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Vamesu S, Ursica OA, Gurita AM, Voda RI, Deacu M, Aschie M, Bosoteanu M, Cozaru GC, Mitroi AF, Orasanu CI. A retrospective study of nonneoplastic and neoplastic disorders of the salivary glands. Medicine (Baltimore) 2023; 102:e35751. [PMID: 37861511 PMCID: PMC10589586 DOI: 10.1097/md.0000000000035751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023] Open
Abstract
The spectrum of major and minor salivary gland disorders varies widely. Epidemiological data on some injury categories are rare and often not up-to-date. This study aims to analyze epidemiological data using clinical, paraclinical, and histopathological parameters. Study was carried out for 5 years on the nonneoplastic and tumoral pathology of the salivary glands. Data were statistically analyzed using the appropriate parameters. Data analysis according to the biological behavior of the lesions revealed great heterogeneity. Statistically significant correlations were observed between the type of injury, age (P = .002) and gender (0.033). The environment of origin of the patients as well as the comorbidities reflected in most cases the nature of the process. Associations were also observed between the biological behavior of the lesions and the hemicranial topography (P = .019), the type of salivary gland (P = .024), and the surgical technique used (P < .001). Most cases were identified in the major salivary glands, often in the parotid. The most common diseases are represented by nonspecific chronic sialadenitis (nonneoplastic lesion), pleomorphic adenoma and Warthin tumor (benign tumors), mucoepidermoid carcinoma (malignant tumor), and squamous carcinoma (secondary tumor). They presented axial diameters between 2 to 95 mm. The most used curative technique was subtotal excision with facial nerve preservation. In conclusion, the study highlighted the main epidemiological aspects of salivary gland disorders. Some data agree with the specialty literature, and particular aspects are also observed. Therefore, this research is useful both in the medical and research fields.
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Affiliation(s)
- Sorin Vamesu
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
| | - Oana Andreea Ursica
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, Constanta, Romania
| | - Ana Maria Gurita
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
| | - Raluca Ioana Voda
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, Constanta, Romania
| | - Mariana Deacu
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, Constanta, Romania
| | - Mariana Aschie
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, Constanta, Romania
- Academy of Medical Sciences of Romania, Bucharest, Romania
| | - Madalina Bosoteanu
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, Constanta, Romania
| | - Georgeta Camelia Cozaru
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, Constanta, Romania
| | - Anca Florentina Mitroi
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, Constanta, Romania
| | - Cristian Ionut Orasanu
- Clinical Service of Anatomic Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, Constanta, Romania
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Johnson F, Hofauer B, Wirth M, Wollenberg B, Stögbauer F, Notohamiprodjo S, Haller B, Reschke R, Knopf A, Strassen U. Novel Discovery of the Somatostatin Receptor (SSTR2) in Pleomorphic Adenomas via Immunohistochemical Analysis of Tumors of the Salivary Glands. Cancers (Basel) 2023; 15:3917. [PMID: 37568733 PMCID: PMC10417029 DOI: 10.3390/cancers15153917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/09/2023] [Accepted: 07/29/2023] [Indexed: 08/13/2023] Open
Abstract
Reliable preoperative diagnosis between salivary gland tumor entities is difficult. In this monocentric retrospective study, we examined the somatostatin receptor 2 (SSTR2) status of salivary gland tumors after salivary gland tumor resection via immunohistochemistry (IHC), and stains were compared in analogy to the HER2 mamma scale. A total of 42.3% of all pleomorphic adenoma (PA) tumors (42 of 99, 95% confidence interval 32.5-52.8%) demonstrated ≥20% of cells displaying the SSTR2 as compared to just 1% of all other tumors (1/160, 95% CI 0.02-3.4%). The other tumor was a neuroendocrine carcinoma. PA had a higher intensity of SSTR2 staining, with 90.9% staining ≥ an intensity of 2 (moderate). Tumors with an intensity of SSTR2 expression equal to or greater than 2 had an 89.9% likelihood of being a PA (95% CI: 82.2-95.0%, AUC: 0.928). Only one Warthin tumor demonstrated a 'strong' SSTR2 staining intensity. No Warthin tumor showed a percentage of cells staining for SSTR2 above ≥20%. This result demonstrates consistent and strong expression of SSTR2 in PAs as compared to Warthin tumors, which may allow physicians to utilize radioligand-somatostatin analog PET CT/MR imaging to diagnose the PA. SSTR2 positivity, if shown to be clinically relevant, may allow peptide receptor radionuclide therapy in the future.
