Difference between revisions of "Secretory carcinoma of the salivary gland"
Jump to navigation
Jump to search
(→Images) |
|||
(30 intermediate revisions by the same user not shown) | |||
Line 1: | Line 1: | ||
{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Mammary analogue secretory carcinoma (H&E, medium power).jpg | |||
| Width = | |||
| Caption = Secretory carcinoma of the salivary gland. [[H&E stain]]. (WC/NormanDy) | |||
| Synonyms = Mammary analogue secretory carcinoma (previous name) | |||
| Micro = large cells with abundant cytoplasm, small nuclei, +/-lymphocytic infiltrate, solid and microcystic growth pattern | |||
| Subtypes = | |||
| LMDDx = [[acinic cell carcinoma]], [[mucoepidermoid carcinoma]] | |||
| Stains = [[PAS stain|PAS]] +ve | |||
| IHC = S-100 +ve, mammaglobin +ve, vimentin +ve | |||
| EM = | |||
| Molecular = ETV6-[[NTRK3]] fusion gene | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[salivary gland]] - usually parotid | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = rare | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = | |||
| Other = | |||
| ClinDDx = other [[salivary gland]] tumours | |||
| Tx = excision | |||
}} | |||
'''Secretory carcinoma of the salivary gland''' is an uncommon [[malignant]] [[salivary gland]] tumour that was first described in 2010.<ref name=pmid22127547>{{Cite journal | last1 = Lei | first1 = Y. | last2 = Chiosea | first2 = SI. | title = Re-evaluating historic cohort of salivary acinic cell carcinoma with new diagnostic tools. | journal = Head Neck Pathol | volume = 6 | issue = 2 | pages = 166-70 | month = Jun | year = 2012 | doi = 10.1007/s12105-011-0312-9 | PMID = 22127547 }}</ref> | |||
It was previously known as '''mammary analogue secretory carcinoma''', abbreviated '''MASC'''.<ref name=pmid31007960>{{cite journal |authors=Montalvo N, Galarza D, Redrobán L |title=Secretory Carcinoma of the Parotid: Making the Correct Diagnosis of a Rare Salivary Gland Carcinoma When Molecular Biology Testing Is Not Available |journal=Case Rep Pathol |volume=2019 |issue= |pages=5103496 |date=2019 |pmid=31007960 |pmc=6441535 |doi=10.1155/2019/5103496 |url=}}</ref> | |||
==General== | ==General== | ||
*Microscopic appearance similar to [[secretory breast carcinoma]].<ref name=pmid20410810>{{Cite journal | last1 = Skálová | first1 = A. | last2 = Vanecek | first2 = T. | last3 = Sima | first3 = R. | last4 = Laco | first4 = J. | last5 = Weinreb | first5 = I. | last6 = Perez-Ordonez | first6 = B. | last7 = Starek | first7 = I. | last8 = Geierova | first8 = M. | last9 = Simpson | first9 = RH. | title = Mammary analogue secretory carcinoma of salivary glands, containing the ETV6-NTRK3 fusion gene: a hitherto undescribed salivary gland tumor entity. | journal = Am J Surg Pathol | volume = 34 | issue = 5 | pages = 599-608 | month = May | year = 2010 | doi = 10.1097/PAS.0b013e3181d9efcc | PMID = 20410810 }}</ref> | *Microscopic appearance similar to [[secretory breast carcinoma]].<ref name=pmid20410810>{{Cite journal | last1 = Skálová | first1 = A. | last2 = Vanecek | first2 = T. | last3 = Sima | first3 = R. | last4 = Laco | first4 = J. | last5 = Weinreb | first5 = I. | last6 = Perez-Ordonez | first6 = B. | last7 = Starek | first7 = I. | last8 = Geierova | first8 = M. | last9 = Simpson | first9 = RH. | title = Mammary analogue secretory carcinoma of salivary glands, containing the ETV6-NTRK3 fusion gene: a hitherto undescribed salivary gland tumor entity. | journal = Am J Surg Pathol | volume = 34 | issue = 5 | pages = 599-608 | month = May | year = 2010 | doi = 10.1097/PAS.0b013e3181d9efcc | PMID = 20410810 }}</ref> | ||
* | *Rare - 21 cases in the world literature as of 2012.<ref name=pmid22127547/> | ||
*Original paper described it only in adults.<ref name=pmid20410810/> | *Original paper described it only in adults.<ref name=pmid20410810/> | ||
