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Difference between revisions of "Salivary duct carcinoma"
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| Width = | | Width = | ||
| Caption = Salivary duct carcinoma. [[H&E stain]]. | | Caption = Salivary duct carcinoma. [[H&E stain]]. | ||
| Micro = varied arch. (sheets, nests, cords, cribriform, micropapillary), neoplastic cells line-up around cystic spaces "Roman bridges", nuclear atypia, apocrine snouts, decapitation secretions | | Micro = varied arch. (sheets, nests, cords, [[cribriform]], micropapillary), neoplastic cells line-up around cystic spaces "Roman bridges", nuclear atypia, apocrine snouts, decapitation secretions | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[ | | LMDDx = [[carcinoma ex pleomorphic adenoma]] with SDC component, [[ductal carcinoma of the breast]], [[intraductal carcinoma of the salivary gland]] | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = LMWK, EMA, CK7, CK19 +ve, AR +ve, BRST2 (GCDFP-15) +ve, HER2 -ve/+ve, p63 -ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
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| Gross = | | Gross = | ||
| Grossing = | | Grossing = | ||
| Site = [[salivary gland]] | | Site = [[salivary gland]] - usu. parotid gland | ||
| Assdx = | | Assdx = | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = | | Clinicalhx = typically male, usu. >50 years old | ||
| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = | ||
| Prevalence = | | Prevalence = rare | ||
| Bloodwork = | | Bloodwork = | ||
| Rads = | | Rads = | ||
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==Microscopic== | ==Microscopic== | ||
Features - resembles ductal breast carcinoma:<ref name=pmid21393874/> | Features - resembles ductal breast carcinoma:<ref name=pmid21393874/> | ||
*Architecture: sheets, nests, cords, cribriform, micropapillary. | *Architecture: sheets, nests, cords, [[cribriform]], micropapillary. | ||
*Neoplastic cells line-up around cystic spaces "Roman bridges". | *Neoplastic cells line-up around cystic spaces "Roman bridges". | ||
*Nuclear atypia (variation in size, shape, staining). | *Nuclear atypia (variation in size, shape, staining). | ||
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DDx: | DDx: | ||
*[[Carcinoma ex pleomorphic adenoma]] with SDC component. | *[[Carcinoma ex pleomorphic adenoma]] with SDC component. | ||
*[[Intraductal carcinoma of the salivary gland]] - previously referred to as ''low-grade salivary duct carcinoma''. | |||
===Images=== | ===Images=== | ||
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Image:Salivary duct carcinoma -a- intermed mag.jpg | SDC - intermed. mag. (WC/Nephron) | Image:Salivary duct carcinoma -a- intermed mag.jpg | SDC - intermed. mag. (WC/Nephron) | ||
</gallery> | </gallery> | ||
[[File: 5 3689176038337 sl 1.png|salivary duct carcinoma]] | |||
[[File: 5 3689176038337 sl 2.png|salivary duct carcinoma]] | |||
[[File: 5 3689176038337 sl 3.png|salivary duct carcinoma]] | |||
[[File: 5 3689176038337 sl 4.png|salivary duct carcinoma]] | |||
[[File: 5 3689176038337 sl 5.png|salivary duct carcinoma]] | |||
[[File: 5 3689176038337 sl 6.png|salivary duct carcinoma]] | |||
Salivary duct carcinoma. 59 y man with a 3 cm right superficial parotid mass. A. Low power shows a predominance of patterns similar to in situ, micropapillary (white arrow), Roman bridge (green arrow), cribriform (blue arrow) patterns. B. Careful search reveals occasional invasive bars (arrow). C. The bar comprises the usual invasive pattern of adenocarcinoma, with cancerous cell clusters, isolated glands, incomplete glands, and adjoined/fused glands. Note the lighter color of stromal desmoplasia (arrows). D. The in situ component has more uniform nuclei than the invasive component. Note the comedo necrosis. E. Cancer cells expressed CK7. F. Cancer cell nuclei were positive for androgen receptor. Not shown: tumor was negative for SOX10 and P63. | |||
===Subtypes=== | ===Subtypes=== | ||
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==IHC== | ==IHC== | ||
*LMWK, EMA, CK7, CK19 +ve. | *LMWK, EMA, CK7, CK19 +ve. | ||
*p63 -ve. | *[[p63]] -ve. | ||
*Androgen receptor +ve. | *[[Androgen receptor]] +ve (~90% of cases).<ref name=pmid10757407>{{Cite journal | last1 = Fan | first1 = CY. | last2 = Wang | first2 = J. | last3 = Barnes | first3 = EL. | title = Expression of androgen receptor and prostatic specific markers in salivary duct carcinoma: an immunohistochemical analysis of 13 cases and review of the literature. | journal = Am J Surg Pathol | volume = 24 | issue = 4 | pages = 579-86 | month = Apr | year = 2000 | doi = | PMID = 10757407 }}</ref> | ||
*BRST2 (GCDFP-15) +ve. | *BRST2 ([[GCDFP-15]]) +ve. | ||
*HER2 +ve ~21%; use of [[trastuzumab]] (Herceptin) not systematically studied. | *HER2 +ve ~21%; use of [[trastuzumab]] (Herceptin) not systematically studied. | ||
Curiosity: | Curiosity: | ||
*PSA +/-. | *[[PSA]] +ve/-ve. | ||
*PSAP +/-. | *[[PSAP]] +ve/-ve. | ||
*ER-beta +ve.<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/MajorSalGlands_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/MajorSalGlands_11protocol.pdf]. Accessed on: 3 April 2012.</ref> | *ER-beta +ve.<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/MajorSalGlands_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/MajorSalGlands_11protocol.pdf]. Accessed on: 3 April 2012.</ref> | ||
*ER-alpha -ve (the common ''ER'' stain). | *ER-alpha -ve (the common ''ER'' stain). | ||
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[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Head and neck pathology]] | [[Category:Head and neck pathology]] | ||
[[Category:Salivary gland]] | |||