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Characterization of undifferentiated carcinoma of the salivary gland: clinicopathological and immunohistochemical analyses in comparison with lymphoepithelial carcinoma
Sangjoon Choi, Gyuheon Choi, Hee Jin Lee, Joon Seon Song, Yoon Se Lee, Seung-Ho Choi, Kyung-Ja Cho
J Pathol Transl Med. 2025;59(6):361-370.   Published online September 8, 2025
DOI: https://doi.org/10.4132/jptm.2025.07.07
  • 2,790 View
  • 258 Download
AbstractAbstract PDF
Background
This study aimed to reclassify a subset of poorly differentiated salivary gland carcinoma that do not conform to any entities of the current World Health Organization (WHO) classification into the category of undifferentiated carcinoma (UDC) because they lack specific histologic differentiation or immunophenotype. Methods: Cases of salivary gland carcinomas from Asan Medical Center (2002–2020) that did not fit any existing WHO classification criteria and were diagnosed as poorly differentiated carcinoma, high-grade carcinoma, or UDC, were retrospectively reviewed. Immunohistochemical (IHC) staining for p40, neuroendocrine markers, androgen receptor (AR), and gross cystic disease fluid protein 15 (GCDFP-15) and Epstein-Barr virus (EBV) in situ hybridization (ISH) were performed. Clinical data were collected from the electronic medical records. Results: Six salivary gland carcinomas did not align with any specific entities and lacked distinct differentiation. Two of six cases displayed lymphoepithelial carcinoma (LEC)-like morphology but were negative or showed negligible immunoreactivity for p40 and EBV ISH, distinguishing them from LEC of the salivary gland. Two cases showed strong AR positivity, suggesting a potential overlap with salivary duct carcinoma (SDC) but lacked classic SDC morphologies and GCDFP-15 expression. No cases expressed neuroendocrine markers. Conclusions: This study proposes reclassifying these poorly differentiated or high-grade salivary gland carcinomas as UDC based on their indeterminate differentiation and IHC profiles. This may lead to a clearer diagnostic category and enhance our understanding of these high-grade tumors.
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Primary Merkel cell carcinoma of the salivary gland: a clinicopathologic study of four cases with a review of literature
Gyuheon Choi, Joon Seon Song, Hee Jin Lee, Gi Hwan Kim, Young Ho Jung, Yoon Se Lee, Kyung-Ja Cho
J Pathol Transl Med. 2025;59(3):171-179.   Published online April 30, 2025
DOI: https://doi.org/10.4132/jptm.2025.03.25
  • 3,580 View
  • 155 Download
  • 1 Crossref
AbstractAbstract PDF
Background
Primary Merkel cell carcinoma of the salivary gland is currently not listed in the World Health Organization classification. However, cases of Merkel cell type neuroendocrine carcinomas of the salivary gland with perinuclear cytokeratin 20 positivity have been intermittently reported. We here investigated the clinicopathologic features of additional cases.
Methods
Data of four cases of Merkel cell type small cell neuroendocrine carcinoma of the salivary gland were retrieved. To confirm the tumors’ primary nature, clinical records and pathologic materials were reviewed. Optimal immunohistochemical staining was performed to support the diagnosis.
Results
All tumors were located in the parotid gland. Possibilities of metastasis were excluded in all cases through a meticulous clinicopathological review. Tumor histology was consistent with the diagnosis of small cell neuroendocrine carcinoma. Tumors’ immunohistochemical phenotypes were consistent with Merkel cell carcinoma, including Merkel cell polyomavirus large T antigen positivity in two of the four cases.
Conclusions
Merkel cell carcinomas can originate in salivary glands and are partly associated with Merkel cell polyomavirus infection as in cutaneous Merkel cell carcinomas.

Citations

Citations to this article as recorded by  
  • Parotid intranodal metastasis of Merkel cell carcinoma: a rare case report
    Tong Gao, Dengshun Wang, Hongwei Yu, Yu’e Wang, Haibin Lu
    BMC Oral Health.2025;[Epub]     CrossRef
Case Study
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Adenocarcinoma of the minor salivary gland with concurrent MAML2 and EWSR1 alterations
Sangjoon Choi, Junhun Cho, Seung Eun Lee, Chung-Hwan Baek, Yi-Kyung Kim, Hyung-Jin Kim, Young Hyeh Ko
J Pathol Transl Med. 2021;55(2):132-138.   Published online January 22, 2021
DOI: https://doi.org/10.4132/jptm.2020.12.11
  • 7,365 View
  • 126 Download
  • 12 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Salivary gland tumors are histologically diverse, and each entity has distinctive histopathological and molecular features. We report two cases of salivary gland tumors with unique histological and molecular findings, which have not been documented previously. The tumors were located in the base of the tongue in both patients. Most tumor cells were arranged in cords and nests, giving a trabecularlike appearance. Focally, glandular structures with intraluminal mucin and perivascular pseudorosette-like configurations were identified. Tumor cells had eosinophilic to clear cytoplasm, and showed mild nuclear atypia. They were positive for pancytokeratin and negative for S-100, p63, c-KIT, androgen receptor, and neuroendocrine markers. Multiple foci of capsular or lymphovascular invasion were identified, but the Ki-67 labeling index was low (< 5%). Fluorescence in situ hybridization revealed concurrent alterations of MAML2 and EWSR1 gene. Further investigations with a larger number of cases with similar histological and molecular features will accurately classify this tumor.

Citations

Citations to this article as recorded by  
  • A novel fusion of EWSR1::PRKD1 in cribriform adenocarcinoma of salivary glands: A rare case report
    Zecra Yahia
    Human Pathology Reports.2025; 42: 300801.     CrossRef
  • Salivary Gland Neoplasms With a Unique Trabecular Histology and MAML2 Translocation
    Bokyung Ahn, Seung-Ho Choi, Doeun Kim, Deokhoon Kim, Kyung-Ja Cho
    American Journal of Surgical Pathology.2023; 47(10): 1085.     CrossRef
  • Mesonephric-like Adenocarcinoma of the Ovary: Clinicopathological and Molecular Characteristics
    Hyun Hee Koh, Eunhyang Park, Hyun-Soo Kim
    Diagnostics.2022; 12(2): 326.     CrossRef
  • The evolving role of molecular pathology in the diagnosis of salivary gland tumours with potential pitfalls
    Kanwalpreet Kaur, Shailee Mehta, Sangita Vanik, Priti Trivedi, Nirmalya Banerjee, Harsh Dhar, Sourav Datta, Subhadeep Karanjai
    European Archives of Oto-Rhino-Laryngology.2022; 279(8): 3769.     CrossRef
  • Alveolar Soft Part Sarcoma of the Uterus: Clinicopathological and Molecular Characteristics
    Yurimi Lee, Kiyong Na, Ha Young Woo, Hyun-Soo Kim
    Diagnostics.2022; 12(5): 1102.     CrossRef
  • Endometrioid Carcinomas of the Ovaries and Endometrium Involving Endocervical Polyps: Comprehensive Clinicopathological Analyses
    Jihee Sohn, Yurimi Lee, Hyun-Soo Kim
    Diagnostics.2022; 12(10): 2339.     CrossRef
  • Mesonephric-like Differentiation of Endometrial Endometrioid Carcinoma: Clinicopathological and Molecular Characteristics Distinct from Those of Uterine Mesonephric-like Adenocarcinoma
    Sujin Park, Go Eun Bae, Jiyoung Kim, Hyun-Soo Kim
    Diagnostics.2021; 11(8): 1450.     CrossRef
  • Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors
    Hyunjin Kim, Kiyong Na, Go Eun Bae, Hyun-Soo Kim
    Diagnostics.2021; 11(11): 2042.     CrossRef
Original Articles
Article image
Primary squamous cell carcinoma of the salivary gland: immunohistochemical analysis and comparison with metastatic squamous cell carcinoma
Uiree Jo, Joon Seon Song, Seung-Ho Choi, Soon Yuhl Nam, Sang Yoon Kim, Kyung-Ja Cho
J Pathol Transl Med. 2020;54(6):489-496.   Published online August 31, 2020
DOI: https://doi.org/10.4132/jptm.2020.07.19
  • 10,145 View
  • 207 Download
  • 18 Web of Science
  • 18 Crossref
AbstractAbstract PDFSupplementary Material
Background
Primary squamous cell carcinoma (SCC) of the salivary gland is a rare disease, and distinguishing primary SCC from metastatic SCC is difficult. This study investigated the histological and immunohistochemical differences between primary and metastatic salivary gland SCC to improve the accuracy of diagnosis and to explore the pathogenesis of this disease.
Methods
Data of 16 patients who underwent surgery for SCC of salivary glands between 2000 and 2018 at Asan Medical Center were retrieved. Eight patients had a history of SCC at other sites, and eight patients had only salivary gland SCC. Immunostaining for p16, p53, androgen receptor (AR), gross cystic disease fluid protein 15 (GCDFP-15), and c-erbB2, as well as mucicarmine staining, were compared between the two groups.
Results
Most tumors were located in the center of the salivary glands with extraparenchymal extension. The histology of primary SCC of the salivary gland was consistent with moderately differentiated SCC with extensive desmoplastic reaction and peritumoral inflammation. Involvement of the salivary gland ducts and transition into the ductal epithelium were observed in two cases. Metastatic SCC resembled the primary tumor histologically and was associated with central necrosis. Both groups exhibited negative mucin staining. Two, one, and one primary SCC case exhibited AR, GCDFP-15, and c-erbB2 positivity, respectively.
Conclusions
A subset of primary SCCs originated in salivary ducts or was related to salivary duct carcinoma. Distinguishing primary from metastatic SCC of the salivary gland is difficult using histologic features and immunoprofiles. A comprehensive review of the medical history is essential.