**Has been described in a pediatric patient.<ref name=pmid21873597>{{Cite journal | last1 = Rastatter | first1 = JC. | last2 = Jatana | first2 = KR. | last3 = Jennings | first3 = LJ. | last4 = Melin-Aldana | first4 = H. | title = Mammary analogue secretory carcinoma of the parotid gland in a pediatric patient. | journal = Otolaryngol Head Neck Surg | volume = 146 | issue = 3 | pages = 514-5 | month = Mar | year = 2012 | doi = 10.1177/0194599811419044 | PMID = 21873597 }}</ref> | **Has been described in a pediatric patient.<ref name=pmid21873597>{{Cite journal | last1 = Rastatter | first1 = JC. | last2 = Jatana | first2 = KR. | last3 = Jennings | first3 = LJ. | last4 = Melin-Aldana | first4 = H. | title = Mammary analogue secretory carcinoma of the parotid gland in a pediatric patient. | journal = Otolaryngol Head Neck Surg | volume = 146 | issue = 3 | pages = 514-5 | month = Mar | year = 2012 | doi = 10.1177/0194599811419044 | PMID = 21873597 }}</ref> | ||
Line 17: | Line 50: | ||
*+/-Lymphocytic infiltrate. | *+/-Lymphocytic infiltrate. | ||
*Solid and microcystic growth pattern. | *Solid and microcystic growth pattern. | ||
*+/-Cystic changes lined by hobnail cells - useful feature. | |||
DDx: | DDx: | ||
Line 24: | Line 58: | ||
===Images=== | ===Images=== | ||
====Case 1==== | |||
<gallery> | |||
Image:Mammary_analogue_secretory_carcinoma_(H%26E,_low_power).jpg | SC - low. (WC/NormanDy) | |||
Image:Mammary_analogue_secretory_carcinoma_(H%26E,_medium_power).jpg | SC - med. (WC/NormanDy) | |||
Image:Mammary_analogue_secretory_carcinoma_(H%26E,_high_power).jpg | SC - high. (WC/NormanDy) | |||
Image:Mammary_analogue_secretory_carcinoma_(H%26E,_high_power),_solid.jpg | SC - high solid. (WC/NormanDy) | |||
</gallery> | |||
====Case 2==== | |||
<gallery> | |||
Image: Secretory carcinoma of salivary gland -- low mag.jpg | SCSG - low mag. (WC) | |||
Image: Secretory carcinoma of salivary gland -- intermed mag.jpg | SCSG - intermed. mag. (WC) | |||
Image: Secretory carcinoma of salivary gland -- high mag.jpg | SCSG - high mag. (WC) | |||
Image: Secretory carcinoma of salivary gland - alt -- high mag.jpg | SCSG - high mag. (WC) | |||
</gallery> | |||
====www==== | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370021/figure/Fig2/ MASC (nih.gov)].<ref name=pmid22127547/> | *[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370021/figure/Fig2/ MASC (nih.gov)].<ref name=pmid22127547/> | ||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370021/figure/Fig1/ AcCC - the main DDx of MASC (nih.gov)].<ref name=pmid22127547/> | |||
==Stains== | ==Stains== | ||
Features:<ref name=pmid20410810/> | Features:<ref name=pmid20410810/> | ||
*[[PAS stain]] +ve. | *[[PAS stain]] +ve - secretory material. | ||
**Does ''not'' have PAS +ve cytoplasmic granules like [[AcCC]]. | |||
**Secretory material also [[PASD stain]] +ve. | |||
*[[Mucicarmine stain]] +ve. | *[[Mucicarmine stain]] +ve. | ||
==IHC== | ==IHC== | ||
Features:<ref name=pmid20410810/> | Features:<ref name=pmid20410810/> | ||
*S-100 +ve.<ref name=pmid22127547/> | *[[S-100]] +ve.<ref name=pmid22127547/> | ||
* | *Mammaglobin +ve. | ||
*Vimentin +ve. | *Vimentin +ve. | ||
Others: | |||
*[[p63]] -ve. | |||
**Unusual in mucoepidermoid carcinoma. | |||
*HMWCK -ve. | |||
*[[GATA3]] +ve. | |||
Panel: | |||
*S-100, mammaglobin, p63, HMWCK. | |||
===Images=== | |||
<gallery> | |||
Image:Mammary_analogue_secretory_carcinoma_(mammaglobin_immunohistochemstry,_medium_power).jpg | MASC - mammaglobin. (WC/NormanDy) | |||
Image:Mammary_analogue_secretory_carcinoma_(S100immunohistochemstry,_low_power).jpg | MASC - S-100. (WC/NormanDy) | |||
</gallery> | |||
==Molecular== | ==Molecular== | ||
*t(12;15)(p13;q25). | *t(12;15)(p13;q25). | ||
**Fusion of the genes ''ETV6'' and ''NTRK3''.<ref name=pmid22127547/> | **Fusion of the genes ''ETV6'' and ''[[NTRK3]]''.<ref name=pmid22127547/> | ||
Note: | Note: | ||
*The translocation seen in [[secretory breast carcinoma]] | *The translocation seen in [[secretory breast carcinoma]], [[congenital-infantile fibrosarcoma]] and [[mesoblastic nephroma]]. | ||
==Sign out== | |||
<pre> | |||
Right Parotid Lesion, Core Biopsy: | |||
- SECRETORY CARCINOMA of the salivary gland, see comment. | |||
Comment: | |||
Secretory carcinoma of the salivary gland was previously known as "mammary analogue secretory carcinoma" (MASC). | |||
The tumour stains as follows: | |||
POSITIVE: CK7 (strong, diffuse), mammaglobin (strong, diffuse), S100 (moderate, patchy), mucin (focal). | |||
NEGATIVE: p63. | |||
NTRK testing was ordered; the results will be reported in an addendum. | |||
</pre> | |||
===Micro=== | |||
