Difference between revisions of "Oncocytoma of the salivary gland"

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'''Oncocytoma of the salivary gland''' is a rare benign tumour of the [[salivary glands]].
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Parotid_gland_oncocytoma_-_very_high_mag.jpg
| Width      =
| Caption    = Salivary gland oncocytoma. [[H&E stain]]. (WC/Nephron)
| Synonyms  = salivary gland oncocytoma
| Micro      = abundant eosinophilic cytoplasm; architecture: solid, trabecular or duct-like
| Subtypes  =
| LMDDx      = [[acinic cell carcinoma]], metastatic [[renal cell carcinoma]], oncocytic carcinoma, [[granular cell tumour]]
| Stains    =
| IHC        = p63 +ve
| EM        = increased numbers of mitochondria
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Staging    =
| Site      = [[salivary gland]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = very rare
| Bloodwork  =
| Rads      = blends with normal salivary gland on T1 postcontrast and fat-saturated T2 MR images
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    = other salivary gland tumours
| Tx        =
}}
'''Oncocytoma of the salivary gland''' (also '''salivary gland oncocytoma''') is a rare benign tumour of the [[salivary glands]].


==General==
==General==
*No risk of malignant transformation.
*No risk of malignant transformation.
*Rare ~20 reported in literature.<ref>{{cite journal |author=Uzunkulaoğlu H, Yazici H, Can IH, Doğan S, Uzunkulaoğlu T |title=Bilateral oncocytoma in the parotid gland |journal=J Craniofac Surg |volume=23 |issue=3 |pages=e246–7 |year=2012 |month=May |pmid=22627459 |doi=10.1097/SCS.0b013e31824dfccd |url=}}</ref>
*Rare ~20 reported in literature.<ref name=pmid22627459>{{cite journal |author=Uzunkulaoğlu H, Yazici H, Can IH, Doğan S, Uzunkulaoğlu T |title=Bilateral oncocytoma in the parotid gland |journal=J Craniofac Surg |volume=23 |issue=3 |pages=e246–7 |year=2012 |month=May |pmid=22627459 |doi=10.1097/SCS.0b013e31824dfccd |url=}}</ref>
*Thought to be ~1% of all salivary gland tumours.
*Thought to be ~1% of all salivary gland tumours.
*Typical age: 60s-80s.
*Typical age: 60s-80s.
*Associated with radiation exposure.
*Associated with radiation exposure.
*Major salivary glands - usually parotid gland.<ref name=pmid19796983>{{Cite journal  | last1 = Zhou | first1 = CX. | last2 = Gao | first2 = Y. | title = Oncocytoma of the salivary glands: a clinicopathologic and immunohistochemical study. | journal = Oral Oncol | volume = 45 | issue = 12 | pages = e232-8 | month = Dec | year = 2009 | doi = 10.1016/j.oraloncology.2009.08.004 | PMID = 19796983 }}</ref>
*Major salivary glands - usually parotid gland.<ref name=pmid19796983>{{Cite journal  | last1 = Zhou | first1 = CX. | last2 = Gao | first2 = Y. | title = Oncocytoma of the salivary glands: a clinicopathologic and immunohistochemical study. | journal = Oral Oncol | volume = 45 | issue = 12 | pages = e232-8 | month = Dec | year = 2009 | doi = 10.1016/j.oraloncology.2009.08.004 | PMID = 19796983 }}</ref>
*Case report of oncocytoma of parotid as manifestation of [[Birt-Hogg-Dubé syndrome]].<ref name=pmid29971177>{{cite journal |authors=Yoshida K, Miyagawa M, Kido T, Ide K, Sano Y, Sugawara Y, Takahata H, Monden N, Furuya M, Mochizuki T |title=Parotid Oncocytoma as a Manifestation of Birt-Hogg-Dubé Syndrome |journal=Case Rep Radiol |volume=2018 |issue= |pages=6265175 |date=2018 |pmid=29971177 |pmc=6008813 |doi=10.1155/2018/6265175 |url=}}</ref>


==Gross==
==Gross==
*Golden brown appearance.
*Golden brown appearance.


