Difference between revisions of "Salivary glands"

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==Salivary duct carcinoma==
==Salivary duct carcinoma==
===General===
{{Main|Salivary duct carcinoma}}
*Malignant counterpart of ''salivary duct adenoma''.
*Male:female ~= 4:1.
*Dismal prognosis.<ref name=pmid21393874>{{Cite journal  | last1 = Rajesh | first1 = NG. | last2 = Prayaga | first2 = AK. | last3 = Sundaram | first3 = C. | title = Salivary duct carcinoma: correlation of morphologic features by fine needle aspiration cytology and histopathology. | journal = Indian J Pathol Microbiol | volume = 54 | issue = 1 | pages = 37-41 | month =  | year =  | doi = 10.4103/0377-4929.77321 | PMID = 21393874 | url = http://www.ijpmonline.org/text.asp?2011/54/1/37/77321 }}</ref>
*Typically >50 years old.
*Mostly in the parotid.
 
===Microscopic===
Features - resembles ductal breast carcinoma:<ref name=pmid21393874/>
*Architecture: sheets, nests, cords, cribriform, micropapillary.
*Neoplastic cells line-up around cystic spaces "Roman bridges".
*Nuclear atypia (variation in size, shape, staining).
*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.
 
Notes:
*Similar to ductal breast carcinoma - '''key to remember'''.
 
DDx:
*[[Carcinoma ex pleomorphic adenoma]] with SDC component.
 
====Images====
<gallery>
Image:Salivary duct carcinoma - very low mag.jpg | SDC - very low mag. (WC/Nephron)
Image:Salivary_duct_carcinoma_-_low_mag.jpg | SDC - low mag. (WC/Nephron)
Image:Salivary duct carcinoma - intermed mag.jpg | SDC - intermed. mag. (WC/Nephron)
Image:Salivary_duct_carcinoma_-_high_mag.jpg | SDC - high mag. (WC/Nephron)
Image:Salivary duct carcinoma - very high mag.jpg | SDC - very high mag. (WC/Nephron)
</gallery>
<gallery>
Image:Salivary_duct_carcinoma_-a-_low_mag.jpg | SDC - low mag. (WC/Nephron)
Image:Salivary duct carcinoma -a- intermed mag.jpg | SDC - intermed. mag. (WC/Nephron)
</gallery>
www:
*[http://www.webpathology.com/image.asp?case=122&n=2 Salivary duct carcinoma (webpathology.com)].
 
====Subtypes====
*Conventional.
*Mucinous - worse prognosis; opposite of what would one expect from the outcomes in [[breast cancer]].
*Micropapillary - assoc. with a poor prognosis.
*Sarcomatoid/spindle cell.
 
===IHC===
*LMWK, EMA, CK7, CK19 +ve.
*p63 -ve.
*Androgen receptor +ve.
*BRST2 (GCDFP-15) +ve.
*HER2 +ve ~21%; use of [[trastuzumab]] (Herceptin) not systematically studied.
 
Curiosity:
*PSA +/-.
*PSAP +/-.
*ER-beta +ve.<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/MajorSalGlands_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/MajorSalGlands_11protocol.pdf]. Accessed on: 3 April 2012.</ref>
*ER-alpha -ve (the common ''ER'' stain).


==Polymorphous low-grade adenocarcinoma==
==Polymorphous low-grade adenocarcinoma==
Michael
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