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Affiliation(s)
- Felix Johnson
- Department of Otorhinolaryngology, University Clinic of Innsbruck, 6020 Innsbruck, Austria
| | - Benedikt Hofauer
- Department of Otorhinolaryngology, University Clinic of Innsbruck, 6020 Innsbruck, Austria
| | - Markus Wirth
- Department of Otorhinolaryngology, Technical University of Munich (TUM), 85354 Freising, Germany
| | - Barbara Wollenberg
- Department of Otorhinolaryngology, Technical University of Munich (TUM), 85354 Freising, Germany
| | - Fabian Stögbauer
- Institute of General and Surgical Pathology, TUM School of Medicine, Technical University of Munich (TUM), 81675 Munich, Germany
| | - Susan Notohamiprodjo
- Department of Nuclear Medicine, Technical University of Munich (TUM), 85354 Freising, Germany
| | - Bernhard Haller
- Institut für KI und Informatik in der Medizin, 81675 München, Germany
| | - Robin Reschke
- Department of Dermatology and Venereology, Universitätsklinikum Hamburg-Eppendorf, Fleur Hiege Center for Skin Cancer Research, 20246 Hamburg, Germany
| | - Andreas Knopf
- Department of Otorhinolaryngology, Head and Neck Surgery, Albert-Ludwigs-Universität Freiburg, 79085 Freiburg, Germany
| | - Ulrich Strassen
- Department of Otorhinolaryngology, Technical University of Munich (TUM), 85354 Freising, Germany
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Feng B, Wang Z, Cui J, Li J, Xu H, Yu D, Zeng Q, Xiu J. Distinguishing Parotid Polymorphic Adenoma and Warthin Tumor Based on the CT Radiomics Nomogram: A Multicenter Study. Acad Radiol 2022:S1076-6332(22)00363-4. [PMID: 35953356 DOI: 10.1016/j.acra.2022.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 11/20/2022]
Abstract
RATIONALE AND OBJECTIVES To develop, validate, and test a comprehensive radiomics prediction model to distinguish parotid polymorphic adenomas (PAs) and warthin tumors (WTs) using clinical data and enhanced computed tomography (CT) from a multicenter cohort. MATERIALS AND METHODS A total of 267 patients with PAs (n =172) or WTs (n = 95) from two hospitals were randomly divided into training (n =188) and validation (n =79) datasets. Radiomics features were extracted from the enhanced CT (arterial phase) followed by dimensionality reduction. Clinical and CT features were combined to establish a prediction model. A radiomics nomogram was constructed by combining RadScore and clinical factors. Moreover, an independent dataset of 31 patients from a third hospital was employed to test the model. Thus, the performance of the nomogram, radiomics signature, and clinical models was evaluated on the training, validation, and the independent testing datasets. Receiver operating characteristic (ROC) curves were used to compare the performance, and decision curve analysis (DCA) was used to evaluate the clinical effectiveness of the model. RESULTS A total of 15 radiomics features were selected from CT data as the imaging markers to generate RadScores, and demographics or clinical data like age, sex, and smoking factors combined with RadScores were used to distinguish PAs and WTs based on multivariate logistic regression analyses. The results showed that radiomics nomograms combining clinical factors and RadScores provided satisfactory predictive values for distinguishing PAs from WTs, with areas under ROC curves (AUC) of 0.979, 0.922, and 0.903 for the training, validation, and the independent testing datasets, respectively. Decision curve analysis revealed that the radiomics nomogram outperformed the clinical factor models in terms of accuracy and effectiveness. CONCLUSION CT-based radiomics nomograms combining RadScores and clinical factors can be used to identify PAs and WTs, which may help tumor management by clinicians.