Citations

Citations to this article as recorded by  
  • Clinical diagnosis, treatment, and survival analysis of 61 cases of salivary duct carcinoma: a retrospective study
    Shubin Dong, Mengru Li, Zhiwei Zhang, Bowei Feng, Wei Ding, Jiang Chang, Feng Liu
    PeerJ.2025; 13: e19626.     CrossRef
  • Characterization of undifferentiated carcinoma of the salivary gland: clinicopathological and immunohistochemical analyses in comparison with lymphoepithelial carcinoma
    Sangjoon Choi, Gyuheon Choi, Hee Jin Lee, Joon Seon Song, Yoon Se Lee, Seung-Ho Choi, Kyung-Ja Cho
    Journal of Pathology and Translational Medicine.2025; 59(6): 361.     CrossRef
  • Primary salivary gland squamous cell carcinoma with sialolithiasis in the submandibular gland: A case report and literature review
    Sawako Ono, Katsutoshi Hirose, Yuji Hirata, Marie Yamada, Satoko Nakamura, Hidetaka Yamamoto
    Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology.2024; 36(5): 768.     CrossRef
  • A case of primary squamous cell carcinoma of the parotid gland and review of the literature
    Jingli Zhao, Xinrong Nan, Chuhuan Zhou, Nan Jiang, Liangliang Tian
    Journal of Case Reports and Images in Oncology.2024; 10(1): 7.     CrossRef
  • Metastatic cutaneous squamous cell carcinoma accounts for nearly all squamous cell carcinomas of the parotid gland
    Patrick J. Bradley, Göran Stenman, Lester D. R. Thompson, Alena Skálová, Roderick H. W. Simpson, Pieter J. Slootweg, Alessandro Franchi, Nina Zidar, Alfons Nadal, Henrik Hellquist, Michelle D. Williams, Ilmo Leivo, Abbas Agaimy, Alfio Ferlito
    Virchows Archiv.2024; 485(1): 3.     CrossRef
  • Common skin cancers and their association with other non-cutaneous primary malignancies: a review of the literature
    Lindsay Holic
    Medical Oncology.2024;[Epub]     CrossRef
  • Salivary duct carcinoma with squamous differentiation: histomorphological and immunophenotypical analysis of six cases
    Melad N Dababneh, Christopher C Griffith, Kelly R Magliocca, Ivan J Stojanov
    Histopathology.2024; 85(4): 590.     CrossRef
  • Comprehensive Next Generation Sequencing Reveals that Purported Primary Squamous Cell Carcinomas of the Parotid Gland are Genetically Heterogeneous
    Justin A. Bishop, Masato Nakaguro, Ilan Weinreb, Doreen Palsgrove, Lisa M. Rooper, Travis W. Vandergriff, Brian Carlile, Jeffrey A. Sorelle, Jeffrey Gagan, Toshitaka Nagao
    Head and Neck Pathology.2024;[Epub]     CrossRef
  • Salivary gland fine needle aspiration: a focus on diagnostic challenges and tips for achieving an accurate diagnosis
    Carla Saoud, Hansen Lam, Sandra I. Sanchez, Zahra Maleki
    Diagnostic Histopathology.2023; 29(8): 357.     CrossRef
  • Salivary gland pathologies: evolution in classification and association with unique genetic alterations
    Michał Żurek, Łukasz Fus, Kazimierz Niemczyk, Anna Rzepakowska
    European Archives of Oto-Rhino-Laryngology.2023; 280(11): 4739.     CrossRef
  • A retrospective study of nonneoplastic and neoplastic disorders of the salivary glands
    Sorin Vamesu, Oana Andreea Ursica, Ana Maria Gurita, Raluca Ioana Voda, Mariana Deacu, Mariana Aschie, Madalina Bosoteanu, Georgeta Camelia Cozaru, Anca Florentina Mitroi, Cristian Ionut Orasanu
    Medicine.2023; 102(42): e35751.     CrossRef
  • Pembrolizumab as a first line therapy in a patient with extensive mucoepidermoid salivary gland carcinoma. A complete clinical, radiological and pathological response. A very specific case
    Raed Farhat, Noam Asna, Yaniv Avraham, Ashraf Khater, Majd Asakla, Alaa Safia, Sergio Szvalb, Nidal Elkhatib, Shlomo Merchavy
    Discover Oncology.2022;[Epub]     CrossRef
  • Morphologic CT and MRI features of primary parotid squamous cell carcinoma and its predictive factors for differential diagnosis with mucoepidermoid carcinoma
    Xiaohua Ban, Huijun Hu, Yue Li, Lingjie Yang, Yu Wang, Rong Zhang, Chuanmiao Xie, Cuiping Zhou, Xiaohui Duan
    Insights into Imaging.2022;[Epub]     CrossRef
  • A Rare Case of Primary Squamous Cell Carcinoma of the Submandibular Salivary Gland: Brief Overview of Diagnostic Ambiguity and Treatment Challenges
    Pawan Hingnikar, Anendd Jadhav, Nitin D Bhola
    Cureus.2022;[Epub]     CrossRef
  • Necrotizing Sialometaplasia of the Hard Palate: Diagnosis and Treatment
    Sangeun Lee, Yun Sung Lim, Kyuho Lee, Bo Hae Kim
    Journal of Clinical Otolaryngology Head and Neck Surgery.2022; 33(4): 236.     CrossRef
  • Parotid Salivary Duct Carcinoma With a Prominent Squamous Component: Immunohistochemical Profile, Diagnostic Pitfalls, and Therapeutic Implications
    Naomi Hardy, Joshua Thompson, Ranee Mehra, Cinthia B. Drachenberg, Kyle Hatten, John C. Papadimitriou
    International Journal of Surgical Pathology.2021; 29(7): 726.     CrossRef
  • Intrasalivary Thymic Carcinoma: A Case Report and Literature Review
    Michał Kunc, Alexandra Kamieniecki, Grzegorz Walczak, Tomasz Nowicki, Bartosz Wasąg, Bogusław Mikaszewski, Dominik Stodulski, Wojciech Biernat
    Head and Neck Pathology.2021; 16(3): 857.     CrossRef
  • Cancer Stem Cell Markers in Squamous Cell Carcinomas of the Salivary Glands
    Mattis Bertlich, Julia Kitz, Marie Kruizenga, Jennifer Lee Spiegel, Martin Canis, Friedrich Ihler, Frank Haubner, Bernhard G. Weiss, Mark Jakob
    Oncology.2021; 99(6): 402.     CrossRef
Article image
A retrospective cytohistological correlation of fine-needle aspiration cytology with classification by the Milan System for Reporting Salivary Gland Cytopathology
Ji Hyun Park, Yoon Jin Cha, Ja Yeong Seo, Jae Yol Lim, Soon Won Hong
J Pathol Transl Med. 2020;54(5):419-425.   Published online July 8, 2020
DOI: https://doi.org/10.4132/jptm.2020.06.09
  • 7,036 View
  • 201 Download
  • 11 Web of Science
  • 14 Crossref
AbstractAbstract PDF
Background
Before publication of the new classification system named the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) in 2018, there was no standard classification for salivary gland lesions obtained by fine-needle aspiration (FNA). We therefore aimed to evaluate the diagnostic utility of this system by retrospectively reviewing FNA samples using the MSRSGC and to determine their risk of developing into neoplasms and becoming malignant.
Methods
Retrospective slide review and classification of salivary gland FNAs obtained over a 6-year period (2013–2018) at a single center were performed by two pathologists. The risks of neoplasm and malignancy for each category also were calculated.
Results
This study surveyed 374 FNAs (371 patients) performed over a six-year period and selected 148 cases that included documented surgical follow-up (39.6%). Among the surgically treated cases, the distributions of FNA categories were as follows: non-diagnostic (ND; 16.9%), non-neoplastic (NN; 2.7%), atypia of undetermined significance (AUS; 3.4%), benign (BN; 54.7%), salivary gland neoplasm of uncertain malignant potential (SUMP; 10.1%), suspicious for malignancy (SM; 6.8%), and malignant (M; 5.4%). The risk of malignancy (ROM) was 24.0% for ND, 0% for NN, 40.0% for AUS, 2.5% for BN, 46.7% for SUMP, 100% for SM, and 87.5% for M. The overall diagnostic accuracy was 95.9% (142/148 cases).
Conclusions
The newly proposed MSRSGC appears to be a reliable system for classification of salivary gland lesions according to the associated ROM.

