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Original Article
- Frequent apocrine changes in pleomorphic adenoma with malignant transformation: a possible pre-malignant step in ductal carcinoma ex pleomorphic adenoma
- Joon Seon Song, Yeseul Kim, Yoon-Se Lee, Seung-Ho Choi, Soon Yuhl Nam, Sang Yoon Kim, Kyung-Ja Cho
- J Pathol Transl Med. 2023;57(3):158-165. Published online May 10, 2023
- DOI: https://doi.org/10.4132/jptm.2023.03.13
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- 196 Download
- 4 Web of Science
- 4 Crossref
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Abstract
PDF - Background
The most common type of carcinoma ex pleomorphic adenoma (CPA) is histologically equivalent to salivary duct carcinoma, which has an apocrine phenotype. Invasive CPA is often accompanied by non-invasive or in situ carcinoma, an observation that suggests the presence of precursor lesions. The aim of this study was to identify candidate precursor lesions of CPA within pleomorphic adenoma (PA).
Methods
Eleven resected cases of CPA with residual PA and 17 cases of PA with atypical changes were subjected to immunohistochemistry (IHC) for p53, human epidermal growth factor receptor 2 (HER2), androgen receptor (AR), pleomorphic adenoma gene 1, gross cystic disease fluid protein-15 (GCDFP-15), and anti-mitochondrial antibody.
Results
Invasive or in situ carcinoma cells in all CPAs were positive for AR, GCDFP-15, and HER2. Atypical foci in PAs corresponded to either apocrine or oncocytic changes on the basis of their reactivity to AR, GCDFP-15, and anti-mitochondrial antibody. Atypical cells in PAs surrounding CPAs had an apocrine phenotype without HER2 expression.
Conclusions
Our study identified frequent apocrine changes in residual PAs in CPA cases, suggesting a possible precursor role of apocrine changes. We recommend the use of HER2 IHC in atypical PAs, and that clinicians take HER2 positivity into serious consideration. -
Citations
Citations to this article as recorded by
- Pleomorphic Adenoma with Epithelial Atypia, Apocrine Metaplasia, and/or In situ/Intracapsular Salivary Duct Carcinoma Are Indolent Lesions with Good Prognosis: A Proposal for Unified Nomenclature and Clinical Observation
Grayson G. Cole, Matt Levin, David Ferber, Spencer C. Roark, Peter M. Sadow, Daniel Lubin, Julie Guilmette, Jason R. Pettus, Adam S. Fisch, Dipti P. Sajed, Fouad R. Zakka, Mark W. Lingen, Nicole A. Cipriani
Head and Neck Pathology.2025;[Epub] CrossRef - Progression of Nasopharyngeal Pleomorphic Adenoma to Carcinoma Ex Pleomorphic Adenoma With Metastases: A Case Report
Krystsina Zhukovich, Alisher Tashbayev, Vladimir Osipov
Cureus.2025;[Epub] CrossRef - Carcinoma Ex Pleomorphic Adenoma of the Palate in a Young Female: A Rare and Aggressive Malignant Transformation
Sakshi Akolkar, Alka Hande, Archana Sonone, Husna Tehzeeb
Journal of Datta Meghe Institute of Medical Sciences University.2025; 20(4): 919. CrossRef - Characterization of a Molecularly Distinct Subset of Oncocytic Pleomorphic Adenomas/Myoepitheliomas Harboring Recurrent ZBTB47-AS1::PLAG1 Gene Fusion
Ziyad Alsugair, Jimmy Perrot, Françoise Descotes, Jonathan Lopez, Anne Champagnac, Daniel Pissaloux, Claire Castain, Mihaela Onea, Philippe Céruse, Pierre Philouze, Charles Lépine, Marie-Delphine Lanic, Marick Laé, Valérie Costes-Martineau, Nazim Benzerdj
American Journal of Surgical Pathology.2024; 48(5): 551. CrossRef
- Pleomorphic Adenoma with Epithelial Atypia, Apocrine Metaplasia, and/or In situ/Intracapsular Salivary Duct Carcinoma Are Indolent Lesions with Good Prognosis: A Proposal for Unified Nomenclature and Clinical Observation
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