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Cha CH, Luo SD, Chiang PL, Chen WC, Tung YC, Su YY, Lin WC. Long-Term Outcomes of Radiofrequency Ablation for Treatment of Cystic Warthin Tumors versus Solid Warthin Tumors. Int J Environ Res Public Health 2021; 18:6640. [PMID: 34205502 DOI: 10.3390/ijerph18126640] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/06/2021] [Accepted: 06/17/2021] [Indexed: 11/17/2022]
Abstract
Background: To describe the long-term outcomes of radiofrequency ablation (RFA) of parotid Warthin tumors that have different consistencies and locations. Methods: We reviewed ten patients with Warthin tumors undergoing RFA treatment from 2016 to 2019. The mean follow-up was 24.3 ± 13.1 months (range 7–42 months). Results: RFA was performed on 11 tumors in ten patients. Cystic tumors (n = 4) had better volume reduction ratios (VRR) than solid tumors (n = 7) at month one and month six, following RFA (77.9% vs. 47.3%, 95.1% vs. 80.6%, respectively, p = 0.003). Tumors in both superficial lobes and deep lobes (n = 7) were larger than tumors in superficial lobes alone (n = 4), though there was no difference in VRR after treatment. All residual tumors were found in superficial lobes. There was no increase in residual tumor size. Every patient showed marked cosmetic improvements, with visible tumors becoming non-palpable masses. Conclusions: RFA is a safe and effective treatment for Warthin tumors, with better volume reduction in cystic tumors. Results remained satisfying over the long-term for all residual tumors found in superficial lobes, making it easier for re-intervention if necessary.
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Abstract
Papillary thyroid carcinoma (PTC) is one of the most common thyroid malignancy with various histologic variants. Acknowledging the correct histological variant of PTC helps to know about the tumor's nature and prognosis. The Warthin-like variant of papillary thyroid (WLPTC), a newly described histologic variant of PTC, is relatively uncommon. A 16-year-old female presented with complaints of painful thyroid swelling for two years. Fine needle aspiration cytology (FNAC) from the lobes showed lymphocytic thyroiditis features with Hurthle cell change. Sections from the left lobe revealed a diagnosis of a Warthin‑like variant of PTC without nodal metastasis. WLPTC is a rare variant having a favorable outcome due to the absence of lymph node metastasis, extra-thyroidal extension, and a low recurrence rate. The correct cytological and histomorphological features are of utmost importance to render the diagnosis of WLPTC for better management.
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Affiliation(s)
- Tarun Kumar
- Pathology, All India Institute of Medical Sciences, Patna, IND
| | | | - Prerna Tewari
- Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, IND
| | - Chandan K Jha
- Endocrine Surgery, All India Institute of Medical Sciences, Patna, IND
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Zahran M, Alsedra S, Cope D, Youssef A. The Role of FNAC in the Diagnosis and Management of Warthin Tumour: Analysis of 74 Cases. Int Arch Otorhinolaryngol 2020; 25:e379-e382. [PMID: 34377171 PMCID: PMC8321636 DOI: 10.1055/s-0040-1715148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/21/2020] [Indexed: 10/26/2022] Open
Abstract
Introduction After pleomorphic adenoma, Warthin tumor gets its popularity as the second most common benign neoplasm of the parotid gland. Fine-needle aspiration cytology (FNAC) is the most cost-effective and minimally-invasive way to determine the histological character of a parotid gland tumor. Objective To determine the accuracy of FNAC in the diagnosis of Warthin Tumour. Methods A retrospective study conducted between 2014 and 2018. Out of 243 FNACs performed for parotid lesions, a histopathological correlation was established in 74 cases to reveal the accuracy of FNAC in the diagnosis of Warthin tumor. Results A total of 243 FNACs of parotid lesions were performed, and a histopathological correlation was established in 74 (30.4%) cases. Later on, we confirmed that 16 (21.6%) out of these 74 patients had cases of Warthin tumor. In total, 15 (20.3%) out of those 74 cases were confirmed as Warthin tumors on the initial cytology, which revealed a true positive concordance between the cytology and the final histological diagnosis; 55/74 (74%) were true negative results; on the other hand, 1/74 (1.4%) was a false negative, and 3/74 (4.1%) were false positive results. The sensitivity of the FNAC in the diagnosis of Warthin tumor was of 93%, while the specificity was of 94.8%, and the accuracy, of 94.6%. Conclusion In the present study, FNAC had a high diagnostic accuracy, reaching 94%.