Citations

Citations to this article as recorded by  
  • The Impact of Lesion-Specific and Sampling-Related Factors on Success of Salivary Gland Fine-Needle Aspiration Cytology
    Marcel Mayer, Mohammad Marwan Alfarra, Kathrin Möllenhoff, Marianne Engels, Christoph Arolt, Alexander Quaas, Philipp Wolber, Louis Jansen, Lisa Nachtsheim, Maria Grosheva, Jens Peter Klussmann, Sami Shabli
    Head and Neck Pathology.2025;[Epub]     CrossRef
  • The Myriad Spectrum of Salivary Gland Lesions: Cytohistological Correlation on Fine Needle Aspiration Cytology, Core Needle Biopsy, and Resections in a 5‐Year Single Institutional Experience of North India
    Zachariah Chowdhury, Pallavi Majumdar, Sumeet Narain, Komal Lamba
    Diagnostic Cytopathology.2025; 53(8): 391.     CrossRef
  • Diagnostic Performance of the Milan System for Reporting Salivary Gland Cytopathology and a Proposed Algorithm for Fine-Needle Aspiration Cytology of Salivary Gland Lesions
    Norihide Mochizuki, Hirotaka Fujita, Takuma Tajiri, Masataka Ueda, Makiko Kurata, Chie Inomoto, Tomoko Sugiyama, Daisuke Maki, Shuichi Shiraishi, Tomohisa Machida, Hitoshi Ito, Yohei Masugi, Naoya Nakamura
    Acta Cytologica.2025; 69(4): 324.     CrossRef
  • A study of fine needle aspiration cytology and histopathology correlation of salivary gland neoplasms in a tertiary care hospital: an observational study
    Asima Malik, Ahlam Mushtaq, Salma Bhat, Suhail Naik
    International Journal of Contemporary Pediatrics.2025; 13(1): 23.     CrossRef
  • The Milan system for reporting salivary gland cytopathology – Assessment of utility and the risk of malignancy
    Annu E. Prakash, Renu Sukumaran, Nileena Nayak, K. Lakshmi, Anitha Mathews, Jayasree Kattoor
    Indian Journal of Cancer.2024; 61(3): 575.     CrossRef
  • Salivary gland fine-needle aspiration biopsy: quality assurance results from a tertiary cancer center
    Fanni Ratzon, Dominique L. Feliciano, Nora Katabi, Bin Xu, Oscar Lin, Xiao-Jun Wei
    Journal of the American Society of Cytopathology.2023; 12(3): 206.     CrossRef
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    Tarun Kumar, Prerna Tewari, Jitendra Singh Nigam, Shreekant Bharti, Surabhi, Ruchi Sinha, Punam Prasad Bhadani
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  • Assessment of Risk of Malignancy of Fine-needle Aspiration Cytology in Salivary Gland Lesions Using the Milan System for Reporting Salivary Gland Cytopathology Categorization: A Systematic Review and Meta-analysis
    Amit Kumar, Subhash Chandra, Bishnupati Singh, Swati Sharma, Ankita Tandon, Ajoy Kumar Shahi
    The Journal of Contemporary Dental Practice.2023; 23(10): 1039.     CrossRef
  • Milan Sınıflandırma Sistemi’ne Göre Değerlendirilen Tükürük Bezi İnce İğne Aspirasyon Sitolojilerinin Histopatolojik Tanı Uyumu
    Özlem SARAYDAROĞLU, Selin YİRMİBEŞ
    Uludağ Üniversitesi Tıp Fakültesi Dergisi.2023; 49(3): 285.     CrossRef
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    Samih J. Nassif, Ali R. Sasani, Garrey T. Faller, Jennifer L. Harb, Jagdish K. Dhingra
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  • Nondiagnostic salivary gland FNAs are associated with decreased risk of malignancy compared with “all‐comer” patients: Analysis of the Milan System for Reporting Salivary Gland Cytopathology with a focus on Milan I: Nondiagnostic
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Case Studies
Primary Necrobiotic Xanthogranulomatous Sialadenitis with Submandibular Gland Localization without Skin Involvement
Myunghee Kang, Na Rae Kim, Dong Hae Chung, Jae Yeon Seok, Dong Young Kim
J Pathol Transl Med. 2019;53(4):261-265.   Published online January 16, 2019
DOI: https://doi.org/10.4132/jptm.2019.01.08
  • 8,951 View
  • 169 Download
  • 2 Web of Science
  • 6 Crossref
AbstractAbstract PDF
Necrobiotic xanthogranulomatous reaction is a multiorgan, non-Langerhans cell histiocytosis with an unknown etiology. Occurrence in the salivary gland is extremely rare. We recently identified a case of necrobiotic xanthogranulomatous sialadenitis in a 73-year-old Korean woman who presented with a painless palpable lesion in the chin. There was no accompanying cutaneous lesion. Partial resection and subsequent wide excision with neck dissection were performed. Pathological examination showed a severe inflammatory lesion that included foamy macrophages centrally admixed with neutrophils, eosinophils, lymphocytes, plasma cells, and scattered giant cells, as well as necrobiosis. During the 12-month postoperative period, no grossly remarkable change in size was noted. Necrobiotic xanthogranulomatous inflammation may be preceded by or combined with hematologic malignancy. Although rare, clinicians and radiologists should be aware that an adhesive necrobiotic xanthogranuloma in the salivary gland may present with a mass-like lesion. Further evaluation for hematologic disease and close follow-up are needed when a pathologic diagnosis is made.

Citations

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  • Salivary gland macrophages in health and disease: heterogeneity, niche crosstalk, and therapeutic avenues
    Xinglei Li, Yan Feng, Huixin Xue, Xinxin Ni
    Frontiers in Immunology.2025;[Epub]     CrossRef
  • Five Cases of Xanthogranulomatous Sialadenitis
    Satoshi Kiyama, Hiroyuki Iuchi, Kotoko Ito, Kengo Nishimoto, Tsutomu Matsuzaki, Masaru Yamashita
    Practica Oto-Rhino-Laryngologica.2022; 115(4): 315.     CrossRef
  • Xanthogranulomatous change in a pleomorphic adenoma: An extremely rare variant/degenerative change. Is it fine needle aspiration induced?
    Mukta Pujani, Dipti Sidam, Kanika Singh, Aparna Khandelwal, Khushbu Katarya
    Diagnostic Cytopathology.2021;[Epub]     CrossRef
  • A Case of Xanthogranulomatous Sialadenitis with Facial Palsy Mimicking Malignancy
    Sang Hyun Kim, Sun Woo Kim, Sang Hyuk Lee
    Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2021; 64(6): 422.     CrossRef
  • Xanthogranulomatous Sialadenitis, an Uncommon Reactive Change is Often Associated with Warthin’s Tumor
    Lihong Bu, Hui Zhu, Emilian Racila, Sobia Khaja, David Hamlar, Faqian Li
    Head and Neck Pathology.2020; 14(2): 525.     CrossRef
  • A Case of Xanthogranulomatous Sialadenitis of the Sublingual Gland:A Review of Literature
    Naoya KITAMURA, Seiji OHNO, Tetsuya YAMAMOTO
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Cytopathologic Features of Secretory Carcinoma of Salivary Gland: Report of Two Cases
Young Ah Kim, Jae Won Joung, Sun-Jae Lee, Hoon-Kyu Oh, Chang Ho Cho, Woo Jung Sung
J Pathol Transl Med. 2019;53(1):70-74.   Published online December 28, 2018
DOI: https://doi.org/10.4132/jptm.2018.11.09
  • 8,261 View
  • 147 Download
  • 7 Web of Science
  • 6 Crossref
AbstractAbstract PDF
Secretory carcinoma of the salivary gland (SC) is a newly introduced rare salivary gland tumor that shares histological, immunohistochemical, and genetic characteristics with secretory carcinoma of the breast. Here, we report the cytologic features of two cases of SC confirmed by surgical resection. In these two cases, SC was incidentally detected in a 64-year-old female and a 56-yearold male. Fine needle aspiration cytology revealed nests of tumor cells with a papillary or glandular structure floating in mucinous secretions. The tumor cells demonstrated uniform, round, smooth nuclear contours and distinct nucleoli. Multiple characteristic cytoplasmic vacuoles were revealed. Singly scattered tumor cells frequently showed variable sized cytoplasmic vacuoles. The cytopathologic diagnosis of SC should be considered when characteristic cytological findings are revealed. Further immunohistochemistry and gene analyses are helpful to diagnose SC.

Citations

Citations to this article as recorded by  
  • Salivary Gland Secretory Carcinoma; Review of 13 Years World‐Wide Experience and Meta‐Analysis
    Eyal Yosefof, Tomer Boldes, Daniel Dan, Eyal Robenshtok, Yulia Strenov, Gideon Bachar, Thomas Shpitzer, Aviram Mizrachi
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    Yinan Hua, Bing Leng, Kenneth E. Youens, Lina Liu
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    Lísia Daltro Borges Alves, Andreia Cristina de Melo, Thayana Alves Farinha, Luiz Henrique de Lima Araujo, Leandro de Souza Thiago, Fernando Luiz Dias, Héliton Spíndola Antunes, Ana Lucia Amaral Eisenberg, Luiz Claudio Santos Thuler, Daniel Cohen Goldember
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Original Article
PLAG1, SOX10, and Myb Expression in Benign and Malignant Salivary Gland Neoplasms
Ji Hyun Lee, Hye Ju Kang, Chong Woo Yoo, Weon Seo Park, Jun Sun Ryu, Yuh-Seog Jung, Sung Weon Choi, Joo Yong Park, Nayoung Han
J Pathol Transl Med. 2019;53(1):23-30.   Published online November 14, 2018
DOI: https://doi.org/10.4132/jptm.2018.10.12
  • 12,646 View
  • 382 Download
  • 27 Web of Science
  • 33 Crossref
AbstractAbstract PDF
Background
Recent findings in molecular pathology suggest that genetic translocation and/oroverexpression of oncoproteins is important in salivary gland tumorigenesis and diagnosis. Weinvestigated PLAG1, SOX10, and Myb protein expression in various salivary gland neoplasm tissues.
Methods
A total of 113 cases of surgically resected salivary gland neoplasms at the NationalCancer Center from January 2007 to March 2017 were identified. Immunohistochemical stainingof PLAG1, SOX10, and Myb in tissue samples was performed using tissue microarrays.
Results
Among the 113 cases, 82 (72.6%) were benign and 31 (27.4%) were malignant. PLAG1 showednuclear staining and normal parotid gland was not stained. Among 48 cases of pleomorphicadenoma, 29 (60.4%) were positive for PLAG1. All other benign and malignant salivary glandneoplasms were PLAG1-negative. SOX10 showed nuclear staining. In normal salivary gland tissuesSOX10 was expressed in cells of acinus and intercalated ducts. In benign tumors, SOX10 expressionwas observed in all pleomorphic adenoma (48/48), and basal cell adenoma (3/3), but not inother benign tumors. SOX10 positivity was observed in nine of 31 (29.0%) malignant tumors.Myb showed nuclear staining but was not detected in normal parotid glands. Four of 31 (12.9%)malignant tumors showed Myb positivity: three adenoid cystic carcinomas (AdCC) and onemyoepithelial carcinoma with focal AdCC-like histology.
Conclusions
PLAG1 expression is specificto pleomorphic adenoma. SOX10 expression is helpful to rule out excretory duct origin tumor,but its diagnostic value is relatively low. Myb is useful for diagnosing AdCC when histology isunclear in the surgical specimen.

