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
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;[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
Background In this meta-analysis, we aimed to evaluate the PAX8 immunohistochemical expressions in primary lung cancers and metastatic cancers to the lung.
Methods We identified and reviewed relevant articles from the PubMed databases. Ultimately, 18 articles were included in this meta-analysis. PAX8 expression rates were analyzed and compared between primary and metastatic lung cancers.
Results The PAX8 expression rate in primary lung cancers was 0.042 (95% confidence interval [CI], 0.025 to 0.071). PAX8 expression rates of small cell (0.129; 95% CI, 0.022 to 0.496) and non-small cell carcinomas of the lung (0.037; 95% CI, 0.022 to 0.061) were significantly different (p=.049 in a meta-regression test). However, the PAX8 expression rates of adenocarcinoma (0.013; 95% CI, 0.006 to 0.031) and squamous cell carcinoma (0.040; 95% CI, 0.016 to 0.097) were not significantly different. PAX8 expression rates of metastatic carcinomas to the lung varied, ranging from 1.8% to 94.9%. Metastatic carcinomas from the lung to other organs had a PAX8 expression rate of 6.3%. The PAX8 expression rates of metastatic carcinomas from the female genital organs, kidneys, and thyroid gland to the lung were higher than those of other metastatic carcinomas.
Conclusions Primary lung cancers had a low PAX8 expression rate regardless of tumor subtype. However, the PAX8 expression rates of metastatic carcinomas from the female genital organs, kidneys, and thyroid were significantly higher than those of primary lung cancers.
Citations
Citations to this article as recorded by
Prognostic value of PAX8 in small cell lung cancer Fengyun Tao, Hangyan Zhu, Jiayun Xu, Yanan Guo, Xin Wang, Lei Shao, Deng Pan, Guosheng Li, Rong Fang Heliyon.2024; 10(7): e28251. CrossRef
Background The aim of this study is to elucidate the clinicopathological significances, including the prognostic role, of metastatic lymph node ratio (mLNR) and tumor deposit diameter in papillary thyroid carcinoma (PTC) through a retrospective review and meta-analysis.
Methods We categorized the cases into high (≥ 0.44) and low mLNR (< 0.44) and investigated the correlations with clinicopathological parameters in 64 PTCs with neck level VI lymph node (LN) metastasis. In addition, meta-analysis of seven eligible studies was used to investigate the correlation between mLNR and survival.
Results Among 64 PTCs with neck level VI LN metastasis, high mLNR was found in 34 PTCs (53.1%). High mLNR was significantly correlated with macrometastasis (tumor deposit diameter ≥ 0.2 cm), extracapsular spread, and number of metastatic LNs. Based on linear regression test, mLNR was significantly increased by the largest LN size but not the largest metastatic LN (mLN) size. High mLNR was not correlated with nuclear factor κB or cyclin D1 immunohistochemical expression, Ki-67 labeling index, or other pathological parameters of primary tumor. Based on meta-analysis, high mLNR significantly correlated with worse disease-free survival at the 5-year and 10-year follow-up (hazard ratio [HR], 4.866; 95% confidence interval [CI], 3.527 to 6.714 and HR, 5.769; 95% CI, 2.951 to 11.275, respectively).
Conclusions Our data showed that high mLNR significantly correlated with worse survival, macrometastasis, and extracapsular spread of mLNs. Further cumulative studies for more detailed criteria of mLNR are needed before application in daily practice.
