Oncocytic mucoepidermoid carcinoma of the parotid gland: Report of a case with DNA ploidy analysis and review of the literature

Gulhane Military Medical Academy, Engüri, Ankara, Turkey
Pathology International (Impact Factor: 1.69). 12/2000; 50(11):905-9. DOI: 10.1046/j.1440-1827.2000.01129.x
Source: PubMed

ABSTRACT A 44-year-old female presented with a painful mass in the left parotid gland. Histologic examination revealed the characteristic picture of oncocytic mucoepidermoid carcinoma (OMEC) composed mainly of sheets of oncocytic cells with uniform nuclei and eosinophilic cytoplasm, focally smaller epidermoid cells surrounding poorly formed glandular spaces, and a few cystic structures lined by well-differentiated mucous cells with intracytoplasmic mucin. Immunohistochemical staining with antimitochondrial antibody showed granular cytoplasmic positivity in oncocytic cells. The resulting histogram for DNA ploidy analysis was of diploid type. OMEC of the parotid gland is a recently described rare neoplasm. Only six cases have been previously reported in the literature. For an accurate approach in the management of patients, OMEC should be considered in the differential diagnosis of oncocytic lesions of the parotid gland, most of which are benign.

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    • "More important is the distinction of these lesions from their malignant counterparts, oncocytic carcinomas, as well as the oncocytic variants of other salivary gland carcinomas and metastatic lesions with oncocytic morphology. Also, oncocytic cells have been reported to occur in mucoepidermoid carcinoma (MEC); in addition, a rare variant of MEC known as oncocytic MEC has been described in the last decade [16] [17] [18] [19]. These tumors are composed exclusively of oncocytic cells arranged in nests and sheets in sclerotic stroma with variable number of chronic inflammatory cells [19]. "
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    ABSTRACT: The purpose of the present study is to determine the presence and distribution of epithelial and myoepithelial cells in mucoepidermoid carcinoma (MEC) of salivary glands and to compare them with normal salivary gland tissue and other primary carcinomas. This is in order to establish novel diagnostic criteria and to better understand MEC histogenesis. Formalin-fixed paraffin-embedded tissues from ten well-differentiated MECs, three adenoid cystic carcinomas (ACC), four acinic cell carcinomas (AC), and three epithelial-myoepithelial carcinomas (EMCC) of salivary glands were studied with immunohistochemistry using antibodies that recognise antigens indicative of epithelial and myoepithelial cell differentiation. An anti-mitochondrial antibody was also employed. Normal salivary tissue was present for comparative study in non-tumorous areas of the same section from 12 cases. MEC contained numerous keratin-positive cells. Anti mitochondrial antibody was diffusely positive in all ten of these tumours. Smooth muscle actin, h-caldesmon, and smooth muscle heavy chain myosin, which are indicative of myoepithelial cell differentiation, were negative. Rare cells in only one case were stained by calponin. Cytokeratin 14 (CK14) and anti mitochondrial antibody stained cells located mainly at the periphery of neoplastic nests and cystic spaces, while CK7 was mainly present in cells bordering gland lumina (zoning pattern). The immunohistochemical cell profile was similar to that seen in striated normal ducts. All others tumours studied showed a different immunohistochemical pattern, mostly consisting of a lack of mitochondrion-rich cells and the presence of myoepithelial cells in ACC and EMCC. Immunoreactivity in MEC for CK7, CK14 and mitochondrial antibodies appears as a peculiar pattern of staining, different from that of other salivary gland tumors; this seems helpful for diagnostic purposes. In addition, a differentiation of the "striated duct phenotype" is suggested.
    Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 06/2002; 440(5):536-42. DOI:10.1007/s00428-001-0585-6 · 2.65 Impact Factor
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