcinoma cell line as a surrogate for functional studies.

MATERIALS AND METHODS

Cells obtained from a primary ACC of the base of tongue were cultivated in vitro and immortalized with h-TERT. Morphologic, cytogenetic and functional studies were performed.

RESULTS

Tumor cells were verified by positive reactions to keratin and smooth muscle actin and phenotypic cellular and nuclear features. In-vitro cell growth and colony formation assay supported their tumor nature.

CONCLUSION

We authenticated an ACC cell line with hybrid epithelial-myoepithelial feature as a resource for functional experimentation.

Wnt signaling as a possible promoting factor of cell differentiation in pleomorphic adenomas

There are well known that Wnt signaling was some roles of cell differentiation at the development tissues, especially the oral and maxillofacial regions of some developmental stages. Therefore, to determine Wnt signaling in the pleomorphic adenoma tissues, we examined. The expression of Wnt1 and β-catenin as well as the distribution of various cytoskeletal proteins CK7 and CK13 was examined in 30 cases of pleomorphic adenoma by immunohistochemistry. Wnt1 was detected in almost all tumor cells. The peripheral columnar cells in squamous metaplasia and small cuboidal cells in duct-like structures were strongly positive to Wnt1. Although β-catenin was clearly localized on the cell membrane of tumor cells, nuclear translocation was observed in small cuboidal cells and in some basaloid cells. The immunofluorescent staining pattern of Wnt1 and CK7 as well as Wnt1 and CK13 was consistent with IHC results. Thus, in pleomorphic adenoma, Wnt is involved in tumor cell differentiation of peripheral columnar cells forming solid nests and small peripheral columnar cells forming duct-like structures. Moreover, among the three currently known Wnt pathways, β-catenin is the suggested pathway working during cell differentiation. Furthermore, peripheral columnar cells in solid tumor nests and in squamous metaplasia are governed by another Wnt pathway other than β-catenin. Therefore, Wnt signaling through β-catenin pathway may be involved in the 'mixed' differentiation characteristic of pleomorphic adenoma although another pathway may also be possibly working in other parts of the tumor tissue.

Serum biomarkers of papillary thyroid cancer

Objective

To identify serum biomarkers of papillary thyroid cancer.

Methods

Prospective analysis was performed of banked tumor and serum specimens from 99 patients with thyroid masses. Enzyme-linked immunosorbent assay (ELISA) was employed to measure levels of five serum proteins previously demonstrated to be up-regulated in papillary thyroid cancer (PTC): angiopoietin-1 (Ang-1), cytokeratin 19 (CK-19), tissue inhibitor of metalloproteinase-1 (TIMP-1), chitinase 3 like-1 (YKL-40), and galectin-3 (GAL-3). Serum levels were compared between patients with PTC and those with benign tumors.

Results

A total of 99 patients were enrolled in the study (27 men, 72 women), with a median age of 54 years. Forty-three patients had PTC and 58 cases were benign tumors. There were no statistically significant differences when comparing all five different biomarkers between PTC and other benign thyroid tumors. The p-values were 0.94, 0.48, 0.72, 0.48, and 0.90 for YKL-40, Gal-3, CK19, TIMP-1, and Ang-1, respectively.

Conclusion

Serum levels of four of the five proteins were elevated in patients with thyroid masses relative to normal values. However, the difference between benign and PTC was not significant. Two of the markers (Gal-3 & TIMP-1) displayed a greater potential difference, which may warrant further investigation. This study suggests that other serum markers should be sought. This is the first study to investigate potential serum biomarkers based on over-expressed proteins in thyroid cancer versus benign pathology.