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Case Study
Fine-Needle Aspiration Cytology of Carcinosarcoma in the Salivary Gland: An Extremely Rare Case Report
Hyo Jung An, Hye Jin Baek, Jin Pyeong Kim, Min Hye Kim, Dae Hyun Song
J Pathol Transl Med. 2018;52(2):136-139.   Published online December 28, 2017
DOI: https://doi.org/10.4132/jptm.2017.07.27
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AbstractAbstract PDF
Carcinosarcoma of the salivary gland is an extremely rare tumor that is composed of both malignant epithelial and mesenchymal components. Diagnosing carcinosarcoma with fine-needle aspiration cytology is challenging because of its overlapping cytomorphologic characteristics with other high-grade malignant salivary gland tumors. Among the many features, including pleomorphic oncocytoid epithelial components, necrotic background, and mitoses, recognizing the singly scattered atypical spindle cells is most essential in carcinosarcoma. We present a case of a 66-year-old male patient with characteristic features of carcinosarcoma, who was successfully treated by wide local excision and subsequent radiation therapy.

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Original Article
Accuracy of Core Needle Biopsy Versus Fine Needle Aspiration Cytology for Diagnosing Salivary Gland Tumors
In Hye Song, Joon Seon Song, Chang Ohk Sung, Jong-Lyel Roh, Seung-Ho Choi, Soon Yuhl Nam, Sang Yoon Kim, Jeong Hyun Lee, Jung Hwan Baek, Kyung-Ja Cho
J Pathol Transl Med. 2015;49(2):136-143.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2015.01.03
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AbstractAbstract PDF
Background
Core needle biopsy is a relatively new technique used to diagnose salivary gland lesions, and its role in comparison with fine needle aspiration cytology needs to be refined. Methods: We compared the results of 228 ultrasound-guided core needle biopsy and 371 fine needle aspiration procedures performed on major salivary gland tumors with their postoperative histological diagnoses. Results: Core needle biopsy resulted in significantly higher sensitivity and more accurate tumor subtyping, especially for malignant tumors, than fine needle aspiration. No patient developed major complications after core needle biopsy. Conclusions: We recommend ultrasoundguided core needle biopsy as the primary diagnostic tool for the preoperative evaluation of patients with salivary gland lesions, especially when malignancy is suspected.

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Brief Case Report
Cytokeratin-Positive Gastrointestinal Stromal Tumor of Biphasic Morphology: A Case Report
Sung Sun Kim, Yoo Duk Choi, Jae Hyuk Lee, Chan Choi
Korean J Pathol. 2014;48(5):375-378.   Published online October 27, 2014
DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.5.375
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PDF

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  • CYTOKERATINS: NOT AN EPITHELIAL ENTITY ANYMORE?
    Geetpriya Kaur, Devicharan Shetty, Seema Sikka, Aparna Pathak
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Case Studies
Cytomorphological Findings and Histological Correlation of Low-Grade Cribriform Cystadenocarcinoma of Salivary Gland in Fine-Needle Aspiration: A Case Study
Young Sin Ko, Ja Seung Koo
Korean J Pathol. 2013;47(6):592-595.   Published online December 24, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.6.592
  • 9,103 View
  • 70 Download
  • 13 Crossref
AbstractAbstract PDF

Low-grade cribriform cystadenocarcinoma (LGCCC) of the salivary gland is a rare tumor. We report the cytologic features and histologic correlation of a patient with LGCCC. A 57-year-old man had a hardly palpable, nontender mass in the right cheek area followed over nine months. Radiologic analysis revealed a 1.2 cm multiseptated, cystic, solid nodule in an anterior superficial lobe of the right parotid gland. Fine-needle aspiration cytology revealed many irregular overlapping sheets or clusters of ductal epithelial cells forming solid, pseudopapillary, and cribriform architectures. Nuclei of the tumor cells revealed inconspicuous atypia with minimal size variation. On the basis of these findings, we confirmed a diagnosis of ductal epithelial proliferative lesion, favoring neoplasm, with uncertain malignant potential. Tumor excision was performed, revealing a tiny multicystic nodule (0.7 cm). Histopathologically, this tumor showed the characteristic morphology of LGCCC. This is the first report of cytomorphological findings of LGCCC in Korea.

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    Swati Raj, Monika Singh, Mamta Gupta, Naveen Thapliyal
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    Lester D.R. Thompson, Justin A. Bishop
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    Yukiya HIRATA, Kayoko HIGUCHI, Toshitaka NAGAO, Yoko ZUKERAN, Takao KINJO, Naoki WADA
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    Andrea Palicelli
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    Andrea Palicelli
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    Esther Diana Rossi, Zubair Baloch, William Faquin, Liron Pantanowitz
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    Francesco Giovacchini, Caterina Bensi, Stefano Belli, Maria Elena Laurenti, Martina Mandarano, Daniele Paradiso, Michele Giansanti, Antonio Tullio
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  • Mammary analogue secretory carcinoma of parotid gland
    Atsuko NASU, Sakae HATA, Masaru FUJITA, Toyoko YAMAUCHI, Satoko NAKAMURA, Takehiro TANAKA, Kouichi ICHIMURA, Hiroyuki YANAI
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Fine-Needle Aspiration Cytology of Low-Grade Cribriform Cystadenocarcinoma with Many Psammoma Bodies of the Salivary Gland
Ji Yun Jeong, Dongbin Ahn, Ji Young Park
Korean J Pathol. 2013;47(5):481-485.   Published online October 25, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.5.481
  • 8,401 View
  • 49 Download
  • 12 Crossref
AbstractAbstract PDF

Low-grade cribriform cystadenocarcinoma (LGCCC) is a rare salivary gland tumor that was recently defined as a variant of cystadenocarcinoma by the 2005 World Health Orgazniation (WHO) classification system. We report cytologic findings of an unusual case of LGCCC with many psammoma bodies. A 90-year-old man presented a palpable mass on his left parotid gland. Fine-needle aspiration (FNA) cytology showed tumor cells that were arranged in clusters and dispersed individually. The tumor cells showed mild atypia and had clear or dense cytoplasm with some vacuoles. Numerous psammoma bodies were noted. After surgical resection, the histologic examination revealed a mixed solid and cystic mass showing intraductal growth with focal stromal invasion. The S-100 protein expressed in the tumor cells, but smooth muscle actin and p63 were positive only in myoepithelial cells. Although LGCCCs resemble other salivary gland tumors, differentiating LGCCC during preoperative FNA is important to avoid unnecessary overtreatment.

Citations

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  • Salivary Gland Intraductal Carcinoma: How Do 183 Reported Cases Fit Into a Developing Classification
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    Advances in Anatomic Pathology.2023; 30(2): 112.     CrossRef
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    Swati Raj, Monika Singh, Mamta Gupta, Naveen Thapliyal
    Cytojournal.2023; 20: 22.     CrossRef
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    Yukiya HIRATA, Kayoko HIGUCHI, Toshitaka NAGAO, Yoko ZUKERAN, Takao KINJO, Naoki WADA
    The Journal of the Japanese Society of Clinical Cytology.2022; 61(6): 431.     CrossRef
  • Intraductal carcinoma of the retromolar trigone found with elevated serum CEA and CA19-9 levels: a case report
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    Marcela Pessoa de Melo, Diego Filipe Bezerra Silva, Rodrigo Alves Ribeiro, Tony Santos Peixoto, Daliana Queiroga de Castro Gomes, Pollianna Muniz Alves, Cassiano Francisco Weege Nonaka, Bárbara Vanessa de Brito Monteiro
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    Francesco Giovacchini, Caterina Bensi, Stefano Belli, Maria Elena Laurenti, Martina Mandarano, Daniele Paradiso, Michele Giansanti, Antonio Tullio
    Journal of Oral Biology and Craniofacial Research.2019; 9(1): 96.     CrossRef
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Original Articles
Finding and Characterizing Mammary Analogue Secretory Carcinoma of the Salivary Gland
Min Jung Jung, Joon Seon Song, Sang Yoon Kim, Soon Yuhl Nam, Jong-Lyel Roh, Seung-Ho Choi, Sung-Bae Kim, Kyung-Ja Cho
Korean J Pathol. 2013;47(1):36-43.   Published online February 25, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.1.36
  • 14,797 View
  • 117 Download
  • 73 Crossref
AbstractAbstract PDF
Background

A new tumor entity of the salivary glands, mammary analogue secretory carcinoma (MASC) with ETV6-NTRK3 translocation, has recently been proposed. MASC was originally diagnosed as adenocarcinoma, not otherwise specified (ANOS), or acinic cell carcinoma (AciCC) by the current World Health Organization classification. We aimed to identify MASC cases by molecular tests, and to characterize their clinical, histological, and immunohistochemical features.