Citations
Citations to this article as recorded by
Application and subgroup analysis of competing risks model based on different lymph node staging systems in differentiated thyroid cancer Zhe Xu Cao, Jiang Sheng Huang, Ming Ming Wang Updates in Surgery.2024;[Epub] CrossRef
Thyroglobulin expression, Ki-67 index, and lymph node ratio in the prognostic assessment of papillary thyroid cancer Helene Lindfors, Marie Karlsen, Ellinor Karlton, Jan Zedenius, Catharina Larsson, Catharina Ihre Lundgren, C. Christofer Juhlin, Ivan Shabo Scientific Reports.2023;[Epub] CrossRef
Incidental Node Metastasis as an Independent Factor of Worse Disease-Free Survival in Patients with Papillary Thyroid Carcinoma Renan Aguera Pinheiro, Ana Kober Leite, Beatriz Godoi Cavalheiro, Evandro Sobroza de Mello, Luiz Paulo Kowalski, Leandro Luongo Matos Cancers.2023; 15(3): 943. CrossRef
A High-Quality Nomogram for Predicting Lung Metastasis in Newly Diagnosed Stage IV Thyroid Cancer: A Population-Based Study WenYi Wang, JiaJing Liu, XiaoFan Xu, LiQun Huo, XuLin Wang, Jun Gu Technology in Cancer Research & Treatment.2023; 22: 153303382311678. CrossRef
Lymph Node Ratio Predicts Recurrence in Patients with Papillary Thyroid Carcinoma with Low Lymph Node Yield Il Ku Kang, Joonseon Park, Ja Seong Bae, Jeong Soo Kim, Kwangsoon Kim Cancers.2023; 15(11): 2947. CrossRef
Superiority of metastatic lymph node ratio over number of node metastases and TNM/AJCC N classification in predicting cancer‐specific survival in medullary thyroid cancer Andreas Machens, Kerstin Lorenz, Frank Weber, Henning Dralle Head & Neck.2022; 44(12): 2717. CrossRef
Value of Combining Clinical Factors, Conventional Ultrasound, and Contrast-Enhanced Ultrasound Features in Preoperative Prediction of Central Lymph Node Metastases of Different Sized Papillary Thyroid Carcinomas Yanfang Wang, Fang Nie, Guojuan Wang, Ting Liu, Tiantian Dong, Yamin Sun Cancer Management and Research.2021; Volume 13: 3403. CrossRef
Atypical Histiocytoid Cells and Multinucleated Giant Cells in Fine-Needle Aspiration Cytology of the Thyroid Predict Lymph Node Metastasis of Papillary Thyroid Carcinoma Ji Eun Choi, Ja Seong Bae, Dong-Jun Lim, So Lyung Jung, Chan Kwon Jung Cancers.2019; 11(6): 816. CrossRef
Patients Aged ≥55 Years With Stage T1-2N1M1 Differentiated Thyroid Cancer Should Be Downstaged in the Eighth Edition AJCC/TNM Cancer Staging System Zeming Liu, Sichao Chen, Yihui Huang, Di Hu, Min Wang, Wei Wei, Chao Zhang, Wen Zeng, Liang Guo Frontiers in Oncology.2019;[Epub] CrossRef
Prognostic Implication of Metastatic Lymph Node Ratio in Colorectal Cancers: Comparison Depending on Tumor Location Jung-Soo Pyo, Young-Min Shin, Dong-Wook Kang Journal of Clinical Medicine.2019; 8(11): 1812. CrossRef
Survey of recurrent diagnostic challenges in breast phyllodes tumours Benjamin Yongcheng Tan, Stephen B Fox, Sunil R Lakhani, Puay Hoon Tan Histopathology.2023; 82(1): 95. CrossRef
Management of a periductal stromal tumor in a young woman: Our breast unit experience Irene Valente, Adela Ristani, Cristina Mancini, Eugenia Martella, Leonardo Quartieri, Cecilia D'Aloia The Breast Journal.2020; 26(7): 1375. CrossRef
A Diagnostic Approach to Fibroepithelial Breast Lesions Benjamin Yongcheng Tan, Puay Hoon Tan Surgical Pathology Clinics.2018; 11(1): 17. CrossRef
A case of local recurrence of periductal stromal sarcoma of the breast Kana TERAMOTO, Yasuro DOI, Kayo YAMAMOTO, Kaname MATSUKAWA, Hisaka IWAIHARA, Rumi MOTOSHIMA, Noboru TAKATA, Ichiro YOSHINAKA, Kazunori HARADA Choonpa Igaku.2018; 45(1): 61. CrossRef
Digital papillary adenocarcinoma: A case report Betty A. Kasimo, Vivian Akello, James J. Yahaya Clinical Case Reports.2021;[Epub] CrossRef
A rare case of a digital papillary carcinoma of the hand with secondary conservative management Rabeet Khan, Renu Irri, Effie Katsarma Journal of Surgical Case Reports.2020;[Epub] CrossRef
Cytologic examination of the body cavity fluid is very important because the specimens represent a significant percentage of nongynecologic samples and this cytologic examination may be the first, best or only chance for making the diagnosis of an underlying malignancy. The purposes of body cavity fluid examination are to correctly identify cancer cells and if possible, to identify the tumor types and primary sites when presented with unknown primary tumor sites. The most important basic differential diagnosis is that of benign and reactive disease vs malignant disease.
Reactive mesothelial cells are a consistent population in body cavity fluid, and these are the most versatile cells in the body. Due to the specific environment of the body cavity, the exfoliated reactive mesothelial cells may show significant morphologic overlap with the morphology of cancer cells. With a focus on the differential points between reactive mesothelial cells and metastatic adenocarcinoma cells, the practical diagnostic approaches, the diagnostic clues and the pitfalls to achieve a correct diagnosis are presented in this review.