Sinonasal seromucinous hamartoma: a review of the literature and a case report with focal myoepithelial cells

Seromucinous hamartoma is a benign lesion of the sinonasal tract. Since its description in 1974, only a small number of additional cases have been reported. It is composed of a proliferation of seromucinous glands and ducts within a variable fibrous stroma. The serous component typically stains positively for S100 (at least focally) and lacks p63 positive abluminal cells. The lack of myoepithelial/basal cells is an important diagnostic feature of seromucinous hamartoma; their absence could lead to an incorrect diagnosis of low-grade sinonasal adenocarcinoma. We report the case of a polypoid mass resected from the posterior nasal cavity and nasopharynx of a 54-year-old woman. The lesion contained a population of small and large glands lined by cuboidal to flattened cells within a hypocellular stroma varying from dense and sclerotic to myxoid. Additionally, there was a superficial focus of ciliated invaginated surface epithelium and glands. Throughout the lesion there were no cytologic or architectural features of malignancy. The histologic features were diagnostic of seromucinous hamartoma. Immunohistochemistry showed focal S100 positivity of the serous glands. However, in contrast to previously reported cases, the glands focally showed an outer basal layer that was calponin, p63 and actin positive. Our case demonstrates two important points. First, complete absence of p63 staining should not necessarily be a required feature in the diagnosis of seromucinous hamartoma. Second, the ciliated larger glands--in keeping with respiratory epithelial adenomatoid hamartoma (REAH)--support the suggestion that seromucinous hamartoma and REAH are a spectrum of lesions, often seen together.

Pleomorphic adenoma with extensive squamous metaplasia and keratin cyst formations in minor salivary gland: a case report

Pleomorphic adenoma (PA), the most common salivary gland tumor, accounts for 54 to 65% of all salivary gland neoplasias and 80% of the benign salivary gland tumors. It most frequently affects the parotid gland, followed by the submandibular and the minor salivary glands. Microscopically, mucous, sebaceous, oncocytic and squamous metaplasia, sometimes with the formation of keratin pearls, may be present, but the latter rarely results in the formation of extensive keratin-filled cysts lined by squamous epithelium. Extensive squamous metaplasia can be mistaken for malignancy, including mucoepidermoid carcinoma and squamous cell carcinoma. Here, we present an unusual case of PA with extensive squamous metaplasia and keratin cyst formations in a minor salivary gland, and discuss its microscopic features, including the immunohistochemical characteristics, and differential diagnosis of this uncommon presentation.

Basaloid squamous cell carcinoma of the head and neck: report of 18 cases

Objective:

To evaluate the clinical course and pathological characteristics of basaloid head and neck squamous cell carcinoma.

Method:

Retrospective study of 18 cases of basaloid head and neck squamous cell carcinoma. Epidemiological, clinical and histological data were analysed and the Kaplan–Meier test used to estimate survival rates.

Results:

The majority of lesions were at an advanced stage. These lesions were primarily localised in the larynx, hypopharynx and oropharynx. Routine pre-therapeutic assessment of squamous cell carcinoma was performed. Pathological diagnosis was difficult, although immunostaining was extremely useful. Positive staining for KL1, MNF 116 and 34βE12 and negative immunostaining for chromogranin and synaptophysin were also important factors in obtaining a definitive diagnosis. In the majority of cases, treatment involved surgery and radiotherapy. The five-year survival rate was 5 per cent.

Conclusion:

Basaloid squamous cell carcinoma is an uncommon head and neck lesion, with a challenging histological diagnosis. These lesions must be carefully monitored due to their aggressive course, and require multimodality treatment.

Spontaneous poorly differentiated carcinoma with cells positive for vimentin in a salivary gland of a young rat

Spontaneous salivary gland tumors in rats are rare. The authors report a poorly differentiated carcinoma of a submandibular gland in a ten-week-old rat that was positive for vimentin. Microscopically, the neoplastic cells showed a diffuse growth pattern in most areas of the tumor mass and a nestlike structure in a part of the peripheral area. Immunohistochemically, the cells were positive for keratin and vimentin but not for alpha-smooth muscle actin. Ultrastructurally, desmosome-like structures were observed. Based on these findings, the tumor was diagnosed as a poorly differentiated carcinoma. The origin of the neoplastic cells would be either acinar or ductal cells. This suggests that acinar or ductal cells have the potential to transform into vimentin-expressing cells.