Methods

Thirty cases of MASC candidates were selected after review of 196 salivary gland tumors, and subjected to break-apart ETV6 fluorescence in situ hybridization (FISH), and immunohistochemical study for S100 protein, gross cystic disease fluid protein 15, DOG1, estrogen receptor, and progesterone receptor.

Results

Valid FISH results were obtained in 23 cases, and 13 positive cases were retrieved. MASCs were histologically varied, and the most frequent features observed in 10 cases were low-grade papillary/cystic/glandular patterns, intraluminal secretory materials, ovoid/wrinkled nuclei, and relatively abundant granular eosinophilic cytoplasms, corresponding to papillary-cystic or follicular types of AciCC. All cases showed diffuse immunopositivity for S100 protein. Three cases developed recurrences, but all patients remained alive.

Conclusions

MASC could be a molecularly well-defined salivary gland neoplasm, encompassing some portions of AciCC and ANOS, but its histological spectrum and clinical implication require further investigation.

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Diagnostic Difficulties in Fine Needle Aspiration of Benign Salivary Glandular Lesions
Hye Jung Jo, Hyo Jung Ahn, Soojin Jung, Hye-Kyoung Yoon
Korean J Pathol. 2012;46(6):569-575.   Published online December 26, 2012
DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.6.569
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AbstractAbstract PDF
Background

The diagnostic accuracy of fine needle aspiration cytology (FNAC) of salivary lesions is relatively high, but cytologic interpretation might be confusing if the sample is lacking typical cytologic features.

Methods

There were 77 cases of benign salivary lesions, consisting of pleomorphic adenoma (PA) in 61 cases, Warthin's tumor (WT) in 12 cases, and other benign lesions in 4 cases. The causes of the discrepancies between the FNAC and the histologic diagnoses were evaluated.

Results

Major discrepancies were noted in 4 of the 61 PA cases, and in 1 of 12 WT cases. The causes of the major discrepancies were a mislabeled site in 1 PA and 1 WT case, and an interpretation error in 3 PA cases. Minor discrepancies were more common in the WT cases (7 of 12 cases) than in the PA cases (11 of 61 cases). The causes of the minor discrepancies were a mislabeled site in 1 PA and 1 WT case, an inadequate sample in 7 PA and 2 WT cases, a lack of typical cytomorphology in 2 PA and 2 WT cases, and an interpretation error in 1 PA and 2 WT cases.

Conclusions

To increase the diagnostic accuracy in the benign salivary lesions, recognition of both characteristic and less typical cytomorphology is needed.

Citations

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Case Report
Osteoclast-like Giant Cell Tumor of Parotid Gland with a Carcinomatous Component: A Case Report
Jung Wook Yang, Hyeon Cheol Kim, Jeong Hee Lee, Jong Sil Lee, Dong Chul Kim, Dae Hyun Song, Jin Pyeong Kim, Gyung Hyuck Ko
Korean J Pathol. 2012;46(3):297-301.   Published online June 22, 2012
DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.3.297
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AbstractAbstract PDF

The giant cell tumor of the salivary gland is very rare, and 20 cases have been reported in the English-language literature. We report an additional case. A 57-year old man had noticed a mass in the right parotid area for several weeks. The diagnosis using aspiration cytology was a giant cell tumor possibly with a carcinomatous component. Superficial parotidectomy was carried out. The resected parotid gland contained a 1.8 cm-sized well-circumscribed brownish tumor. Histologically the tumor consisted of evenly distributed osteoclast-like giant cells, mononuclear cells and two small foci of a carcinomatous component. The osteoclast-like giant cells and mononuclear cells were positive for vimentin and CD68, and the carcinomatous component was positive for cytokeratin and epithelial membrane antigen. There was no metastatic lesion in the cervical lymph nodes. We believe this is the first case in Korea of an osteoclast-like giant cell tumor of the parotid gland.

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Original Article
Diagnostic Features of Fine Needle Aspiration Cytology of Pleomorphic Adenoma, Adenoid Cystic Carcinoma, and Mucoepidermoid Carcinoma of Salivary Gland.
Eun Sook Nam, Won Bo Jo, Jung Ho Han, Insun Kim
J Pathol Transl Med. 1990;1(1):60-67.
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  • 299 Download
AbstractAbstract PDF
The evaluate the diagnostic findings of salivary gland tumors, we reexamined aspiration cytology smears of 7 cases of pleomorphic adenoma, 3 cases of adenoid cystic carcinoma, and 3 cases of mucoepidermoid carcinoma, performed during April 1986 to March 1990, which were comfurmed by surgical excision and histologic diagnosis. The results obtained are summarized as follows : 1. All cases of pleomorphic adenoma showed branching cellular clusters of epithelial and myoepithelial cells. Acellular elements including myxomatous and chondroid components were observed. There were no cellular pleomorphism and nucleoli. Keratinizing squamous epithelial cells and keratin pearls were noted. 2. The smears of adenoid cystic carcinoma showed cell balls or cell cords containing a central hyaline core. Nuclear atypism and the nucleoli were frequently observed. There were no keratinizing squamous epithelial cells. 3. The smears of mucoepidermoid carcinoma showed mainly sheets or clusters of intermediate cells and some mucin-producing cells. Some nuclear pleomorphism was observed. Mucinous material and many inflammatory cells were present in the background.
Case Reports
Sclerosing Polycystic Adenosis of the Parotid Gland: A Case Report.
Byung Joo Jeong, Mi Ran Kim, Zhe Long Liang, Bon Seok Koo, Jin Man Kim
Korean J Pathol. 2011;45:S79-S83.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S79
  • 5,216 View
  • 49 Download
  • 3 Crossref
AbstractAbstract PDF
Sclerosing polycystic adenosis (SPA) of the salivary glands is a rare entity analogous to fibrocystic disease of the breast. Less than 50 cases of SPA have been published in the literature. We report the first Korean case of SPA of the right parotid gland. A 34-year-old man presented with a slowly growing right parotid mass. Computed tomography showed a relatively well-demarcated, heterogeneously enhancing mass with multiple small calcifications. Fine needle aspiration showed cohesive sheets of epithelial cells with granular oncocytic cytoplasm and scattered lymphocytes. The parotidectomy specimen showed a 3 cm-sized solid nodular lesion with small cysts. Microscopically, the lesion was an unencapsulated mass of sclerotic fibrous tissue with cystic ducts, multiple calcifications, and lymphoplasma cell infiltration. Sclerosing adenosis and cystic ducts with frequent apocrine-like cells were noted. Familiarity with the cytologic and histological features of SPA is very important making the correct diagnosis.

Citations

Citations to this article as recorded by  
  • Clinicopathological profile of sclerosing polycystic adenoma/adenosis: A systematic review
    Talita de Carvalho Kimura, Reydson Alcides de Lima‐Souza, João Figueira Scarini, Luccas Lavareze, Erika Said Abu Egal, Albina Altemani, Fernanda Viviane Mariano
    Head & Neck.2023; 45(9): 2449.     CrossRef
  • Juvenile sclerosing polycystic adenosis cytologically mimicking Warthin tumor
    Masataka Kawai, Tomohiro Inoue, Takaaki Yonaga, Kunio Mochizuki, Tadao Nakazawa, Keisuke Masuyama, Tetsuo Kondo
    Diagnostic Cytopathology.2019; 47(11): 1208.     CrossRef
  • A Case of Sclerosing Polycystic Adenosis of Parotid Gland
    Young-Jun Kim, Jang-Won Choi, Young-Joong Kim, Soo-Kweon Koo
    Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2014; 57(8): 559.     CrossRef
Acinic Cell Carcinoma of the Palatine Tonsil: A Brief Case Report.
Hun Soo Kim, Keum Ha Choi
Korean J Pathol. 2010;44(4):441-443.
DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.4.441
  • 4,284 View
  • 30 Download
  • 1 Crossref
AbstractAbstract PDF
Acinic cell carcinoma (ACC) is a rare, low-grade malignancy of the salivary glands. Most cases occur in the major salivary glands, especially the parotid gland, with only a few cases involving the minor salivary gland previously described. A 67-year-old male patient was admitted complaining of an obstructive feeling in the throat. On examination, a lobulated mass in the tonsillar surface was noticed. Tonsillectomy was performed under general anesthesia. Histopathological examination of the mass revealed sheets of large, polygonal acinar cells with granular, slightly basophilic cytoplasm, which led to the diagnosis of ACC. Here, we present a case of low-grade ACC of the palatine tonsil, which we believe to be the first reported case of ACC in this location.

