Difference between revisions of "Salivary glands"

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Salivary glands (view source)

Revision as of 15:28, 10 November 2013

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→‎Pleomorphic adenoma: split-out
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==Pleomorphic adenoma==
==Pleomorphic adenoma==
*Abbreviated ''PA''.
{{Main|Pleomorphic adenoma}}
 
===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.


==Myoepithelioma==
==Myoepithelioma==
Michael
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