Note:
*"Disappear" into background salivary gland on MRI: isointense to normal on fat-saturated T2 and T1 postcontrast images.<ref name=pmid21757520>{{Cite journal  | last1 = Patel | first1 = ND. | last2 = van Zante | first2 = A. | last3 = Eisele | first3 = DW. | last4 = Harnsberger | first4 = HR. | last5 = Glastonbury | first5 = CM. | title = Oncocytoma: the vanishing parotid mass. | journal = AJNR Am J Neuroradiol | volume = 32 | issue = 9 | pages = 1703-6 | month = Oct | year = 2011 | doi = 10.3174/ajnr.A2569 | PMID = 21757520 }}</ref>
===Image===
===Image===
<gallery>
<gallery>
Image:Oncocytoma_of_the_Salivary_Gland.jpg | Salivary gland oncocytoma (WC/euthman)
Image:Oncocytoma_of_the_Salivary_Gland.jpg | Salivary gland oncocytoma (WC/euthman)
</gallery>
</gallery>
===Microscopic===
==Microscopic==
Features:
Features:
*Like [[oncocytoma]]s elsewhere.  
*Like [[oncocytoma]]s elsewhere.  
**Eosinophilic cytoplasm (on [[H&E stain]]).
**Abundant eosinophilic cytoplasm (on [[H&E stain]]).
***Due to increased number of mitochrondria.
***Due to increased number of mitochrondria.
**Fine capillaries.
**Fine capillaries.
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DDx:
DDx:
*[[Warthin tumour]] - have lymphocytes, classical bilayer.
*[[Acinic cell carcinoma]].
*[[Acinic cell carcinoma]].
*Metastatic [[renal cell carcinoma]] - esp. [[chromophobe renal cell carcinoma]].
*Oncocytic carcinoma.
*[[Granular cell tumour]].


===Images===
===Images===
Line 42: Line 81:
==IHC==
==IHC==
*p63 +ve<ref name=pmid20614263>{{Cite journal  | last1 = McHugh | first1 = JB. | last2 = Hoschar | first2 = AP. | last3 = Dvorakova | first3 = M. | last4 = Parwani | first4 = AV. | last5 = Barnes | first5 = EL. | last6 = Seethala | first6 = RR. | title = p63 immunohistochemistry differentiates salivary gland oncocytoma and oncocytic carcinoma from metastatic renal cell carcinoma. | journal = Head Neck Pathol | volume = 1 | issue = 2 | pages = 123-31 | month = Dec | year = 2007 | doi = 10.1007/s12105-007-0031-4 | PMID = 20614263 | PMC = 2807526}}</ref> focally in nucleus.
*p63 +ve<ref name=pmid20614263>{{Cite journal  | last1 = McHugh | first1 = JB. | last2 = Hoschar | first2 = AP. | last3 = Dvorakova | first3 = M. | last4 = Parwani | first4 = AV. | last5 = Barnes | first5 = EL. | last6 = Seethala | first6 = RR. | title = p63 immunohistochemistry differentiates salivary gland oncocytoma and oncocytic carcinoma from metastatic renal cell carcinoma. | journal = Head Neck Pathol | volume = 1 | issue = 2 | pages = 123-31 | month = Dec | year = 2007 | doi = 10.1007/s12105-007-0031-4 | PMID = 20614263 | PMC = 2807526}}</ref> focally in nucleus.
*DOG1 -ve.<ref name=pmid26425134>{{Cite journal  | last1 = Canberk | first1 = S. | last2 = Onenerk | first2 = M. | last3 = Sayman | first3 = E. | last4 = Goret | first4 = CC. | last5 = Erkan | first5 = M. | last6 = Atasoy | first6 = T. | last7 = Kilicoglu | first7 = GZ. | title = Is DOG1 really useful in the diagnosis of salivary gland acinic cell carcinoma? - A DOG1 (clone K9) analysis in fine needle aspiration cell blocks and the review of the literature. | journal = Cytojournal | volume = 12 | issue =  | pages = 18 | month =  | year = 2015 | doi = 10.4103/1742-6413.162774 | PMID = 26425134 }}</ref>
*PAX8 -ve.<ref name=pmid24771139>{{cite journal |authors=Butler RT, Alderman MA, Thompson LD, McHugh JB |title=Evaluation of PAX2 and PAX8 expression in salivary gland neoplasms |journal=Head Neck Pathol |volume=9 |issue=1 |pages=47–50 |date=March 2015 |pmid=24771139 |pmc=4382472 |doi=10.1007/s12105-014-0546-4 |url=}}</ref>
==EM==
*Increased numbers of mitochondria.
==Sign out==
<pre>
Nodule, Right Parotid Gland, Core Biopsy:
- ONCOCYTOMA.
Comment:
The tumour stains as follows:
POSITIVE: p63 (focal, nuclear).
NEGATIVE: CD10, RCC, S-100, CD68, vimentin.
</pre>
===Micro===
The sections show cells with abundant eosinophilic cytoplasm and bland round nuclei in a tubular architecture. Mitotic activity is not readily apparent. Significant nuclear atypia is absent.


==See also==
==See also==

Latest revision as of 17:23, 25 March 2021

Oncocytoma of the salivary gland
Diagnosis in short

Salivary gland oncocytoma. H&E stain. (WC/Nephron)
Synonyms salivary gland oncocytoma
LM abundant eosinophilic cytoplasm; architecture: solid, trabecular or duct-like
LM DDx acinic cell carcinoma, metastatic renal cell carcinoma, oncocytic carcinoma, granular cell tumour
IHC p63 +ve
EM increased numbers of mitochondria
Site salivary gland
Prevalence very rare
Radiology blends with normal salivary gland on T1 postcontrast and fat-saturated T2 MR images
Prognosis benign
Clin. DDx other salivary gland tumours

Oncocytoma of the salivary gland (also salivary gland oncocytoma) is a rare benign tumour of the salivary glands.