Effect of SP3 silencing on cytokeratin expression pattern in HPV-positive cells

In an attempt to understand the molecular factors underlying squamous cell carcinogenesis in HPV-infected oral and cervical tissues, we examined the Sp3-dependent cytokeratin expression in HPV-positive CaSki cells. Two sets of cytokeratins were examined: the simple epithelial CK 7, 8, 18, 19, and 20, which are generally expressed in simple epithelia and CK4, 10, 13, and 17, which are expressed in squamous epithelia. Two additional CK pairs, i.e. CK6/CK16 and CK4/CK13 were analyzed as controls of the proliferation/differentiation cell status, respectively. We report that Sp3 gene silencing specifically hits CK18 and CK19, which are markers of oral and cervical squamous tumors. These data may be of help in immunopathological definition of squamous carcinogenesis.

Comparative cytokeratin expression in the different cell types of salivary gland mucoepidermoid carcinoma

Mucoepidermoid carcinoma is the most common malignant salivary gland tumor, composed of several different cell types, with controversial histogenesis. The aim of this study was to assess the expression of cytokeratins in mucoepidermoid carcinoma, comparing to cytokeratin expression in normal salivary glands, in order to establish a possible correlation between tumor cells immunostaining and mucoepidermoid carcinoma histogenesis and differentiation. Eighty cases of salivary gland mucoepidermoid carcinoma were immunohistochemically examined with the use of antibodies against cytokeratins 6, 7, 8, 13, 14, 18, and 19. Cytokeratin expression varied according to the cellular type: squamous cells presented high expression of cytokeratins 6, 7, 8, 14, 18, and 19; intermediate and mucous cells of cytokeratin 7; clear and columnar cells of cytokeratins 6, 7, 8 and the latter also expressed cytokeratin 18. Cytokeratin 13 expression was low in all cell types. Cytokeratin immunoexpression in mucoepidermoid carcinoma was variable according to the cellular type; but regardless of the cellular type studied, cytokeratins 7 and 13 were, respectively, constantly high and low expressed. The immunoprofile of the normal salivary glands was variable according to the component but, in general, cytokeratin profile in mucoepidermoid carcinoma showed similarity to the immunoexpression on the excretory duct unit of normal salivary glands.

Myoepithelial carcinoma of the submandibular gland: report of a case with multiple cutaneous metastases

Myoepithelial carcinoma is a rare and aggressive neoplasm of the salivary glands. One-third of the patients may develop regional distant metastases, and lungs and kidneys have been regarded as the most usual sites for implantation. There is, however, little information on the metastatic behavior of this malignancy. We report the first case of patient with multiple cutaneous metastases from a myoepithelial carcinoma of the submandibular gland, which depicted a very aggressive clinical course.

Epithelial-myoepithelial carcinoma: a review of the clinicopathologic spectrum and immunophenotypic characteristics in 61 tumors of the salivary glands and upper aerodigestive tract

To further define the clinicopathologic spectrum of epithelial-myoepithelial carcinoma (EMCa), we report the gross, histologic, and immunophenotypic characteristics of 61 tumors seen within a 30-year-period. The mean age at presentation was 60.9 years, with a female predominance (1.5:1). The most common sites were parotid (62.1%), sinonasal mucoserous glands (10.3%), palate (8.6%), and submandibular (8.6%). Most EMCas showed a characteristic nodular/multinodular growth pattern and classic biphasic tubular histology. However, new morphologies in EMCa such as ancient change (8.2%), "Verocay"-like change (3.3%), and sebaceous differentiation (13.1%) were noted. Specific histologic variants were dedifferentiated EMCa (3.3%), oncocytic EMCa (8.2%), EMCa ex pleomorphic adenoma (1.6%), double-clear EMCa (3.3%), and EMCa with myoepithelial anaplasia (3.3%). All cytokeratin cocktails selectively highlighted the epithelial component well. Of the myoepithelial markers, p63, smooth muscle actin and vimentin performed best. Bcl-2 and c-kit were frequently positive (66.7% and 69.2%, respectively). p53 was highly expressed only in 1 dedifferentiated EMCa. The recurrence rate was 36.3% (median disease-free survival 11.34 y), but death was rare with 5-year and 10-year disease-specific survivals of 93.5% and 81.8%, respectively. The most important univariate predictors of recurrence were margin status (log rank P=0.006), angiolymphatic invasion (P=0.002), tumor necrosis (P=0.004), and myoepithelial anaplasia (P=0.038). Thus, EMCa is generally a low-grade tumor with a broader morphologic spectrum than previously thought, with several key features predictive of recurrence. Immunohistochemistry can aid diagnosis by highlighting the biphasic nature of the tumor.

