Oncocytoma of the salivary gland

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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. ↑ "Parotid Oncocytoma as a Manifestation of Birt-Hogg-Dubé Syndrome". Case Rep Radiol 2018: 6265175. 2018. 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. ↑ "Evaluation of PAX2 and PAX8 expression in salivary gland neoplasms". Head Neck Pathol 9 (1): 47–50. March 2015. doi:10.1007/s12105-014-0546-4. PMC 4382472. PMID 24771139. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382472/.
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