Citations
Citations to this article as recorded by
A cytological observation of the fluid in the primo-nodes and vessels on the surfaces of mammalian internal organs Baeckkyoung Sung, Min Su Kim, Byung-Cheon Lee, Seong-Hun Ahn, Sung-Yeoun Hwang, Kwang-Sup Soh Biologia.2010; 65(5): 914. CrossRef
Gestational trophoblastic disease associated with the tubal pregnancy is uncommon, and the incidence has been described as 1/5000 tubal pregnancy. We have experienced a case of metastatic gestational trophoblastic disease(GTD) in the lung occuring with complete hydatidiform mole arising in tubal pregnancy. The patient was a 39-year-old, G4P2A2L2 woman with amenorrhea for 5 weeks. Ectopic pregnancy in the right fallopian tube was suspected on transvaginal ultrasonogram. A right adnexectomy was performed. The fallopian tube was markedly dilated and ruptured. The right ovary and a round hematoma had adhered to the external surface of the fallopian tube. On gross examination, no molar tissue was identified. On microscopic examination, the lumen of the dilated fallopian tube was filled with blood clots admixed with several chorionic villi showing hydropic swelling and marked proliferation of atypical trophoblasts.
Proliferating syncytio-and cytotrophoblasts invaded the wall of the blood vessels of the fallopian tube and sheets of trophoblasts and some villi were identified in the lumen of blood vessels. Multiple pulmonary nodules thought to be metastatic nodules were identified in the chest X-ray and serum beta-HCG had increased 2 weeks later. This case indicates that a careful pathological examination in the ectopic pregnancy is mandatory, because tubal GTD is not clinically distinguishable from ordinary tubal pregnancy.
A case of hepatic fascioliasis misdiagnosed as metastatic carcinoma was reported. The patient was a 22-year-old woman who had had rectal adenocarcinoma (Duke stage C2), and had been treated by Mile'operation 8 months ago. A computed tomogram(CT) demonstrated multiple low density nodules in the liver suggesting a metastatic tumor. A partial liver lobectomy was performed. The resected liver showed multiple necrotic nodules, which appeared to be abscesses containing eggs of the Fasciola species. Parasitic infection should be considered as one of the possible etiologies of hepatic nodules which mimic metastatic carcinoma either clinically or radiologically.
The p53 gene, one of the tumor suppressor genes, is believed to play an important role through mutation and overexpression in the progression of various human malignant tumors. To compare the p53 mutation status between the primary and metastatic lesions of breast cancers and to investigate the mutational pattern of p53, immunohistochemistry (IHC) and polymerase chain reaction and single strand conformational polymorphism (PCR-SSCP) were performed in 25 cases of breast cancers with paraffin embedded tissue. Mutant protein products or point mutation were detected through IHC or PCR-SSCP method. And flow cytometrical (FCM) analysis were performed in the same paraffin blocks to correlate the DNA ploidy and p53 mutation. The following results are summarized. 1. The detection of the p53 gene mutation and overexpression of the p53 protein were measured in 40% and 48%, respectively, in 25 primary tumors, either or both methods was detected in 64%. 2. A concordance rate of the p53 protein expression between the primary and metastatic lesions of 25 breast cancers was 100%, but the concordance rate of the p53 gene mutation was 72%. 3. The correlation between the p53 mutation and the DNA aneuploidy was not statistically significant (p=0.38) 4. A p53 mutation by IHC or PCR-SSCP was more frequently detected in grade III breast cancers than in grade I or II. 5. Among 5 to 9 exons of the p53 gene, exon 7 was the most frequent mutation spot in this study. 6. Additional mutation of the p53 gene was developed in the three metastatic lesions. With the above results it is suggested that the p53 protein overexpression by immunohistochemistry is not correlated with the p53 mutation by PCR-SSCP. The p53 mutation pattern between the primary and metastatic lesions are not idenitical and an additional point mutation can occur in the metastatic lesion. The DNA aneuploidy is more frequently detected in the cases with the p53 protein overexpression than in the p53 protein negative, but it is not statistically significant.
The distinction between cholangiocarcinoma (CC) and metastatic colonic adenocarcinoma of the liver (MCA) is often difficult, particularly in needle biopsy and fine-needle aspiration specimens, if histologic features alone are used. To examine the differences in the expressions of the cytokeratin (CK) 7 and 20 in the CCs and MCAs, we performed immunohistochemical studies on surgically resected 19 CCs and 23 MCAs. We used monoclonal antibodies against CK 7 and CK 20, and applied microwave antigen retrieval technique on formalin-fixed, paraffin-embedded tissue. We interpreted diffuse cytoplasmic reactivity found in > or =5% of tumor cells as positive. CCs showed CK 7+/CK 20- immunophenotype in 63%, CK 7+/CK 20+ in 32%, CK 7-/CK 20+ in 5%, and CK 7-/CK 20- in 0%. MCAs exhibited CK 7-/CK 20+ immunophenotype in 87%, CK 7+/CK 20+ in 9%, CK 7-/CK 20- in 4%, and CK 7+/CK 20- in 0%. CK 20-reactive cells in CCs were frequently columnar in shape (p<0.05). In conclusion, the CK 7/CK 20 immunophenotype was useful in the differentiation of CCs from MCAs: the CK 7+/CK 20- immunophenotype strongly suggested CCs, whereas the CK 7-/CK 20+ immunophenotype strongly suggested MCAs.