Citations

Citations to this article as recorded by  
  • A case of unusual heteratopic salivary gland tissue mimicking tonsillar neoplasm and review of literature
    Aysegul Sule Altindal, Nermin Unal
    Journal of Otolaryngology-ENT Research.2018;[Epub]     CrossRef
Original Article
Oncocytoma and Oncocytic Carcinoma of the Salivary Glands, Single Institute Experience.
Jeong Hyeon Jo, Seung Ho Choi, Jong Lyel Roh, Soon Yuhl Nam, Sang Yoon Kim, Kyung Ja Cho
Korean J Pathol. 2010;44(4):370-375.
DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.4.370
  • 4,491 View
  • 65 Download
  • 2 Crossref
AbstractAbstract PDF
BACKGROUND
Oncocytic neoplasms of the salivary glands are rare and the differential diagnosis between oncocytic carcinomas (OCs) and oncocytomas is difficult. We present 5 cases of oncocytoma and 3 cases of OC of the salivary glands with clinicopathological and immunohistochemical comparisons.
METHODS
Eight cases of oncocytic neoplasms diagnosed at Asan Medical Center between 1998 and 2009 were reviewed for clinical data and histological features. Immunohistochemical staining for epidermal growth factor receptor (EGFR), human epidermal growth factor receptor 2 (Her-2), c-kit, p53, and Ki-67 was done.
RESULTS
Cytological differences between oncocytomas and OCs were not obvious, but unequivocal infiltrative growths were identified in 3 cases, rendering the diagnosis of oncocytic carcinoma. When the remaining cases were classified as oncocytomas, there was no difference in age, size, and clinical symptoms between oncocytomas and OCs. Two of 3 OCs showed strong membranous expression of c-kit, but all oncocytomas were negative. The proportion of p53-positive cells was larger in OCs than oncocytomas. Her-2 or EGFR expression was absent, and Ki-67 labeling indices were less than 1% in all cases.
CONCLUSIONS
An infiltrative growth pattern, strong membranous expression of c-kit, and an increased proportion of p53-positive cells are features that can differentiate OCs from oncocytomas of the salivary glands.

Citations

Citations to this article as recorded by  
  • Clinicopathological Study of Oncocytomas of Head and Neck Region: A Systematic Review
    João Paulo Gonçalves de Paiva, Laura Borges Kirschnick, Daniela Giraldo Roldán, Manoela Domingues Martins, Alan Roger Santos‐Silva, Ciro Dantas Soares, Jacks Jorge
    Journal of Oral Pathology & Medicine.2025; 54(8): 635.     CrossRef
  • Primary oncocytic carcinoma of ectopic salivary gland: a unique case
    E. Touli, A. Manganaris, C. Nikolaidou, I. Karasmanis
    International Journal of Oral and Maxillofacial Surgery.2022; 51(4): 463.     CrossRef
Case Report
Cytology of Plasmacytoid Type Myoepithelioma: Report of Two Cases.
Na Rae Kim, Hyun Yee Cho, Seung Yeon Ha
Korean J Pathol. 2009;43(5):489-493.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.5.489
  • 4,645 View
  • 71 Download
  • 4 Crossref
AbstractAbstract PDF
Myoepithelioma is a rare benign tumor of salivary gland myoepithelial cells, most commonly as a spindle subtype. Here, we present two cases of fine needle aspiration cytology of plasmacytoid myoepithelioma arising from a parotid gland and a hard palate. Aspirates showed plasmacytoid cells with pink-staining, homogeneous, abundant eosinophilic cytoplasm eccentrically displacing the nucleus in cohesive and dissociated forms. Rarely, nuclear grooves and intranuclear cytoplasmic inclusions were evident. These unfamiliar cytologic findings of uncommon myoepithelioma often cause diagnostic difficulties in preoperative aspiration cytology. Recognition of those rare findings provides a reliable diagnostic clue.

