Low‐grade papillary adenocarcinoma of buccal mucosa salivary gland origin
E.N.T. Soroka University Hospital, Beer-Sheva, Israel. Head & Neck
(Impact Factor: 2.64).
05/1989; 11(3):237-41. DOI: 10.1002/hed.2880110308
The clinicopathologic features of a low-grade papillary adenocarcinoma arising in minor salivary gland tissue are presented. This tumor demonstrates a predilection for minor salivary glands of the oral cavity, a slow growth pattern, recurrence in spite of radical excision, and a tendency to produce nodal metastasis. This is the second documented case in the English literature of this recently defined subtype of polymorphous low-grade adenocarcinoma arising in a minor salivary gland of the buccal mucosa.
Available from: Hervé Reychler
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ABSTRACT: Because the data on the antigenic phenotype of mucoepidermoid carcinoma (MEC) are incomplete and somewhat disparate, 45 MECs were evaluated immunohistochemically for low- and high-molecular-weight keratins, vimentin, glial fibrillary acidic protein, smooth muscle actin, and S-100 protein. Tumors stained uniformly for keratins and, on occasion, focally for vimentin. Tumors were nonreactive with antibodies to glial fibrillary acidic protein and, with few exceptions, to muscle-specific actins and S-100 protein. Clear cell and papillary histologic variants were seen as potential diagnostic pitfalls. If used with hematoxylin-and-eosin-stained sections, limited potential is seen for this antibody panel in surgical pathology. Myoepithelial cell-associated antigens are expressed to a very limited extent in MECs.
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ABSTRACT: Histologic diversity is intrinsic to salivary gland tumors, but it is a particular feature of polymorphous low-grade adenocarcinoma as denoted by the terminology. Application of immunohistochemistry and electron microscopy to three examples allowed the study of some aspects of tumor cell differentiation in this minor salivary gland lesion. In one case where the tumor cells were cytologically of one type, immunohistochemistry clearly identified both luminal and nonluminal tumor cells, but the latter showed no evidence of myoepithelial cell differentiation. A second case revealed differentiation only of luminal-type tumor cells, while a third example was largely differentiated as myoepithelial cells but again immunohistochemistry confirmed focal formation of duct-like structures by luminal epithelium. These cases show a considerable range of tumor cell heterogeneity as well as variations in their organization. This variation in differentiation characteristics underlies the histology of polymorphous low-grade adenocarcinomas, and likely occurs in other salivary gland tumors. To establish specific and reliable diagnostic criteria for such tumors requires awareness of this neoplastic process. The limited malignant potential and excellent survival of patients with polymorphous low-grade adenocarcinoma is apparently little affected by patterns of differentiation in this particular neoplasm.
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