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The '''salivary glands''' help digest food. ENT surgeons take 'em out and want you to diagnose 'em. [[Cytopathology]] of the salivary glands is covered in the ''[[Head and neck cytopathology]]'' article. | The '''salivary glands''' help digest food. ENT surgeons take 'em out and want you to diagnose 'em. [[Cytopathology]] of the salivary glands is covered in the ''[[Head and neck cytopathology]]'' article. | ||
=Normal= | =Normal salivary glands= | ||
==Types of salivary glands== | ==Types of salivary glands== | ||
Types of glands:<ref>[http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Oral/oral.htm#LABSALIVA http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Oral/oral.htm#LABSALIVA]</ref> | Types of glands:<ref>[http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Oral/oral.htm#LABSALIVA http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Oral/oral.htm#LABSALIVA]</ref> | ||
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| [[adenoid cystic carcinoma]] | | [[adenoid cystic carcinoma]] | ||
| occ. encapsulated, <br>mixed pop. of glandular, <br>myoepithelial and mesenchymal cells | | occ. encapsulated, <br>mixed pop. of glandular, <br>myoepithelial and mesenchymal cells | ||
| [ | | [[Image:Pleomorphic_adenoma_(1)_parotid_gland.jpg | thumb | center |150px| PA. (WP)]] | ||
|- | |- | ||
|[[Warthin tumour]] | |[[Warthin tumour]] | ||
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| [[sebaceous lymphadenoma]] | | [[sebaceous lymphadenoma]] | ||
| AKA ''papillary cystadenoma lymphomatosum'' | | AKA ''papillary cystadenoma lymphomatosum'' | ||
| [ | | [[Image:Papillary_cystadenoma_lymphomatosum2.jpg| thumb| center | 150px| PCL. (WP/Nephron)]] | ||
|- | |- | ||
|[[Basal cell adenoma]] | |[[Basal cell adenoma]] | ||
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| SCC (?) | | SCC (?) | ||
| IHC: p63+ | | IHC: p63+ | ||
| [ | | [[Image:Mucoepidermoid_carcinoma_%282%29_HE_stain.jpg |thumb| center| 150px | MEC. (WC)]] | ||
|- | |- | ||
|[[Adenoid cystic carcinoma]] (AdCC) | |[[Adenoid cystic carcinoma]] (AdCC) | ||
Line 132: | Line 132: | ||
| [[pleomorphic adenoma]], [[PLGA]] | | [[pleomorphic adenoma]], [[PLGA]] | ||
| Stains: PAS+ (pseudocyst material), CD117+, cyclin D1+ | | Stains: PAS+ (pseudocyst material), CD117+, cyclin D1+ | ||
| [ | | [[Image:Adenoid_cystic_carcinoma_-_high_mag.jpg|thumb|center|150px| AdCC. (WC/Nephron)]] | ||
|- | |- | ||
|[[Acinic cell carcinoma]] (AcCC) | |[[Acinic cell carcinoma]] (AcCC) | ||
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| adenocarcinoma not otherwise specified, [[oncocytoma of salivary gland]] | | adenocarcinoma not otherwise specified, [[oncocytoma of salivary gland]] | ||
| Stains: PAS +ve, PAS-D +ve; [[IHC]]: S-100 -ve, p63 -ve | | Stains: PAS +ve, PAS-D +ve; [[IHC]]: S-100 -ve, p63 -ve | ||
| [ | | [[Image:Acinic_cell_carcinoma_-_high_mag.jpg | thumb| center|150px| AcCC. (WC/Nephron)]] | ||
|- | |- | ||
|[[Salivary duct carcinoma]] | |[[Salivary duct carcinoma]] | ||
Line 152: | Line 152: | ||
| metastatic breast carcinoma | | metastatic breast carcinoma | ||
| similar to ductal<br>breast carcinoma; male>female | | similar to ductal<br>breast carcinoma; male>female | ||