Citations

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  • Plasmacytoid myoepithelioma: Diagnostic algorithm and a tailored therapeutic protocol for a geriatric individual
    Pratik N. Patel, Aatish Thennavan, Venkadasalapathy Narayanaswamy, Raghu Radhakrishnan
    Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology.2015; 27(5): 737.     CrossRef
  • Imprint Cytology of Soft Tissue Myoepithelioma: A Case Study
    Seok Ju Park, Ae Ri Kim, Mi Jin Gu, Joon Hyuk Choi, Duk Seop Shin
    Korean Journal of Pathology.2013; 47(3): 299.     CrossRef
  • Fine Needle Aspiration Cytology of Benign Salivary Gland Tumors with Myoepithelial Cell Participation: An Institutional Experience of 575 Cases
    Soomin Ahn, Yuil Kim, Young Lyun Oh
    Acta Cytologica.2013; 57(6): 567.     CrossRef
  • Plasmacytoid Myoepithelioma of the Palate: Case Report
    Matina T. Zormpa, Asimina S. Sarigelou, Anna N. Eleftheriou, Anthoula S. Assimaki, Alexandros E. Kolokotronis
    Head and Neck Pathology.2011; 5(2): 154.     CrossRef
Original Article
Fine Needle Aspiration Cytology of the Salivary Gland: An analysis of 221 cases .
Ayoung Park, Hee Kyoung Kim, Dong Won Kim, So Young Jin, Dong Wha Lee
J Pathol Transl Med. 1999;10(2):133-143.
  • 1,983 View
  • 16 Download
AbstractAbstract PDF
Fine needle aspiration cytology of the salivary lesions was performed on 221 patients at Soonchunhyang University Hospital for 10 years. Of 221 aspirates, 6 aspirates(2.7%) were inadequate, 116 cases(52.5%) were non-neoplastic lesions, 76(34.4%) cases were benign neoplasms and 23 cases(10.4%) were malignant neoplasms. The cytologic diagnoses could be correlated with histologic findings in 58 cases. FNAC correctly discriminated between neoplastic and nonneoplastic lesions in fifty-seven lesions and failed in a case, and overall accuracy, sensitivity, and specificity were 98.3%, 98.0%, and 100.0%. FNAC correctly discriminated malignant neoplasms from benign neoplastic/non- neoplastic lesions in fifty-three cases and failed in five cases, and overall accuracy, sensitivity, and specificity were 91.3%, 72.7%, and 95.7%. Among three false negative cases, two mucoepidermoid carcinomas were misdiagnosed as mucocele and benign neoplasm, and an acinic cell carcinoma were misdiagnosed as Warthin's tumor. Two false positive cases were a Warthin's tumor misdiagnosed as squamous cell carcinoma and a pleomorphic adenoma misinterpretated as suggestive of malignancy. In conclusion, diagnostic accuracy of FNAC of salivary lesions is high, and the possibilities of low grade mucoepidermoid carcinoma and acinic cell carcinoma should be considered on hypocellular smears with mucoid or fluidy background.
Case Reports
Fine Needle Aspiration Cytology of Small Cell Carcinoma of the Parotid Gland: A Case Report .
Chan Kwon Jung, Eun Sun Jung, Youn Soo Lee, Sun Moo Kim, Byung Kee Kim
J Pathol Transl Med. 1999;10(2):163-167.
  • 1,976 View
  • 23 Download
AbstractAbstract PDF
Primary small cell carcinoma of the salivary gland is a rare neoplasm that accounts for approximately 1.8% of all primary major salivary gland malignancies. Because of its rarity, it is difficult to diagnose small cell carcinoma of the parotid gland by fine needle aspiration cytology(FNAC). We experienced a case of primary small cell carcinoma of the parotid gland in a 72-year-old woman who presented with two palpable masses of the left infraauricular and ocular regions of two to three month's duration, respectively. Aspirate smears from the left infraauricular area were highly cellular on necrotic and lymphocytic background and showed individually dispersed cells or three-dimensional clusters of small cells. The tumor cells were round to oval with a very high nucleocytoplasmic ratio. Nuclei were about two times the size of lymphocytes and had uniformly dispersed but hyperchromatic to pyknotic chromatin. Nucleoli were occasionally visible but were generally inconspicuous. Numerous mitotic figures were detected. The clusters of these small tumor cells exhibited angular nuclear molding, irregular nuclear outlines, and occasionally rosette like arrangement. The tumor was confirmed by histology and immunohistochemistry.
Fine Needle Aspiration Cytology of Papillary-Cystic Variant of Acinic Cell Carcinoma of Salivary Gland: A Case Report .
Ah Won Lee, Jin Young Yoo, Seok Jin Kang, Byung Kee Kim
J Pathol Transl Med. 2001;12(1):45-48.
  • 1,987 View
  • 26 Download
AbstractAbstract PDF
Acinic cell carcinoma(ACC) is the third common malignancy in major salivary gland. Fine needle aspiration cytology is a useful tool for the diagnosis of salivary gland lesions. However, some low grade malignancies, such as ACC and mucoepidermoid carcinoma show relatively high false negative rate, mainly due to deceptively benign cytomorphologic appearance. We experienced a papillary-cystic variant of ACC, having different cytopathologic features compared with those of classic ACC. Our case showed monolayered sheets and papillary clusters without any acinic structures or naked nuclei of the tumor cells. Foamy proteinaceous material was seen in the background. The tumor cells had a large amount of granular cytoplasm and eccentric nuclei. Many vacuolated or clear cells were also noted.
Fine Needle Aspiration Cytology of Salivary Duct Carcinoma with Calcification in Submandibular Gland: A Case Report .
Ki Jung Yun, Weon Cheol Han, Hyang Jeong Jo, Kwang Man Lee
J Pathol Transl Med. 2001;12(1):49-52.
  • 2,040 View
  • 26 Download
AbstractAbstract PDF
Salivary duct carcinoma is an uncommon aggressive malignant epithelial neoplasm with similarity to intraductal carcinoma of the breast. This neoplasm occurs most often in the parotid gland of middle-aged and older males. About 7% of reported tumors occured in the submandibular gland. The report of salivary duct carcinoma with calcification is rare. We report a case of salivary duct carcinoma with calcification in the submandibular gland. The patient was a 73-year-old male with a mass of the right submandibular gland for 1 year. On the fine needle aspiration cytology, the aspirate showed scant cellularity, small clusters of tumor cells, and scattered small calcifications. Nuclei of the tumor cells showed mild pleomorphism and round to oval in shape, and cytoplasm was abundant and finely granular. Nucleoli were indistinct and necrosis was not noted. There were no cribriform or papillary arrangements of tumor cells. Cytologic findings of salivary duct carcinoma are variable depending on histologic findings, and calcifications could be an additional cytologic finding.
Combined Epithelial-Myoepithelial Carcinoma and Basal Cell Adenocarcinoma of the Parotid Gland: A case report.
Young Kyung Bae, Dong Sug Kim, Jang Soo Suh, Jae Yun Ro
Korean J Pathol. 1999;33(6):453-456.
  • 2,022 View
  • 32 Download
AbstractAbstract PDF
Epithelial-myoepithelial carcinoma and basal cell adenocarcinoma are uncommon, low-grade malignant epithelial neoplasms of salivary gland. They occur predominantly in the parotid glands with frequent recurrences and occasional distant metastases. We report an unusual case of combined epithelial-myoepithelial carcinoma and basal cell adenocarcinoma within the same mass of the parotid gland in a 32-year-old woman. To the best of our knowledge, this is the first such a combined carcinoma case.
Original Articles
Quality Assuarance on Fine Needle Aspiration Cytology of Malignant Salivary Gland Neoplasms.
Young Hyeh Ko, Young Lyun Oh
J Pathol Transl Med. 2004;15(1):40-44.
  • 2,007 View
  • 11 Download
AbstractAbstract PDF
To evaluate the quality of fine needle aspiration cytology diagnosis on malignant salivary gland neoplasms, cytologic findings were correlated with histologic diagnosis of 56 surgically removed malignant salivary gland tumors. Seven cases (12.5%) were insufficient, 23 cases (41.1%) were diagnosed as malignant, 17 (30.4%) cases were accurately diagnosed by histologic subtype, and 9 cases (16%) were diagnosed as benign. Five out of 9 false negative cases were misdiagnosed as pleomorphic adenomas. Except the cases with insufficient specimen, overall sensitivity was 81.6%, and the sensitivity varied according to the histologic subtype; 91% in salivary duct carcinoma, 100% in carcinoma ex pleomorphic adenoma, 50% in mucoepidermoid carcinoma, 63% in adenoid cystic carcinoma, and 50% in acinic cell carcinoma. The diagnostic accuracy differed among cytopathologists irrespective of periods after acquisition of board of pathologists. These results confirm that salivary gland neoplasm can be easily misdiagnosed in fine needle aspiration cytology and a great caution should be given in diagnosing the benign appearing salivary aspirates to avoid under-diagnosis of malignant neoplasm with low grade cytologic atypia.
A Cytologic Study of Fine Needle Aspiration Biopsy of Salivary Gland Diseases.
Mi Jin Kim, Tae Suk Lee
J Pathol Transl Med. 1994;5(2):120-129.
  • 1,863 View
  • 14 Download
AbstractAbstract PDF
Fine needle aspiration biopsy cytology is a widely recognized and useful technique which can provide diagnosis in lesions of the head and neck, enabling appropriate management plans for individual patient to be made. Fifty one fine needle aspirates from salivary gland masses were examined. Four aspirates(8%) were inadequate for examination. Of the remaning 47 samples, 42 cases(82%) were benign lesions which consist of 30 pleomorphic adenoma(58%), 7 inflammatory lesion(14%) 4 Warthin's tumor (8%) and 1 benign lesion(2%). Two cases(4%) were atypical lesions. Three case(6%) were malignant lesions consisting of 2 adenoid cystic carcinomas(4%) and 1 mucoepidermoid carcinoma(2%). The cytologic diagnoses were compared with the subsequent histologic diagnosis of surgical resected specimen in 24 cases. 19 cases of 21 aspirates from benign tumors were correctly diagnosed by fine needle aspiration cytology, with a specificity of 90%. All 3 aspriates from the 3 patients with malignant tumor were correctly diagnosed by fine needle aspiration cytology, with a sensitivity at 100%. Overall acurracy was 88%. Diagnostic error was encountered in adenoid cystic carcinoma, mucoepidermoid carcinoma and warthin's tumor. Correct histologic diagnosis was made in 86% of benign tumors(84% for pleomorphic adenoma and 100% for Warthin's tumor) and in 100% of malignant tumors.
Case Report
Rosai-Dorfman Disease of the Nose and Salivary Gland: A case report.
Mee Sook Roh, Jin Sook Jeong, Sook Hee Hong
Korean J Pathol. 1999;33(12):1203-1206.
  • 2,211 View
  • 20 Download
AbstractAbstract PDF
Rosai-Dorfman disease (RDD) is a rare type of benign histiocytosis characterized histologically by intracellular engulfment of lymphocytes. Extranodal RDD may occur as a part of generalized process involving lymph nodes or may involve extranodal sites independent of the lymph node status. We have experienced a case of extranodal Rosai-Dorfman disease of the nose as an initial lesion prior to nodal involvement. The patient was a 20-year-old woman who complained of nasal obstruction for 4 years, remotely, and left submandibular mass for 3 months, recently. Histologically, the lesion taken from nasal cavity, submandibular gland and left upper jugular lymph node all showed an heavy infiltrate consisted of plasma cells, lymphocytes and sheets of macrophages with abundant pale cytoplasm, which replaced organ architecture. The associated focal fibrosis made it difficult to differentiate from inflammatory pseudotumor. Some macrophages demonstrated phagocytosis of lymphocytes, plasma cells and occasionally neutrophils. The macrophages were strongly positive for S-100 protein.
Reviews
Cytologic Diagnosis of Basaloid Neoplasms of Salivary Gland.
Kyung Ja Cho
J Pathol Transl Med. 2005;16(2):67-74.
  • 2,228 View
  • 37 Download
AbstractAbstract PDF
Although fine needle aspiration cytology (FNAC) has become one of the primary tools for diagnosing salivary gland lesions, some of these methods continue to confuse pathologists. The most common problems occur so-called basaloid neoplasms. Basal cell adenomas are frequently misdiagnosed as pleomorphic adenomas, and in worse cases, as adenoid cystic carcinomas. The cytologic diagnostic accuracy of basaloid neoplasms could be increased by a better understanding of the histology and the nature of the tumor cells. These are displayed well in aspiration smears. A consideration of differential points on the basis of the epithelial-stromal relationship is offered in this paper.