Mioepitelioma de glândula salivar menor: uma análise imunohistoquímica de quatro casos

INTRODUÇÃO E METODOLOGIA: Realizou-se um estudo imunohistoquímico em 4 casos de mioepiteliomas, visando traçar seu perfil quanto ao grau de diferenciação das células através dos anticorpos alfa-SMA, CK 14 e vimentina, bem como investigar o índice de proliferação celular pelo anti-PCNA, além de comparamos a imunorreatividade com o tecido glandular normal adjacente ao tumor. RESULTADOS: No tecido glandular normal as células mioepiteliais exibiram marcação para alfa-SMA e CK 14, enquanto que nas células ductais somente a presença da CK 14 foi verificada. Em todos os casos foi verificada positividade para CK 14 e vimentina, porém a CK 14 esteve presente somente em células epitelióides e fusiformes, enquanto que a vimentina mostrou-se positiva também nas células plasmocitóides. A alfa-SMA não foi detectada nas células neoplásicas. Imunopositividade para o PCNA foi observada em mais de 75% do componente celular dos tumores analisados, independente do tipo. CONCLUSÕES: Concluiu-se que não houve diferença na atividade proliferativa entre os tipos celulares presentes nos mioepiteliomas e, ainda, que os resultados deste estudo sugerem que as células constituintes desta neoplasia realmente representam células da linhagem mioepitelial, mas em diferentes estágios de diferenciação.

Myoepithelioma of minor salivary gland - An immunohistochemical analysis of four cases

Introduction and Methods

We performed an immunohistochemical study in four cases of myopitheliomas with objective to realize a profile in respect of differentiation grade by the monoclonal antibodies CK14, vimentin and alph-SMA, besides to investigate the cell proliferation by anti-PCNA, besides, we compare the immunoreactive with glandular normal tissue.

Results

In the glandular normal tissue the myoepithelials cells had shown expression for alpha-SMA and CK 14, while that in the ductals cells, only the presence of CK 14 was verified. All the cases was verified positivy for CK 14 and vimentin, however, CK 14 had been present only in epithelioid and fusiform cells, while that the vimentin revealed positive also in the cytoplasm of the plasmocytoid cells. alpha-SMA was not detected in the neoplasic cells. Immunopositivity for the PCNA was observed in more than 75% of the cellular component of the analyzed tumors, independent of the cellular type.

Conclusions

We concluded that it did not have difference in the proliferative activity among the cellular types presents in the myoepitheliomas and, still, the results of this study suggest that the constituent cells of this neoplasia one really represent cells of the mioepitelial ancestry, but in different stages of differentiation.

Application of Two Different Clones of Vimentin to the Diagnosis of Salivary Gland Tumors

With the evolution of IHC techniques, a broad range of antibodies have become available to diagnostic immunohistology. The authors observed different expressions of vimentin in salivary gland tumors using two clones of this antibody. This study was undertaken to show these differences comparing the immunoexpression of two clones of vimentin (V9 and Vim 3B4, DAKO, Carpenteria, CA) using 10 pleomorphic adenomas, 10 adenoid cystic carcinomas, and 4 epithelial/myoepithelial carcinomas of the salivary glands. The V9 clone of vimentin was much more efficient in demonstrating the myoepithelial cells in the different tumors studied. The Vim 3B4 clone was capable of detecting some myoepithelial cells, the plasmacytoid or modified myoepithelial cells in the pleomorphic adenoma, but was very weak in epithelial/-myoepithelial carcinomas. The difference between the two clones studied is a warning that pathologists need to know the specificity and sensitivity of the reagent they are using.