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Affiliation(s)
| | | | - Daron Cope
- Department of Otolaryngology-Head and Neck Surgery, NSW Health, North Sydney, New South Wales, Australia
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Safi M, Sun X, Wang L, Zhang X, Song J, Ameen M. Risk interrelationship among multiple primary tumors: A case report and review of literature. Medicine (Baltimore) 2018; 97:e0289. [PMID: 29642151 PMCID: PMC5908637 DOI: 10.1097/md.0000000000010289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Along with advanced management in oncology, great progress has been recently achieved in the studies of multiple primary tumors. Several reports have studied the coexistence between lymphoma and either renal cell carcinoma (RCC) or Warthin tumor. However, the level of coexistence between these cases remains unclear due to the absence of a distinct link between them. PATIENT CONCERNS We present a unique case of multiple primary tumors (lymphoma, RCC, and Warthin tumor) in an 80-year-old man and a review of the literature on the coexistence of RCC with lymphoma and lymphoma with Warthin tumor. DIAGNOSIS With a history of RCC, the patient had a freely movable lump under his left ear, and the pathological report indicated Hodgkin lymphoma and Warthin tumor. INTERVENTION RCC and Warthin tumor of the patient were surgically treated, followed by 2 cycles (14 days per cycle) of Epirubicin 40 mg day 1, Bleomycin 8 mg day 1, Vincristine 2 mg day 1, and Dacarbazine 500 mg day 1. The chemotherapy protocol was then changed to Epirubicin 40 mg day 1, Vincristine 2 mg day 1, and Dacarbazine 500 mg day 1 for 7 cycles. OUTCOMES After the last day of chemotherapy, the patient showed a complete response. LESSONS To the best of our knowledge, this paper is the first to report a case of multiple primary tumors with a complete response. For their early detection, favorable prognosis, and correlation identification, we suggest a transitive relation between these coexisting tumors. Therefore, similar studies should be conducted.
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Affiliation(s)
- Mohammed Safi
- The Second Hospital of Dalian Medical University, Shahekou, China-Dalian
| | - Xiuhua Sun
- The Second Hospital of Dalian Medical University, Shahekou, China-Dalian
| | - Lifen Wang
- The Second Hospital of Dalian Medical University, Shahekou, China-Dalian
| | - Xinwei Zhang
- The Second Hospital of Dalian Medical University, Shahekou, China-Dalian
| | - Jicheng Song
- The Second Hospital of Dalian Medical University, Shahekou, China-Dalian
| | - Mohammed Ameen
- Sino-German Cancer Diagnosis and Treatment Center, Second Affiliated Hospital of Dalian Medical University, Dalian, China
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Lau RP, Yee-Chang M, Rapkiewicz A. Educational Case: Head and Neck Neoplasia: Salivary Gland Tumors. Acad Pathol 2018; 5:2374289518770655. [PMID: 29978017 PMCID: PMC6024263 DOI: 10.1177/2374289518770655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 02/23/2018] [Accepted: 02/28/2018] [Indexed: 11/23/2022] Open
Abstract
The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see http://journals.sagepub.com/doi/10.1177/2374289517715040.
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Affiliation(s)
- Ryan P. Lau
- New York University School of Medicine, New York, NY, USA
| | | | - Amy Rapkiewicz
- New York University School of Medicine, New York, NY, USA
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Hang JF, Shum CH, Ali SZ, Bishop JA. Cytological features of the Warthin-like variant of salivary mucoepidermoid carcinoma. Diagn Cytopathol 2017; 45:1132-1136. [PMID: 28755513 DOI: 10.1002/dc.23785] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 06/13/2017] [Accepted: 06/29/2017] [Indexed: 11/05/2022]
Abstract
Warthin-like mucoepidermoid carcinoma is a recently proposed variant of musoepidermoid carcinoma. Histologically, it is characterized by its close resemblance to Warthin tumor, including dense lymphocytic infiltration, flattened intermediate epithelium resembling squamous metaplasia, and cystic change. Given its histologic similarity to Warthin tumor, confirmatory testing for MAML2 rearrangement is often required for this diagnosis. Here we present the first cytologic reports of two 53-year-old female patients with parotid masses. In both cases, the fine needle aspirations showed fragments of bland epithelium with a squamous appearance, mucinous cyst content, and focal lymphocytic background. Neither frank keratinization nor mucinous cells were identified in the smears. Fluorescence in situ hybridization (FISH) study confirmed MAML2 rearrangement on the resection specimens in both. Other cytologic differential diagnoses, including Warthin tumor with metaplasia, lymphadenoma, and lymphoepithelial cyst, were briefly discussed.
