Polymorphous adenocarcinoma
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Polymorphous low-grade adenocarcinoma, abbreviated PLGA, is a rare malignant salivary gland tumour.
| 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 |
| Site | oral cavity, salivary gland |
|
| |
| Prevalence | rare |
General
- Almost exclusively in the oral cavity.
- Classically found in the palate -- 60% of PLGAs in palate.
- Tumour of the minor salivary glands.
- Always a low-grade tumour - by definition.
- Female:male ~= 2:1.
- Older people ~50-70 years old.
Microscopic
Features:[1]
- 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.
DDx:
- Adenoid cystic carcinoma.
- Pleomorphic adenoma.
- Cribriform adenocarcinoma of the minor salivary gland.[2]
Images
PLGA - very low mag. (WC/Nephron)
PLGA - high mag. (WC/Nephron)
IHC
Features:[3]
- S100 +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
- ↑ 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.
- ↑ 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.