Fine Needle Aspiration Cytology of High Grade Neoplasm and Spindle Cell Lesion of Salivary Gland.
Young Lyun Oh
J Pathol Transl Med. 2005;16(2):75-87.
  • 1,949 View
  • 21 Download
AbstractAbstract PDF
Fine needle aspiration cytology (FNAC) is a very useful tool in the preoperative diagnosis of lesions of the salivary gland. Surgical therapy of high-grade malignancies (salivary duct carcinoma, mucoepidermoid carcinoma, squamous cellcarcinoma, carcinoma ex pleomorphic adenoma, small cell carcinoma, and sebaceous carcinoma) is different from that of benign lesions or low-grade malignancies. Therefore, the recognition of high-grade malignancies is important in salivary gland FNAC. Although recognition of high-grade malignancies of the salivary gland by FNAC is not difficult, precise classification of these malignancies is often impossible. Additionally, because of its rarity, FNAC of spindle cells and mesenchymal lesions of the salivary glands is a tool that is not familiar to many cytopathologists. The characteristic cytomorphologic features of these lesions are reviewed here with a discussion of specific diagnostic problems.
Case Reports
Epstein-Barr Virus Associated Lymphoepithelial Carcinoma of the Parotid Gland: A case report.
Kwang Il Kim, Young Sik Kim, In Sun Kim
Korean J Pathol. 1998;32(2):150-152.
  • 2,288 View
  • 21 Download
AbstractAbstract PDF
Lymphoepithelial carcinoma is a rare subtype of undifferentiated carcinoma in the salivary gland. The incidence of lymphoepithelial carcinoma is about 0.4% among the patients with major salivary gland tumors. It has a racial preference; about 75% of the patients are of Mongolian ancestry. We report a case of lymphoepithelial carcinoma arising in the left parotid gland of a 52-year-old man. Grossly, the tumor was relatively well demarcated, gray-white, and solid. Microscopically, the irregular shaped syncytial tumor cell islands were evident within lymphoplasma cell-rich and desmoplastic stroma. The carcinoma cells had large vesicular nuclei and prominent nucleoli. The tumor invaded the surrounding salivary gland tissue. Epstein-Barr virus (EBV) was demonstrated by in situ hybridization for EBV-encoded RNA-1 (EBER-1) and polymerase chain reaction for EBV nuclear antigen-1 (EBNA-1).
Papillary Cystadenocarcinoma In The Retromolar Area: A Brief Case Report.
Dongchul Kim
Korean J Pathol. 2005;39(6):433-436.
  • 1,879 View
  • 18 Download
AbstractAbstract PDF
Salivary gland papillary cystadenocarcinomas are rare lesions, and particularly when they are found in the oral cavity. They have been recognized as being low grade carcinomas of the salivary glands. The author reports here on a case of recurrent papillary cystadenocarcinoma in the right retromolar area. The initial mass had multicystic and papillary structures with low grade features. The recurred mass showed basically the same histologic features. However the layer of papillae and the solid portion were increased and the tumor cells were larger and more pleomorphic with prominent nucleoli and frequent mitoses. Focal comedo type tumor necrosis and spindle cell proliferations in the surrounding soft tissue were present. This is a very rare report of a minor salivary gland papillary cystadenocarcinoma in a Korean, and the morphologic dedifferentiation was accompanied by the clinical recurrence.
Cytologic Findings of Epithelial-Myoepithelial Carcinoma of the Salivary Gland: A Case Report.
Eun Sook Nam, Gu Kang, Hyung Sik Shin
J Pathol Transl Med. 1996;7(1):64-68.
  • 2,353 View
  • 35 Download
AbstractAbstract PDF
The report of aspiration cytologic findings of epithelial-myoepithelial carcinoma(EMC) in the salivary gland is extremely rare. We present a case of fine needle aspiration cytology(FNAC) from EMC in the right submandibular gland of a 46 years old male patient. Neck CT scan revealed a confined lesion in the submandibular gland without enlargement of the regional lymph node. FNAC from the tumor showed several three-dimensional cellular clusters with admixed normal acinar cells. They frequently formed branching tubular structures composed of two type of cells; darker cells having eosinophilic scanty cytoplasm with round dense nuclei and clear cells having abudant pale cytoplasm with vesicular nuclei at the periphery of clusters. The tumor cells of both types did not show pleomorphism or mitoses. The resected submandibular gland showed an ill-defined whitish firm tumor, measuring 2 X1.5X2cm. The histology revealed an infiltrative tumor showing characteristic two cell types in a duct-like arrangement surrounded by thin basement menbrane. An inner layer of darker cells and outer layer of clear cells were postive for cytokeratin in the former and S-100 protein in the latter on the immunohistochemical stain.
Original Article
Epithelial-Myoepithelial Carcinoma of Intercalated Duct of Parotid Gland.
Soong Deok Lee, Doo Hyun Chung, Sung Hye Park, Chul Woo Kim, Je G Chi
Korean J Pathol. 1992;26(1):76-81.
  • 2,440 View
  • 20 Download
AbstractAbstract PDF
Epithelial-myoepithelial carcinoma of intercalated duct(origin) is a recently described tumor characterized by its typical biphasic pattern of central duct like cell and peripheral clear cell. We described a case of epithelial-myoepithelial carcinoma in a 10-year-old boy. Microscopically, the tumor showed typical biphasic pattern, diffuse proliferation of clear cells and linining epithelial cells of tubular structures. Immunohistochemically, the clear cell showed positive reaction to S-100 protein, and the epithelial cells expressed cytokeratin indicating myoepithelial and epithelial differentiation respectively. Biphasic differentiation of the tumor cells could be also proved by electronmicroscopic study.
Case Report
Fine Needle Aspiration Cytology of Acinic Cell Carcinoma of the Parotid Gland: A Case Report.
Seok Hoon Jeon, Seung Sam Paik, Won Mi Lee, Moon Hyang Park, Jung Dal Lee
J Pathol Transl Med. 1996;7(2):225-229.
  • 2,460 View
  • 71 Download
AbstractAbstract PDF
We experienced a case of well-differentiated acinic cell carcinoma of the parotid gland in a 65 year-old woman, which was correctly diagnosed preoperatively by fine needle aspiration(FNA) cytology. FNA cytology smears showed clusters or sheets of monomorphic acinic cells having reticulated or finely vacuolated basophilic or acidophilic cytoplasm. The cellular population was homogeneous or slightly polymorphic, having centrally located, round nuclei with finely reticular chromatin and incon- spicuous nucleoli. Herein we report this case with its histologic features and review of literatures.
Original Article
Beckwith-Wiedemann Syndrome with Unusual Sialoadenomegaly.
Hye Seung Han, Seung Sook Lee, Suk Keun Lee, Je G Chi
Korean J Pathol. 1996;30(10):939-942.
  • 2,151 View
  • 19 Download
AbstractAbstract PDF
Beckwith-Wiedemann syndrome is a rare clinical entity characterized by exomphalos, macroglossia, macrosomia, and renal hyperplasia/dysplasia. Although its entity is established, its etiology and obligatory features have not been settled. We report an autopsy case with the unusual involvement of the salivary gland. This infant was born to a 37-year-old mother as a normal full-term spontaneous delivery. At 11 days of age she developed with purulent eye discharge and weak sucking, and died suddenly. At autopsy the baby weighed 2,630 gm and the head circumference was 35 cm. She showed thick and prominent skin folds, bilateral aural fissures, macroglossia, hepatomegaly, cardiomegaly, dysmorphic kidneys, and nesidioblastosis. Both kidneys showed dysplastic tubules and hyperplastic cortical tissue enclosing the medulla. In this case there were characteristic findings in major and minor salivary glands with both acinar and ductal hyperplasia, and hypertrophy of mammary glands. Besides, she had generalized depletion of subcutaneous fat, immature buccal fat, patent ductus arteriosus, hyperlobation of the right lung, two accessory spleens, and hyperplasia of basophils and chromophobes in the pituitary gland. The lungs showed diffuse interstitial pneumonia and multiple fibrin thrombi. There were no adrenal cytomegaly, umbilical hernia and exophthalmos.
Case Reports
Cytologic and Histologic Findings of Acinic Cell Carcinoma of the Salivary Gland Related to Malignant Behavior: 2 Cases Report .
Sung Suk Paeng, Hee Jin Chang, Jung Il Suh, Hyo Sook Park
J Pathol Transl Med. 1997;8(1):62-68.
  • 2,074 View
  • 20 Download
AbstractAbstract PDF
Acinic cell carcinoma is a slow-growing solid neoplasm of salivary gland. Although their cytological and histological finding is bland-looking, their biological behavior is unpredictable. We experienced two cases of acinic cell carcinoma of the salivary gland diagnosed by fine needle aspiration biopsy and confirmed by tissue examination. They showed different clinical courses. We compared their cytologic and histologic findings. The first case was a right preauricular mass in a 58 year-old female of 3 years duration. The cytologic smear revealed sheets or small clusters of monotonous cells mimicking normal serous acinar cells with little cellular pleomorphism. She underwent superficial parotid lobectomy. The tumor was a well demarcated 1.5cm sized nodular mass without infiltration into surrounding parenchyme. The second case was a left submandibular mass in a 23 year-old male of 4 years duration. The smear showed more severe pleomorphism of the tumor cells than those of previous case. Excisional biopsy was done. The excised tumor was 5.5*3.5*3cm sized multilobulated solid mass with invasion into surrounding parenchyme. The tumor recurred after 20months, thus total excision of the mass and modified radical neck dissection was carried out. From the above findings, cytologic atypism, infiltrative growth pattern and type of initial therapy may be correlated with biologic behavior.
Pleomorphic Adenoma of the Bronchus: A case report.
Eun Sun Park, Mi Kyung Jee, Seok Jin Gang, Byung Kee Kim, Sun Moo Kim
Korean J Pathol. 1989;23(1):136-140.
  • 1,883 View
  • 19 Download
AbstractAbstract PDF
Pleomorphic adenoma presenting as primary lesion of the bronchus is very rarely encountered, and in our knowledge only 6 cases have been reported in the literature of the western world, and no case report has been published in Korea. Currently, we experienced a case of bronchial pleomorphic adenoma occuring in a 38 years old woman. On X-ray examination, hazy density in the right upper lobe and emphysematous change in the right lower lobe were noted. A right pneumonectomy was done under bronchoscopic diagnosis of bronchial adeoma. The pathologic examination of the present case showed a polypoid endobronchial tumor, 1.4 x 1.1 cm (with extraluminal portion, 2.2 x 1.7 cm) in the right upper bronchus. The microscopic examination revealed a pleomorphic adenoma showing same morphology as those found in the salivary gland. This case, therefore, was believed to be a genuine example of bronchial pleomorphic adenoma of salivary gland type. We compared this case with 6 cases in the literature.
Carcinosarcoma Arising from Mixed Tumor of the Parotid Gland: A case report.
Jae Soo Koh, Chang Won Ha, Na Hye Myoung, Kyung Ja Cho, Kyung Kyun Oh, Mi Kyung Kim, Ja June Jang
Korean J Pathol. 1992;26(5):530-532.
  • 2,353 View
  • 14 Download
AbstractAbstract PDF
A case of true malignant mixed tumor of the parotid gland is reported. The tumor, occuring in a 55-year-old man, started to grow rapidly after a long history of parotid mass. Total parotidectomy was carried out and the resected tumor measured 5x4x3 cm with a cut surface showing grayish-white solid and myxoid appearance. Microscopically, the tumor had both carcinomatous and sarcomatous elements, the former consisting of undifferentiated carcinoma with focal areas of ductal differentiation and the latter consisting of pleomorphic sarcoma with chondrosarcomatous differentiation. A remnant of benign pleomorphic adenoma could also be identified. Immunohistochemical study demonstrated focal cytokeratin reactivity in the carcinoma cells and vimentin in sarcomatous elements. It is assumed from these clinical and histological findings that the tumor had transformed from a pre-existing benign pleomorphic adenoma.

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