The sections show a cohesive tumor with moderate amphophilic cytoplasm and vacuolation. The vacuolation is focally prominent. Nucleoli are inconspicuous. Poorly formed glands are present. Keratinization is absent. | |||
==See also== | ==See also== | ||
*[[Salivary gland]]. | *[[Salivary gland]]. | ||
*[[Secretory breast carcinoma]]. | *[[Secretory breast carcinoma]]. | ||
*[[Secretory carcinoma]]. | |||
==References== | ==References== |
Latest revision as of 20:53, 2 November 2021
Secretory carcinoma of the salivary gland | |
---|---|
Diagnosis in short | |
![]() Secretory carcinoma of the salivary gland. H&E stain. (WC/NormanDy) | |
| |
Synonyms | Mammary analogue secretory carcinoma (previous name) |
| |
LM | large cells with abundant cytoplasm, small nuclei, +/-lymphocytic infiltrate, solid and microcystic growth pattern |
LM DDx | acinic cell carcinoma, mucoepidermoid carcinoma |
Stains | PAS +ve |
IHC | S-100 +ve, mammaglobin +ve, vimentin +ve |
Molecular | ETV6-NTRK3 fusion gene |
Site | salivary gland - usually parotid |
| |
Prevalence | rare |
Clin. DDx | other salivary gland tumours |
Treatment | excision |
Secretory carcinoma of the salivary gland is an uncommon malignant salivary gland tumour that was first described in 2010.[1]
It was previously known as mammary analogue secretory carcinoma, abbreviated MASC.[2]
General
- Microscopic appearance similar to secretory breast carcinoma.[3]
- Rare - 21 cases in the world literature as of 2012.[1]
- Original paper described it only in adults.[3]
- Has been described in a pediatric patient.[4]
Gross
- Usually parotid gland.[3]
- Well-circumscribed.[citation needed]
Microscopic
Features:
- Large cells with abundant cytoplasm.
- Small nuclei.
- +/-Lymphocytic infiltrate.
- Solid and microcystic growth pattern.
- +/-Cystic changes lined by hobnail cells - useful feature.
DDx:
- Acinic cell carcinoma - very closely mimics.
- Abundant basophilic granular cytoplasm.[1]
- Mucoepidermoid carcinoma.
Images
Case 1
Case 2
www
Stains
Features:[3]
- PAS stain +ve - secretory material.
- Does not have PAS +ve cytoplasmic granules like AcCC.
- Secretory material also PASD stain +ve.
- Mucicarmine stain +ve.
IHC
Features:[3]
Others:
Panel:
- S-100, mammaglobin, p63, HMWCK.
Images
Molecular
Note:
- The translocation seen in secretory breast carcinoma, congenital-infantile fibrosarcoma and mesoblastic nephroma.
Sign out
Right Parotid Lesion, Core Biopsy: - SECRETORY CARCINOMA of the salivary gland, see comment. Comment: Secretory carcinoma of the salivary gland was previously known as "mammary analogue secretory carcinoma" (MASC). The tumour stains as follows: POSITIVE: CK7 (strong, diffuse), mammaglobin (strong, diffuse), S100 (moderate, patchy), mucin (focal). NEGATIVE: p63. NTRK testing was ordered; the results will be reported in an addendum.
Micro
The sections show a cohesive tumor with moderate amphophilic cytoplasm and vacuolation. The vacuolation is focally prominent. Nucleoli are inconspicuous. Poorly formed glands are present. Keratinization is absent.
See also
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Lei, Y.; Chiosea, SI. (Jun 2012). "Re-evaluating historic cohort of salivary acinic cell carcinoma with new diagnostic tools.". Head Neck Pathol 6 (2): 166-70. doi:10.1007/s12105-011-0312-9. PMID 22127547.
- ↑ Montalvo N, Galarza D, Redrobán L (2019). "Secretory Carcinoma of the Parotid: Making the Correct Diagnosis of a Rare Salivary Gland Carcinoma When Molecular Biology Testing Is Not Available". Case Rep Pathol 2019: 5103496. doi:10.1155/2019/5103496. PMC 6441535. PMID 31007960. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441535/.
- ↑ 3.0 3.1 3.2 3.3 3.4 Skálová, A.; Vanecek, T.; Sima, R.; Laco, J.; Weinreb, I.; Perez-Ordonez, B.; Starek, I.; Geierova, M. et al. (May 2010). "Mammary analogue secretory carcinoma of salivary glands, containing the ETV6-NTRK3 fusion gene: a hitherto undescribed salivary gland tumor entity.". Am J Surg Pathol 34 (5): 599-608. doi:10.1097/PAS.0b013e3181d9efcc. PMID 20410810.
- ↑ Rastatter, JC.; Jatana, KR.; Jennings, LJ.; Melin-Aldana, H. (Mar 2012). "Mammary analogue secretory carcinoma of the parotid gland in a pediatric patient.". Otolaryngol Head Neck Surg 146 (3): 514-5. doi:10.1177/0194599811419044. PMID 21873597.