Difference between revisions of "Salivary glands"

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1,206 bytes added ,  02:42, 12 January 2011
+molecular
(+molecular)
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| '''fuffy, clear,<br>abundant'''  
| '''fuffy, clear,<br>abundant'''  
| nuclei sm.
| nuclei sm.
| ?
| SCC (?)
| IHC: p63+
| IHC: p63+
|-
|-
|Acinic cell adenocarcinoma (AcCC)  
|Acinic cell adenocarcinoma (AcCC)  
| acinar (islands)
| sheets, acinar (islands)
| epithelioid
| epithelioid
| clear
| clear
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| stippled, +/-occ. nucleoli
| stippled, +/-occ. nucleoli
| ?
| ?
| ?
| Stains: PAS +ve, PAS-D +ve; [[IHC]]: S-100 -ve, p63 -ve
|-
|-
|Adenoid cystic carcinoma (AdCC)  
|Adenoid cystic carcinoma (AdCC)  
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| scant,<br>hyperchromatic  
| scant,<br>hyperchromatic  
| '''small<br>"carrot-shaped"'''  
| '''small<br>"carrot-shaped"'''  
| ?
| PLGA
| ?
| IHC: C-kit+, cyclin D1+
|-
|-
|Salivary duct carcinoma  
|Salivary duct carcinoma  
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| hyperchromatic  
| hyperchromatic  
| columnar  
| columnar  
| metastatic breast ca
| metastatic breast carcinoma
| similar to ductal<br>breast carcinoma
| similar to ductal<br>breast carcinoma; male>female
|-
|-
|Polymorphous low-grade adenocarcinoma  
|Polymorphous low-grade adenocarcinoma  
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| '''eosinophilic'''  
| '''eosinophilic'''  
| ovoid & small with<br>small nucleoli  
| ovoid & small with<br>small nucleoli  
| ?
| 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+/-
|-
|-
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Scoring:
Scoring:
*Low grade: 0-4 points.
*Low grade = 0-4 points.
*Intermediate grade: 5 or 6 points.
*Intermediate grade = 5-6 points.
*High grade: 7+ points.
*High grade = 7+ points.
 
======Weinreb modification======
Weinreb looks for the following:
*Tumour invades in small nests/islands - 2 points.
**If applicable, the two points are added to the AFIP score.
**The tumour is graded using the AFIP (scoring) cut points -- see above.


===Stains===
===Stains===
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*Alcian blue +ve.
*Alcian blue +ve.
*Mucicarcmine +ve.
*Mucicarcmine +ve.
===Molecular===
*t(11;19)(q21;p13) -- MECT1-MAML2 fusion.<ref name=pmid12539049>{{cite journal |author=Tonon G, Modi S, Wu L, ''et al.'' |title=t(11;19)(q21;p13) translocation in mucoepidermoid carcinoma creates a novel fusion product that disrupts a Notch signaling pathway |journal=Nat. Genet. |volume=33 |issue=2 |pages=208–13 |year=2003 |month=February |pmid=12539049 |doi=10.1038/ng1083 |url=}}</ref><ref name=pmid20588178>{{cite journal |author=Seethala RR, Dacic S, Cieply K, Kelly LM, Nikiforova MN |title=A reappraisal of the MECT1/MAML2 translocation in salivary mucoepidermoid carcinomas |journal=Am. J. Surg. Pathol. |volume=34 |issue=8 |pages=1106–21 |year=2010 |month=August |pmid=20588178 |doi=10.1097/PAS.0b013e3181de3021 |url=}}</ref>
**Present in ~65% of MECs.
**Presence assoc. with low-grade MEC (vs. high-grade MEC) & favourable prognosis.
**Not seen in tumours that are in the DDx of MEC.


==Acinic cell adenocarcinoma==
==Acinic cell adenocarcinoma==
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===IHC===
===IHC===
Features:<ref name=pmid19360297>{{Cite journal  | last1 = Sequeiros-Santiago | first1 = G. | last2 = García-Carracedo | first2 = D. | last3 = Fresno | first3 = MF. | last4 = Suarez | first4 = C. | last5 = Rodrigo | first5 = JP. | last6 = Gonzalez | first6 = MV. | title = Oncogene amplification pattern in adenoid cystic carcinoma of the salivary glands. | journal = Oncol Rep | volume = 21 | issue = 5 | pages = 1215-22 | month = May | year = 2009 | doi =  | PMID = 19360297 }}</ref>
Features:<ref name=pmid19360297>{{Cite journal  | last1 = Sequeiros-Santiago | first1 = G. | last2 = García-Carracedo | first2 = D. | last3 = Fresno | first3 = MF. | last4 = Suarez | first4 = C. | last5 = Rodrigo | first5 = JP. | last6 = Gonzalez | first6 = MV. | title = Oncogene amplification pattern in adenoid cystic carcinoma of the salivary glands. | journal = Oncol Rep | volume = 21 | issue = 5 | pages = 1215-22 | month = May | year = 2009 | doi =  | PMID = 19360297 }}</ref>
*CD117 (C-kit) +ve.
*CD117 +ve.
*Cyclin D1 +ve.
*Cyclin D1 +ve.
Memory device: the '''Cs''' of AdCC: '''C'''-kit+, '''c'''yclin D1+.


==Salivary duct carcinoma==
==Salivary duct carcinoma==
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