| [ | | [[Image:Salivary_duct_carcinoma_-a-_low_mag.jpg | thumb| center|150px | SDC. (WC/Nephron)]] | ||
|- | |- | ||
|[[Polymorphous low-grade adenocarcinoma]] | |[[Polymorphous low-grade adenocarcinoma]] | ||
Line 162: | Line 162: | ||
| AdCC | | AdCC | ||
| minor salivary gland tumour,<br>often in palate,<br> cytologically monotonous; IHC: S100+, CK+, vim.+, GFAP+/-, BCL2+/- | | minor salivary gland tumour,<br>often in palate,<br> cytologically monotonous; IHC: S100+, CK+, vim.+, GFAP+/-, BCL2+/- | ||
| [ | | [[Image:Polymorphous_low-grade_adenocarcinoma_-_very_low_mag.jpg|thumb|center|150px|PLGA. (WC/Nephron)]] | ||
|- | |- | ||
| [[Epithelial-myoepithelial carcinoma]] | | [[Epithelial-myoepithelial carcinoma]] | ||
Line 172: | Line 172: | ||
| [[AdCC]], [[pleomorphic adenoma]] | | [[AdCC]], [[pleomorphic adenoma]] | ||
| rare | | rare | ||
| [ | | [[Image:Epithelial-myoepithelial_carcinoma_-_high_mag.jpg |thumb|center|150px|EMCa. (WC/Nephron)]] | ||
|- | |- | ||
| [[Basal cell adenocarcinoma]] | | [[Basal cell adenocarcinoma]] | ||
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| [[basal cell adenoma]] | | [[basal cell adenoma]] | ||
| rare, usu. parotid gland, may arise from a basal cell adenoma | | rare, usu. parotid gland, may arise from a basal cell adenoma | ||
| [ | | [[Image:Basal_cell_adenocarcinoma_-_parotid_gland_-_high_mag.jpg|thumb|center|150px|BCA. (WC/Nephron)]] | ||
|} | |} | ||
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*[[Lymphoma]] - especially [[MALT lymphoma]].<ref name=pmid22475637>{{Cite journal | last1 = Beasley | first1 = MJ. | title = Lymphoma of the Thyroid and Head and Neck. | journal = Clin Oncol (R Coll Radiol) | volume = | issue = | pages = | month = Apr | year = 2012 | doi = 10.1016/j.clon.2012.02.010 | PMID = 22475637 }}</ref> | *[[Lymphoma]] - especially [[MALT lymphoma]].<ref name=pmid22475637>{{Cite journal | last1 = Beasley | first1 = MJ. | title = Lymphoma of the Thyroid and Head and Neck. | journal = Clin Oncol (R Coll Radiol) | volume = | issue = | pages = | month = Apr | year = 2012 | doi = 10.1016/j.clon.2012.02.010 | PMID = 22475637 }}</ref> | ||
Image | ====Image==== | ||
<gallery> | |||
Image:Chronic_sialadenitis.jpg | Chronic sialadenitis. (WC/Nephron) | |||
</gallery> | |||
==Salivary gland mucocele== | ==Salivary gland mucocele== | ||
*[[AKA]] ''salivary mucocele''. | *[[AKA]] ''salivary mucocele''. | ||
Line 280: | Line 281: | ||
*[[Signet ring cell carcinoma]] - muciphages may mimic signet ring cells. | *[[Signet ring cell carcinoma]] - muciphages may mimic signet ring cells. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Mucocele_of_lower_lip_%281%29.JPG | Mucocele - low mag. (WC/KGH) | |||
Image:Mucocele_of_lower_lip_%282%29.JPG | Mucocele - high mag. (WC/KGH) | |||
Image:Mucocele_-_low_mag.jpg | Mucocele - low mag. (WC/Nephron) | |||
Image:Mucocele_-_high_mag.jpg | Mucocele - high mag. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://dermatlas.med.jhmi.edu/derm/indexDisplay.cfm?ImageID=292590975 Mucocele (dermatlas.med.jhmi.edu)]. | *[http://dermatlas.med.jhmi.edu/derm/indexDisplay.cfm?ImageID=292590975 Mucocele (dermatlas.med.jhmi.edu)]. | ||