TP53 mutations in salivary gland neoplasms

Many studies have demonstrated that loss of TP53 gene function has an important role in the genesis of many neoplasms, including salivary gland neoplasms. The purpose of this study was to examine the mutation profile of the TP53 gene in salivary gland neoplasms. Genomic DNA was extracted from paraffin-embedded tissues of pleomorphic adenoma, carcinoma in pleomorphic adenoma, mucoepidermoid carcinoma, adenoid cystic carcinoma and polymorphous low grade adenocarcinoma. Exons 5 to 8 of the TP53 gene were amplified by polymerase chain reaction (PCR) to perform single-stranded conformational polymorphism (SSCP) analysis. Band shifting was observed in exons 5, 6 and 8 in 9 out of 18 neoplasms. The results of this study suggest that mutations in TP53 gene are related to salivary gland neoplasms pathogenesis and that exons 5 and 8 are most frequently involved.

Relationship between major and minor salivary gland mucoepidermoid carcinoma malignancy grading and presence of stromal myofibroblasts: immunohistochemical study

OBJECTIVE

Mucoepidermoid carcinoma (MEC) is the most common malignant salivary tumour, classified as low, intermediate and high grade. Myofibroblasts are the main stromal component and are included as prognostic factor in some tumours. The aim of this study was to evaluate the myofibroblasts in the stroma of MEC with possible relationship to malignancy grading.

METHODS

Twenty-five cases of MEC (six low grade, 11 intermediate grade, four high grade and four metastasis) were stained for vimentin, desmin and smooth muscle actin (SMA) for the identification of myofibroblasts. Transforming growth factors (TGFbeta1 and TGFbetaRII) were also assessed in our study.

RESULTS

Myofibroblasts were present in all cases, in amounts varying according to histological grading. TGFbeta1 was positive in squamous cells of intermediate grade tumours, and in the stroma of only four cases. TGFbetaRII was positive in most squamous and intermediate cells, regardless of malignancy grading.

CONCLUSIONS

Our study showed that the analysis of neoplastic stroma must be added to the studies of neoplastic cells to draw a better picture leading to tumour diagnosis and prognosis.

Expression of cytoskeletal proteins in developing human minor salivary glands

The presence of an epithelium at different stages of proliferation and differentiation raises interesting questions concerning the histogenesis, cell turnover and differentiation of normal salivary glands. In order to expand knowledge of these aspects, we investigated the expression of cytokeratins (CKs) 7,8,10,13,14,16,18 and 19, vimentin (VIM), and smooth muscle actin (SMA) in developing human minor salivary glands using monoclonal antibodies. Labial, buccal, palatine, and lingual salivary glands and those from the floor of the mouth were obtained from human fetuses (forensic postmortem) ranging in age from gestational weeks 10 to 29. Serial sections, 3 microm thick, were immunostained using a strepto-avidin-biotin technique. Reactivity for all antibodies was negative in the salivary gland epithelium during the developmental stages of bud formation, cord growth, and branching of cord. During canalization and cytodifferentiation, the glandular epithelial cells showed a positive reaction to some CKs and SMA. Cytokeratins 7, 8, 18, and 19 showed strong labeling in luminal duct cells that exhibited some degree of morphological differentiation. Myoepithelial cellc were recognized by antibodies to SMA. Cytoskeletal protein expression changes according to the cell type, degree of differentiation, and stage of morphological development of the glandular structure. These changes occur independently of the localization of the gland.

Keratin expression in human tissues and neoplasms

Keratin expression in human tissues and neoplasms Keratin filaments constitute type I and type II intermediate filaments (IFs), with at least 20 subtypes named keratin 1-20. Since certain keratin subtypes are only expressed in some normal human tissues but not others, and vice versa, various tissues have been subclassified according to the pattern of keratin staining. Simple epithelia generally express the simple epithelial keratins 7, 18, 19, and 20, while complex epithelia express complex epithelial keratins 5/6, 10, 14, and 15. When an epithelium undergoes malignant transformation, its keratin profile usually remains constant. The constitution and expression patterns of keratin filaments in human epithelial neoplasms are complex and often distinctive. In this article, we first briefly review the molecular and cell biology of keratin filaments. We then focus on the expression patterns of keratin filaments in various human neoplasms.