Nasal seromucinous hamartoma (microglandular adenosis of the nose): a morphological and molecular study of five cases.

Sezione di Anatomia Istologia e Citologia Patologica Marcello Malpighi, Dipartimento di Oncologia ed Ematologia, Università di Bologna, Ospedale Bellaria, Bologna, Italy.
Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin (Impact Factor: 2.68). 10/2010; 457(6):727-34. DOI: 10.1007/s00428-010-0984-7
Source: PubMed

ABSTRACT Five cases of nasal seromucinous hamartoma were studied and their clinical, morphological, immunohistochemical and molecular data are reported. The patients, three females and two males, ranged in age from 49 to 66 years (mean 56 year, SD ± 7.91). All lesions were located in the nasal cavity. In four cases where follow-up was obtained, no recurrence was evident. In all cases, numerous small seromucinous tubules, embedded in a cellular stroma, were present in the lamina propria. Tubules were lined by one layer of cuboidal cells which displayed luminal phenotype positive for lysozyme and EMA in four, and S100 protein in all cases. Collagen IV and laminin positive basal lamina outlined the tubules which lacked basal cells. Stromal spindle cells present among tubules were immunoreactive for calponin in all cases and for alpha-smooth muscle actin in four cases. DNA mutation analysis of mitochondrial D-loop region was performed by direct sequencing in order to verify the mutation rate of these lesions. The tubules of the five seromucinous hamartomas showed a higher mutation rate especially in heteroplasmy (0.52% homoplasmy, 2.02% heteroplasmy) in comparison to normal seromucinous glands which exhibited a lower mutation frequency (0.83%). This is considered a sign of a low cellular proliferation rate consistent with a benign process. It is concluded that nasal seromucinous hamartomas are benign glandular proliferations that may resemble microglandular adenosis of the breast. Their distinction from benign and malignant mimics is discussed.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Since the publication of the World Health Organization Classification of Head and Neck Tumors (Barnes et al., World Health Organization classification of tumours. Pathology and genetics head and neck tumours, IARC Press, Lyon, pp 10-80, 2001), a number of sinonasal lesions have been more completely described. This manuscript will focus on three such "new" lesions including sero mucinous hamartoma, HPV-related carcinoma with adenoid cystic-like features and low-grade sinonasal sarcoma with neural and myogenic features.
    Head and Neck Pathology 03/2014;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: 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.
    Head and Neck Pathology 03/2012; 6(3):395-9.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The correct detection of mitochondrial DNA (mtDNA) heteroplasmy by automated sequencing presents methodological constraints. The main goals of this study are to investigate the effect of sense and distance of primers in heteroplasmy detection and to test if there are differences in the accurate determination of heteroplasmy involving transitions or transversions. A gradient of the heteroplasmy levels was generated for mtDNA positions 9477 (transition G/A) and 15,452 (transversion C/A). Amplification and subsequent sequencing with forward and reverse primers, situated at 550 and 150 bp from the heteroplasmic positions, were performed. Our data provide evidence that there is a significant difference between the use of forward and reverse primers. The forward primer is the primer that seems to give a better approximation to the real proportion of the variants. No significant differences were found concerning the distance at which the sequencing primers were placed neither between the analysis of transitions and transversions. The data collected in this study are a starting point that allows to glimpse the importance of the sequencing primers in the accurate detection of point heteroplasmy, providing additional insight into the overall automated sequencing strategy.
    Mitochondrial DNA 01/2013; · 1.71 Impact Factor

Full-text (2 Sources)

Available from
Jun 2, 2014