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Difference between revisions of "Pleomorphic adenoma"
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# | '''Pleomorphic adenoma''', abbreviated '''PA''', is a very common benign [[salivary gland]] tumour. | ||
==General== | |||
Features: | |||
*Very common - approx. 60% of parotid gland tumours.<ref name=Ref_HaNP295>{{Ref HaNP|295}}</ref> | |||
*May transform into a malignant tumour. | |||
**Other benign salivary gland tumours do not do this. | |||
*Only benign childhood salivary gland tumour of significance. | |||
===Weinreb's dictums=== | |||
#Most common salivary tumour in all age groups. | |||
#Seen in all sites (unlike other benign tumours). | |||
#Recurrence and malignancy risk (unlike other benign salivary gland tumours). | |||
#Any part of a tumour that looks like PA makes it a PA. | |||
==Gross== | |||
*May be cartilaginous appearing. | |||
Image: | |||
*[http://screening.iarc.fr/atlasoral_detail.php?flag=1&lang=1&Id=C0100002&cat=C1 PA in situ (iarc.fr)]. | |||
==Microscopic== | |||
Features:<ref name=Ref_HaNP295>{{Ref HaNP|295}}</ref> | |||
*Proliferation of myoepithelium and epithelium (ductal cells) in mesenchymal stroma. | |||
**Cells in ducts = epithelial. | |||
**Cells not in ducts = myoepithelial.<ref name=IW_10jan2011>IW. 10 January 2011.</ref> | |||
*Mesenchymal stroma - '''important feature'''. | |||
**May be any of following: [[myxoid stroma|myxoid]], mucochondroid, hyalinized, osseous, fatty. | |||
***[[chondromyxoid stroma|Chondroid]] = specific for PA; can diagnose PA without an epithelial (ductal) component if chondroid is present. | |||
***Myxoid = not specific for PA. | |||
Notes: | |||
*Mesenchymal stroma not required for diagnosis -- if >5% ducts.<ref name=IW_10jan2011>IW. 10 January 2011.</ref> | |||
**No chondroid stroma ''and'' <5% ductal cells = '''[[myoepithelioma]]'''. | |||
*Complete excision is often elusive; stating "completely excised" on a surgical pathology report is unwise. | |||
*Look for, i.e. rule-out, poorly differentiated carcinoma: ''carcinoma ex pleomorphic adenoma''. | |||
Memory device: '''MEC''' = '''m'''yoepithelium, '''e'''pithelium, '''c'''hondromyxoid stroma. | |||
DDx: | |||
*[[Myoepithelioma]]. | |||
*[[Carcinoma ex pleomorphic adenoma]]. | |||
*[[Epithelial-myoepithelial carcinoma]]. | |||
===Images=== | |||
<gallery> | |||
Image:Pleomorphic_adenoma_%281%29_parotid_gland.jpg | PA. (WC) | |||
Image:Pleomorphic_adenoma_%282%29_parotid_gland.jpg | PA. (WC) | |||
Image:Pleomorphic_adenoma_%283%29_parotid_gland.jpg | PA. (WC) | |||
Image:Pleomorphic_adenoma_%284%29_parotid_gland.jpg | PA. (WC) | |||
</gallery> | |||
www: | |||
*[http://www.webpathology.com/image.asp?n=7&Case=111 PA - myxoid stroma (webpathology.com)]. | |||
==IHC== | |||
*S-100 +ve, SMA +ve, GFAP +ve. | |||
==See also== | |||
*[[Salivary glands]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Salivary gland]] | |||