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Difference between revisions of "Salivary glands"
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*Proliferation of myoepithelium and epithelium (ductal cells) in mesenchymal stroma. | *Proliferation of myoepithelium and epithelium (ductal cells) in mesenchymal stroma. | ||
**Cells in ducts = epithelial. | **Cells in ducts = epithelial. | ||
**Cells not in ducts = myoepithelial.<ref>IW. 10 January 2011.</ref> | **Cells not in ducts = myoepithelial.<ref name=IW_10jan2011>IW. 10 January 2011.</ref> | ||
*Mesenchymal stroma - '''important feature'''. | *Mesenchymal stroma - '''important feature'''. | ||
**May be any of following: [[myxoid stroma|myxoid]], mucochondroid, hyalinized, osseous, fatty. | **May be any of following: [[myxoid stroma|myxoid]], mucochondroid, hyalinized, osseous, fatty. | ||
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Notes: | Notes: | ||
*Mesenchymal stroma not required for diagnosis -- if >5% ducts.<ref>IW. 10 January 2011.</ref> | *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]]'''. | **No chondroid stroma ''and'' <5% ductal cells = '''[[myoepithelioma]]'''. | ||
*Complete excision is often elusive; stating "completely excised" on a surgical pathology report is unwise. | *Complete excision is often elusive; stating "completely excised" on a surgical pathology report is unwise. | ||
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Notes: | Notes: | ||
*The classic description - composed of 3 cell types: epidermoid, intermediate, and mucin producing.<ref>{{Cite journal | last1 = Lennerz | first1 = JK. | last2 = Perry | first2 = A. | last3 = Mills | first3 = JC. | last4 = Huettner | first4 = PC. | last5 = Pfeifer | first5 = JD. | title = Mucoepidermoid carcinoma of the cervix: another tumor with the t(11;19)-associated CRTC1-MAML2 gene fusion. | journal = Am J Surg Pathol | volume = 33 | issue = 6 | pages = 835-43 | month = Jun | year = 2009 | doi = 10.1097/PAS.0b013e318190cf5b | PMID = 19092631 }}</ref> | *The classic description - composed of 3 cell types: epidermoid, intermediate, and mucin producing.<ref>{{Cite journal | last1 = Lennerz | first1 = JK. | last2 = Perry | first2 = A. | last3 = Mills | first3 = JC. | last4 = Huettner | first4 = PC. | last5 = Pfeifer | first5 = JD. | title = Mucoepidermoid carcinoma of the cervix: another tumor with the t(11;19)-associated CRTC1-MAML2 gene fusion. | journal = Am J Surg Pathol | volume = 33 | issue = 6 | pages = 835-43 | month = Jun | year = 2009 | doi = 10.1097/PAS.0b013e318190cf5b | PMID = 19092631 }}</ref> | ||
**"Intermediate cells" are described in textbooks. Weinreb thinks they are a pretty much a myth.<ref>IW. 10 January 2011.</ref> | **"Intermediate cells" are described in textbooks. Weinreb thinks they are a pretty much a myth.<ref name=IW_10jan2011>IW. 10 January 2011.</ref> | ||
*Mucin vacuoles may be rare; in a superficial glance -- it may mimic [[squamous cell carcinoma]]. | *Mucin vacuoles may be rare; in a superficial glance -- it may mimic [[squamous cell carcinoma]]. | ||
*The thought of high-grade MEC should prompt consideration of squamous cell carcinoma. | *The thought of high-grade MEC should prompt consideration of squamous cell carcinoma. | ||
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*Adipose tissue -- present in the salivary glands -- is absent in AcCC. | *Adipose tissue -- present in the salivary glands -- is absent in AcCC. | ||
*May focally resemble thyroid tissue. | *May focally resemble thyroid tissue. | ||
*Smaller (characteristic) microvacuoles (unreported in the literature) may be present that have a bubbly appearance and glassy basophilic inclusions.<ref>IW. 11 January 2011.</ref> | *Smaller (characteristic) microvacuoles (unreported in the literature) may be present that have a bubbly appearance and glassy basophilic inclusions.<ref name=IW_10jan2011>IW. 11 January 2011.</ref> | ||
Memory device: | Memory device: | ||
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*Done to avoid phone calls from clinician. | *Done to avoid phone calls from clinician. | ||
Factors Weinreb uses:<ref>IW. 11 January 2011.</ref> | Factors Weinreb uses:<ref name=IW_10jan2011>IW. 11 January 2011.</ref> | ||
*Necrosis. | *Necrosis. | ||
*Nuclear atypia. | *Nuclear atypia. | ||
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**p63 +ve in mucoepidermoid carcinoma. | **p63 +ve in mucoepidermoid carcinoma. | ||
There are a bunch of other stains that are touted to be useful (amylase, anti-chymotrypsin, lactoferrin); Weinreb thinks they are not helpful.<ref>IW. 11 January 2011.</ref> | There are a bunch of other stains that are touted to be useful (amylase, anti-chymotrypsin, lactoferrin); Weinreb thinks they are not helpful.<ref name=IW_10jan2011>IW. 11 January 2011.</ref> | ||
==Adenoid cystic carcinoma== | ==Adenoid cystic carcinoma== | ||