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*[[Epithelial-myoepithelial carcinoma]]. | *[[Epithelial-myoepithelial carcinoma]]. | ||
Images | ====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=== | ===IHC=== | ||
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*[[Pleomorphic adenoma]]. | *[[Pleomorphic adenoma]]. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Myoepithelioma_-_intermed_mag.jpg | Myoepithelioma - intermed. mag. (WC/Nephron) | |||
Image:Myoepithelioma_-_very_high_mag.jpg | Myoepithelioma - very high mag. (WC/Nephron) | |||
</gallery> | |||
===IHC=== | ===IHC=== | ||
Features:<ref name=Ref_DCHH130>{{Ref DCHH|130}}</ref> | Features:<ref name=Ref_DCHH130>{{Ref DCHH|130}}</ref> | ||
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**Cyst within a lymph node. | **Cyst within a lymph node. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Papillary_cystadenoma_lymphomatosum3.jpg | Warthin tumour - high mag. (WC/Nephron) | |||
Image:Papillary_cystadenoma_lymphomatosum2.jpg | Warthin tumour - intermed. mag. (WC/Nephron) | |||
</gallery> | |||
==Sebaceous adenoma== | ==Sebaceous adenoma== | ||
Line 514: | Line 522: | ||
*Lymphoma. | *Lymphoma. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Sebaceous_lymphadenoma_-_low_mag.jpg| Sebaceous lymphadenoma - low mag. (WC/Nephron) | |||
Image:Sebaceous_lymphadenoma_-_high_mag.jpg| Sebaceous lymphadenoma - high mag. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://path.upmc.edu/cases/case281.html Sebaceous lymphadenoma (upmc.edu)]. | |||
==Oncocytoma of the salivary gland== | ==Oncocytoma of the salivary gland== | ||
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*Golden brown appearance. | *Golden brown appearance. | ||
Image | ====Image==== | ||
<gallery> | |||
Image:Oncocytoma_of_the_Salivary_Gland.jpg | Salivary gland oncocytoma (WC/euthman) | |||
</gallery> | |||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features: | ||
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*[[Acinic cell carcinoma]]. | *[[Acinic cell carcinoma]]. | ||
Images | ====Images==== | ||
www: | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2807526/figure/Fig1/ Salivary gland oncocytoma (nih.gov)].<ref name=pmid20614263/> | |||
<gallery> | |||
Image:Parotid_gland_oncocytoma_-_intermed_mag.jpg | Parotid gland oncocytoma - intermed. mag. (WC/Nephron) | |||
Image:Parotid_gland_oncocytoma_-_very_high_mag.jpg | Parotid gland oncocytoma - very high mag. (WC/Nephron) | |||
</gallery> | |||
===IHC=== | ===IHC=== | ||
Line 594: | Line 605: | ||
*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. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Mucoepidermoid_carcinoma_%282%29_HE_stain.jpg | Mucoepidermoid carcinoma 2. (WC) | |||
Image:Mucoepidermoid_carcinoma_%283%29_HE_stain.jpg | Mucoepidermoid carcinoma 3. (WC) | |||
Image:Mucoepidermoid_carcinoma_-_2_-_intermed_mag.jpg | Mucoepidermoid carcinoma - 2 - intermed. mag. (WC/Nephron) | |||
Image:Mucoepidermoid_carcinoma_-_2_-_high_mag.jpg | Mucoepidermoid carcinoma - 2 - high mag. (WC/Nephron) | |||
Image:Mucoepidermoid_carcinoma_-_2a_-_very_high_mag.jpg | Mucoepidermoid carcinoma - 2 - very high mag. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/D2A001-PQ01-M.htm Mucoepidermoid carcinoma (ouhsc.edu)]. | |||