General

  • No risk of malignant transformation.
  • Rare ~20 reported in literature.[1]
  • Thought to be ~1% of all salivary gland tumours.
  • Typical age: 60s-80s.
  • Associated with radiation exposure.
  • Major salivary glands - usually parotid gland.[2]
  • Case report of oncocytoma of parotid as manifestation of Birt-Hogg-Dubé syndrome.[3]

Gross

  • Golden brown appearance.

Note:

  • "Disappear" into background salivary gland on MRI: isointense to normal on fat-saturated T2 and T1 postcontrast images.[4]

Image

  • Salivary gland oncocytoma (WC/euthman)

Microscopic

Features:

  • Like oncocytomas elsewhere.
    • Abundant eosinophilic cytoplasm (on H&E stain).
      • Due to increased number of mitochrondria.
    • Fine capillaries.
  • Architecture: solid sheets, trabeculae or duct-like structure.[2]

Notes:

  • May have clear cell change.
  • Multiple small incidental lesions = oncocytosis - not oncocytoma.

DDx:

Images

www:

  • Parotid gland oncocytoma - intermed. mag. (WC/Nephron)

  • Parotid gland oncocytoma - high mag. (WC/Nephron)

  • Parotid gland oncocytoma - very high mag. (WC/Nephron)

IHC

  • p63 +ve[5] focally in nucleus.
  • DOG1 -ve.[6]
  • PAX8 -ve.[7]

EM

  • Increased numbers of mitochondria.

Sign out

Nodule, Right Parotid Gland, Core Biopsy:
- ONCOCYTOMA.

Comment:
The tumour stains as follows:
POSITIVE: p63 (focal, nuclear).
NEGATIVE: CD10, RCC, S-100, CD68, vimentin.

Micro

The sections show cells with abundant eosinophilic cytoplasm and bland round nuclei in a tubular architecture. Mitotic activity is not readily apparent. Significant nuclear atypia is absent.

See also

References

  1. ↑ Uzunkulaoğlu H, Yazici H, Can IH, Doğan S, Uzunkulaoğlu T (May 2012). "Bilateral oncocytoma in the parotid gland". J Craniofac Surg 23 (3): e246–7. doi:10.1097/SCS.0b013e31824dfccd. PMID 22627459.
  2. ↑ 2.0 2.1 Zhou, CX.; Gao, Y. (Dec 2009). "Oncocytoma of the salivary glands: a clinicopathologic and immunohistochemical study.". Oral Oncol 45 (12): e232-8. doi:10.1016/j.oraloncology.2009.08.004. PMID 19796983.
  3. ↑ Yoshida K, Miyagawa M, Kido T, Ide K, Sano Y, Sugawara Y, Takahata H, Monden N, Furuya M, Mochizuki T (2018). "Parotid Oncocytoma as a Manifestation of Birt-Hogg-Dubé Syndrome". Case Rep Radiol 2018: 6265175. doi:10.1155/2018/6265175. PMC 6008813. PMID 29971177. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008813/.
  4. ↑ Patel, ND.; van Zante, A.; Eisele, DW.; Harnsberger, HR.; Glastonbury, CM. (Oct 2011). "Oncocytoma: the vanishing parotid mass.". AJNR Am J Neuroradiol 32 (9): 1703-6. doi:10.3174/ajnr.A2569. PMID 21757520.
  5. ↑ 5.0 5.1 McHugh, JB.; Hoschar, AP.; Dvorakova, M.; Parwani, AV.; Barnes, EL.; Seethala, RR. (Dec 2007). "p63 immunohistochemistry differentiates salivary gland oncocytoma and oncocytic carcinoma from metastatic renal cell carcinoma.". Head Neck Pathol 1 (2): 123-31. doi:10.1007/s12105-007-0031-4. PMC 2807526. PMID 20614263. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2807526/.
  6. ↑ Canberk, S.; Onenerk, M.; Sayman, E.; Goret, CC.; Erkan, M.; Atasoy, T.; Kilicoglu, GZ. (2015). "Is DOG1 really useful in the diagnosis of salivary gland acinic cell carcinoma? - A DOG1 (clone K9) analysis in fine needle aspiration cell blocks and the review of the literature.". Cytojournal 12: 18. doi:10.4103/1742-6413.162774. PMID 26425134.
  7. ↑ Butler RT, Alderman MA, Thompson LD, McHugh JB (March 2015). "Evaluation of PAX2 and PAX8 expression in salivary gland neoplasms". Head Neck Pathol 9 (1): 47–50. doi:10.1007/s12105-014-0546-4. PMC 4382472. PMID 24771139. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382472/.
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