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Affiliation(s)
- Jen-Fan Hang
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland.,Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | | | - Syed Z Ali
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland.,Department of Radiology, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Justin A Bishop
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland
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Cope W, Naugler C, Taylor SM, Trites J, Hart RD, Bullock MJ. The association of warthin tumor with salivary ductal inclusions in intra and periparotid lymph nodes. Head Neck Pathol 2014; 8:73-6. [PMID: 23868565 DOI: 10.1007/s12105-013-0477-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 07/06/2013] [Indexed: 10/26/2022]
Abstract
A predominant theory of the much debated histogenesis of Warthin tumor (WT) is that it arises from heterotopic salivary ductal inclusions (SDI) in parotid lymph nodes (LN). If this were the case, we might expect to see an increased number of SDI in the lymph nodes of patients with WT compared to controls. To test this, we compared the prevalence of SDI in patients with WT versus those with pleomorphic adenoma (PA). Cases of WT and PA were retrieved from the case files of the Department of Pathology at the QEII Health Science Centre, Halifax, NS, Canada. We then compared the prevalence of SDI in parotid LN between patients diagnosed with WT versus PA. 46 WT and 52 PA met our inclusion criteria. WT was significantly associated with an older age at surgery (62.5 years vs 50.2 years, p = 0.001). 71.7 % of WT and 32.7 % of PA had inclusions in any LN. The presence of inclusion is a significant predictor for WT versus PA (p = 0.019). Where smoking status was available, 92.5 % of WT patients were smokers/ex-smokers, versus. 55.1 % of PA (p = 0.034 for current smokers). Among PA, 44 % of smokers had inclusions compared with 22.7 % of non-smokers. SDIs are more frequent in parotid LN from patients with WT than PA. The high proportion of smokers among WT patients is consistent with prior studies. The results support the hypothesis that WT arises from SDIs. Individuals with more SDIs may be predisposed to WT.
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Weinreb I. Intraductal carcinoma of salivary gland (so-called low-grade cribriform cystadenocarcinoma) arising in an intraparotid lymph node. Head Neck Pathol 2011; 5:321-5. [PMID: 21442195 DOI: 10.1007/s12105-011-0256-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Accepted: 03/10/2011] [Indexed: 12/27/2022]
Abstract
Since the first description of an entirely intraductal epithelial proliferation of salivary gland by Chen in 1983 as an "intraductal carcinoma", there have been several dozen reported cases with the same and various additional names including "low-grade salivary duct carcinoma", "low-grade cribriform cystadenocarcinoma" and "carcinoma in situ" of salivary gland. These refer to a combination of nests and cysts of varying size formed by a cellular proliferation resembling atypical ductal hyperplasia or ductal carcinoma in situ of the breast. The lesions are generally entirely intraductal with low, intermediate or high-grade dysplasia. Occasional benign tumors of salivary gland, particularly Warthin tumor and rare salivary carcinomas may arise within an intraparotid lymph node. In addition, intraparotid lymph nodes are a routine location for metastatic disease. A case of a 59-year-old female with a parotid mass is described, which grossly had the appearance of a Warthin tumor. Microscopically, it was an entirely intranodal proliferation of cells with diffuse AE1/AE3 and S100 positivity. The nests and cysts were completely surrounded by a rim of non-neoplastic myoepithelial cells, which were positive for CK14, p63, SMA, MSA and calponin. The tumor cells were negative for these markers. The cells were only focally positive for AR and BRST-2. They showed negligible MIB-1 staining. This report describes, for the first time, an entirely intranodal location for a low-grade intraductal carcinoma (so-called low-grade cribriform cystadenocarcinoma).
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