Difference between revisions of "Polymorphous adenocarcinoma"
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| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = | ||
| Prevalence = | | Prevalence = uncommon (varies by study) | ||
| Bloodwork = | | Bloodwork = | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = | | Prognosis = good | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = | ||
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==General== | ==General== | ||
*Female:male ~= 2:1. | *Female:male ~= 2:1. | ||
*Older people ~50-70 years old. | *Older people ~50-70 years old. | ||
*Large variably in the prevalence reported - suggests a lacking of reproducibility in the [[diagnosis]].<ref name=pmid23320410/> | |||
*Slow growing - metastases rare - prognosis good.<ref name=pmid18327037>{{Cite journal | last1 = Paleri | first1 = V. | last2 = Robinson | first2 = M. | last3 = Bradley | first3 = P. | title = Polymorphous low-grade adenocarcinoma of the head and neck. | journal = Curr Opin Otolaryngol Head Neck Surg | volume = 16 | issue = 2 | pages = 163-9 | month = Apr | year = 2008 | doi = 10.1097/MOO.0b013e3282f70441 | PMID = 18327037 }}</ref><ref name=pmid23618791>{{Cite journal | last1 = Fife | first1 = TA. | last2 = Smith | first2 = B. | last3 = Sullivan | first3 = CA. | last4 = Browne | first4 = JD. | last5 = Waltonen | first5 = JD. | title = Polymorphous low-grade adenocarcinoma: a 17 patient case series. | journal = Am J Otolaryngol | volume = 34 | issue = 5 | pages = 445-8 | month = | year = | doi = 10.1016/j.amjoto.2013.03.012 | PMID = 23618791 }}</ref> | |||
==Gross== | |||
*Tumour of the minor [[salivary gland]]s.<ref name=pmid24021444>{{Cite journal | last1 = Andreu-Barasoain | first1 = M. | last2 = Vicente-Martín | first2 = FJ. | last3 = Gómez de la Fuente | first3 = E. | last4 = Salamanca-Santamaría | first4 = J. | last5 = Pampín-Franco | first5 = A. | last6 = López-Estebaranz | first6 = JL. | title = Polymorphous low-grade adenocarcinoma in the upper lip: a well-described but infrequently recognized tumor. | journal = Dermatol Online J | volume = 19 | issue = 8 | pages = 19265 | month = | year = 2013 | doi = | PMID = 24021444 }}</ref> | |||
*Almost exclusively in the [[oral cavity]] - usually palate.<ref name=pmid18327037/> | |||
==Microscopic== | ==Microscopic== | ||
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**Cytoplasm: eosinophilic. | **Cytoplasm: eosinophilic. | ||
*Indistinct cell borders. | *Indistinct cell borders. | ||
Note: | |||
*'''Always'''' a low-grade tumour - by definition. | |||
DDx: | DDx: | ||
Revision as of 16:59, 23 November 2013
| Polymorphous adenocarcinoma | |
|---|---|
| Diagnosis in short | |
 PLGA. H&E stain. | |
|
| |
| LM | low-grade cytology - nuclei ovoid & small, small nucleoli, powdery chromatin (papillary thyroid carcinoma-like appearance); eosinophilic cytoplasm; variable architecture - often small nests, classically has whorling ("eye-of-storm") pattern and single file pattern |
| LM DDx | adenoid cystic carcinoma, pleomorphic adenoma, cribriform adenocarcinoma of the minor salivary gland |
| IHC | S-100 +ve, CK7 +ve, vimentin +ve |
| Site | oral cavity, salivary gland |
|
| |
| Prevalence | uncommon (varies by study) |
| Prognosis | good |
Polymorphous low-grade adenocarcinoma, abbreviated PLGA, is a rare malignant salivary gland tumour.
General
- Female:male ~= 2:1.
- Older people ~50-70 years old.
- Large variably in the prevalence reported - suggests a lacking of reproducibility in the diagnosis.[1]
- Slow growing - metastases rare - prognosis good.[2][3]
Gross
- Tumour of the minor salivary glands.[4]
- Almost exclusively in the oral cavity - usually palate.[2]
Microscopic
Features:[5]
- Architecture: often small nests, may be targetoid.
- Classically has whorling with eye-of-storm & single file.
- Cytologically monotonous (uniform) with variable architecture - key feature.
- Nucleus: ovoid & small, small nucleoli, powdery chromatin.
- Papillary thyroid carcinoma-like appearance.
- Cytoplasm: eosinophilic.
- Nucleus: ovoid & small, small nucleoli, powdery chromatin.
- Indistinct cell borders.
Note:
- Always' a low-grade tumour - by definition.
DDx:
- Adenoid cystic carcinoma.
- Pleomorphic adenoma.
- Cribriform adenocarcinoma of the minor salivary gland.[6]
Images
PLGA - very low mag. (WC/Nephron)
PLGA - high mag. (WC/Nephron)
IHC
Features:[1]
- S-100 +ve.
- CK7 +ve.
- Vimentin +ve.
Others:
- GFAP +ve/-ve.
- BCL2 +ve/-ve.
- Generally negative for myoepithelial markers (calponin, actin) - useful if negative.
See also
References
- ↑ 1.0 1.1 de Araujo, VC.; Passador-Santos, F.; Turssi, C.; Soares, AB.; de Araujo, NS. (2013). "Polymorphous low-grade adenocarcinoma: an analysis of epidemiological studies and hints for pathologists.". Diagn Pathol 8: 6. doi:10.1186/1746-1596-8-6. PMID 23320410.
- ↑ 2.0 2.1 Paleri, V.; Robinson, M.; Bradley, P. (Apr 2008). "Polymorphous low-grade adenocarcinoma of the head and neck.". Curr Opin Otolaryngol Head Neck Surg 16 (2): 163-9. doi:10.1097/MOO.0b013e3282f70441. PMID 18327037.
- ↑ Fife, TA.; Smith, B.; Sullivan, CA.; Browne, JD.; Waltonen, JD.. "Polymorphous low-grade adenocarcinoma: a 17 patient case series.". Am J Otolaryngol 34 (5): 445-8. doi:10.1016/j.amjoto.2013.03.012. PMID 23618791.
- ↑ Andreu-Barasoain, M.; Vicente-Martín, FJ.; Gómez de la Fuente, E.; Salamanca-Santamaría, J.; Pampín-Franco, A.; López-Estebaranz, JL. (2013). "Polymorphous low-grade adenocarcinoma in the upper lip: a well-described but infrequently recognized tumor.". Dermatol Online J 19 (8): 19265. PMID 24021444.
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 74. ISBN 978-0781765275.
- ↑ Skalova, A.; Sima, R.; Kaspirkova-Nemcova, J.; Simpson, RH.; Elmberger, G.; Leivo, I.; Di Palma, S.; Jirasek, T. et al. (Aug 2011). "Cribriform adenocarcinoma of minor salivary gland origin principally affecting the tongue: characterization of new entity.". Am J Surg Pathol 35 (8): 1168-76. doi:10.1097/PAS.0b013e31821e1f54. PMID 21716087.