This study was carried out to evaluate the immunohistochemical expressions of p53, E-cadherin, and nm23 proteins in 114 cases of metastatic carcinoma of the neck lymph node (MTLNCA) and corresponding primary carcinoma (PRCA). The positive expressions of p53, E-cadherin, and nm23 proteins were 62.3%, 58.8% and 64.0%, respectively in PRCA, and 40.4%, 38.6%, and 43.9%, respectively in MTLNCA with significant down-regulation from PRCA to MTLNCA (p<0.05).
The down-regulation was correlated with female gender, moderate and poor differentiation, and adenocarcinoma in p53 protein, female gender, respiratory and gastrointestinal carcinoma in E-cadherin protein, and female gender, respiratory carcinoma, moderate differentiation, and squamous cell carcinoma in nm23 protein (p<0.05). There was no significant relationship among expressions of p53, E-cadherin, and nm23 proteins (p<0.05). In conclusion, these results suggest that the expressions of p53, E-cadherin, and nm23 proteins seem to be down-regulated from PRCA to MTLNCA and this down-regulation may play a role in invasion and metastasis.
A case of metastatic adenoid cystic carcinoma of the lung, originated from the trachea, was diagnosed by fine needle aspiration. Although the cytologic features of adenoid cystic carcinoma have been well described, it is easy to confuse adenoid cystic carcinoma with more common primary small cell neoplasms of the lung, i.e., small cell carcinoma, well differentiated adenocarcinoma, and carcinoid tumor of the lung. The features distinguishing adenoid cystic carcinoma from these neoplasms include 1) tight, globular, honeycomb pattern of cells, 2) acellular basement membrane material in the lumen, and 3) cells lacking true nuclear molding and having bland chromatin pattern. The morphologic feature of metastatic adenoid cystic carcinoma in this case was so distinctive as to permit a definite diagnosis by aspiration cytology.
Bone metastasis of hepatocellular carcinoma appears to be peculiar when clinical manifestation of liver disease is not apparent, and initial diagnosis of metastatic hepatocellular carcinoma by fine needle aspiration cytology is rarely obtained.
We experienced a case of 45-year-old man with metastatic hepatocellular carcinoma in the sacrum, which was diagnosed by fine needle aspiration cytology. The intrahepatic mass, measuring 1.2 cm in diameter and kept unchanged in size for two years, was never proved to be hepatocellular carcinoma histopathologically.
The aspirated neoplastic cells were mostly in sheets, showing abundant acidophilic cytoplasm and large, round.
centrally located nuclei with single, prominent acidophilic mucleoti. In the cell block section, diagnosis of metastatic well-differentiated hepatocellular carcinoma was made without difficulty, and definite trabecular fashion with sinusoidal endothelial cell lining was found.
Most common metastatic tumors of the thyroid gland are squamous cell carcinoma of head and neck region, adenocarcinoma of breast and lung, malignant melanoma, and renal cell carcinoma of kidney in order of frequency.
Metastasis from gastrointestinal tract to the thyroid gland rarely occurs. We experienced a case of fine needle aspiraton cytology of metastatic adenocarcinoma of both thyroid glands from the colon. Cytologic smears showed picket-fence like arrangement of nuclei of carcinoma cells and syncytial type of tissue fragments with acinar pattern on necrotic or mucoid background.
A case of metastatic mucoepidermoid carcinoma of the lung, originating from the hard palate, was diagnosed by sputum and bronchial washing cytology. Although the cytologic features of mucoepidermoid carcinoma have been well described, it is easy to confuse mucoepidermoid carcinoma with the more common primary adenocarcinoma or squamous cell carcinoma of the lung. The features distinguishing mucoepidermoid carcinoma from other primary neoplasms includ 1) mucus-secreting cells individually and in clusters admixed with other cell components, 2) epidermoid cells identified by the presence of abundant spread-out cytoplasm and an oval dark nucleus and 3) intermediate cells resembiling normal ductal epithelial cells with moderate-toscanty cytoplasm, a central, round vesicular nucleus and a prominent nucleolus, The morphologic features of metastatic mucoepidermoid carcinoma in the case were similar to those of primary sallvary mucoepidermoid carcinoma.