====Subtypes==== | ====Subtypes==== | ||
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*Adenocarcinoma not otherwise specified.<ref name=pmid12608654>{{Cite journal | last1 = Ihrler | first1 = S. | last2 = Blasenbreu-Vogt | first2 = S. | last3 = Sendelhofert | first3 = A. | last4 = Lang | first4 = S. | last5 = Zietz | first5 = C. | last6 = Löhrs | first6 = U. | title = Differential diagnosis of salivary acinic cell carcinoma and adenocarcinoma (NOS). A comparison of (immuno-)histochemical markers. | journal = Pathol Res Pract | volume = 198 | issue = 12 | pages = 777-83 | month = | year = 2002 | doi = | PMID = 12608654 }}</ref> | *Adenocarcinoma not otherwise specified.<ref name=pmid12608654>{{Cite journal | last1 = Ihrler | first1 = S. | last2 = Blasenbreu-Vogt | first2 = S. | last3 = Sendelhofert | first3 = A. | last4 = Lang | first4 = S. | last5 = Zietz | first5 = C. | last6 = Löhrs | first6 = U. | title = Differential diagnosis of salivary acinic cell carcinoma and adenocarcinoma (NOS). A comparison of (immuno-)histochemical markers. | journal = Pathol Res Pract | volume = 198 | issue = 12 | pages = 777-83 | month = | year = 2002 | doi = | PMID = 12608654 }}</ref> | ||
Images: | ====Images==== | ||
<gallery> | |||
Image:Acinic_cell_carcinoma_-_intermed_mag.jpg | AcCC - intermed. mag. (WC/Nephron) | |||
Image:Acinic_cell_carcinoma_-_very_high_mag.jpg | AcCC - very high mag. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?f=0&sort=0&s=20080802170246445 AcCC (surgicalpathologyatlas.com)]. | |||
*[http://www.brown.edu/Courses/Digital_Path/systemic_path/hn/acinic.html AcCC (brown.edu)]. | |||
*[http://www.aciniccell.org/acc_images14.html AcCC (aciniccell.org)] - image collection. | |||
====Grading==== | ====Grading==== | ||
General: | General: | ||
Line 766: | Line 778: | ||
*[[Pleomorphic adenoma]], esp. if encapsulated. | *[[Pleomorphic adenoma]], esp. if encapsulated. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Adenoid_cystic_carcinoma_-_intermed_mag.jpg | AdCC - intermed. mag. (WC/Nephron) | |||
Image:Adenoid_cystic_carcinoma_-a-_very_high_mag.jpg | AdCC - very high mag. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://www.nature.com/modpathol/journal/v16/n12/fig_tab/3880915f2.html Adenoid cystic carcinoma (nature.com)]. | *[http://www.nature.com/modpathol/journal/v16/n12/fig_tab/3880915f2.html Adenoid cystic carcinoma (nature.com)]. | ||
Line 809: | Line 824: | ||
*Apocrine snouts - pseudopod-like/lollipop-like undulations of the cell membrane. | *Apocrine snouts - pseudopod-like/lollipop-like undulations of the cell membrane. | ||
*Decapitation secretions - apocrine snouts (membrane bound blobs of cytoplasm) that have separated from its mother cell. | *Decapitation secretions - apocrine snouts (membrane bound blobs of cytoplasm) that have separated from its mother cell. | ||
Notes: | Notes: | ||
Line 821: | Line 830: | ||
DDx: | DDx: | ||
*[[Carcinoma ex pleomorphic adenoma]] with SDC component. | *[[Carcinoma ex pleomorphic adenoma]] with SDC component. | ||
====Images==== | |||
<gallery> | |||
Image:Salivary_duct_carcinoma_-a-_low_mag.jpg | SDC - low mag. (WC/Nephron) | |||
Image:Salivary_duct_carcinoma_-_low_mag.jpg | SDC - low mag. (WC/Nephron) | |||
Image:Salivary_duct_carcinoma_-_high_mag.jpg | SDC - high mag. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://www.webpathology.com/image.asp?case=122&n=2 Salivary duct carcinoma (webpathology.com)]. | |||
====Subtypes==== | ====Subtypes==== | ||
Line 868: | Line 886: | ||
</ref> | </ref> | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Polymorphous_low-grade_adenocarcinoma_-_very_low_mag.jpg | PLGA - very low mag. (WC/Nephron) | |||
Image:Polymorphous_low-grade_adenocarcinoma_high_mag.jpg | PLGA - high mag. (WC/Nephron) | |||
</gallery> | |||
===IHC=== | ===IHC=== | ||
*S100 +ve, CK +ve, vimentin +ve. | *S100 +ve, CK +ve, vimentin +ve. | ||
Line 949: | Line 968: | ||
**Has focal epithelial-myoepithelial carcinoma-like areas. | **Has focal epithelial-myoepithelial carcinoma-like areas. | ||
Images: | ====Images==== | ||
<gallery> | |||
Image:Epithelial-myoepithelial_carcinoma_-_intermed_mag.jpg | EMCa - intermed. mag. (WC/Nephron) | |||
Image:Epithelial-myoepithelial_carcinoma_-_high_mag.jpg | EMCa - high mag. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://www.pathologyimagesinc.com/sgt-cytopath/epith-myoepith-ca/cytopathology/images-features/emc-rev-cyto1-18.jpg EMCa (pathologyimagesinc.com)].<ref>{{cite web |url=http://www.pathologyimagesinc.com/sgt-cytopath/epith-myoepith-ca/cytopathology/fs-emc-cytopath-feat.html |title=Cytopathologic Features of | |||
Epithelial-myoepithelial Carcinoma |last1= |first1= |last2= |first2= |date= |work= |publisher= |accessdate=January 18, 2011}}</ref> | Epithelial-myoepithelial Carcinoma |last1= |first1= |last2= |first2= |date= |work= |publisher= |accessdate=January 18, 2011}}</ref> | ||
*[http://www.headandneckoncology.org/content/2/1/4 EMCa (headandneckoncology.org)]. | |||
===IHC=== | ===IHC=== | ||
Line 994: | Line 1,014: | ||
*Basaloid [[squamous cell carcinoma]]. | *Basaloid [[squamous cell carcinoma]]. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Basal_cell_adenocarcinoma_-_parotid_gland_-_intermed_mag.jpg | BCAC - intermed. mag. (WC/Nephron) | |||
Image:Basal_cell_adenocarcinoma_-_parotid_gland_-_high_mag.jpg | BCAC - high mag. (WC/Nephron) | |||
Image:Basal_cell_adenocarcinoma_-_2_-_parotid_gland_-_high_mag.jpg | BCAC - high mag. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://www.webpathology.com/image.asp?n=5&Case=115 Basal cell adenocarcinoma - intermed. mag. (webpathology.com)]. | |||
*[http://www.webpathology.com/image.asp?n=6&Case=115 Basal cell adenocarcinoma - high mag. (webpathology.com)]. | |||
===IHC=== | ===IHC=== | ||
Line 1,038: | Line 1,059: | ||
*[[Epithelial-myoepithelial carcinoma]]. | *[[Epithelial-myoepithelial carcinoma]]. | ||
Images: | ====Images==== | ||
<gallery> | |||
Image:Hyalinizing_clear_cell_carcinoma_-_intermed_mag.jpg | HCCC - intermed. mag. (WC/Nephron) | |||
Image:Hyalinizing_clear_cell_carcinoma_-_very_high_mag.jpg | HCCC - very high mag. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811632/figure/Fig2/ HCCC (nlm.nih.gov)]. | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811632/figure/Fig5/ HCCC (nlm.nih.gov)].<ref name=pmid20596970/> | |||
===Stains/IHC=== | ===Stains/IHC=== | ||
*PAS +ve. | *PAS +ve. |
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