title: Update on selected salivary gland neoplasms.
abstract: BACKGROUND
  Malignancies of the salivary gland are uncommon and account for 0.3% of all malignancies. In addition to their rarity, diagnosing these tumors can be challenging given the histologic overlap among various subtypes, their morphologic heterogeneity, and the recent recognition of new entities.
  
  
  OBJECTIVE
  To provide an overview of 4 salivary gland malignancies that we often see in consultation, with a focus on essential diagnostic features and the importance of reporting pertinent diagnostic information to ensure appropriate clinical management.
  
  
  METHODS
  Review of the literature, supplemented by the personal experience of the authors, which is based on their respective institutional experiences and consultation services.
  
  
  CONCLUSIONS
  When diagnosing carcinoma ex pleomorphic adenoma, pathologists must report several important pieces of information to allow for optimal clinical management. In addition to histologic subtype, the degree of differentiation as well as the degree of invasion, if any, must be reported because all have prognostic relevance. Polymorphous low-grade adenocarcinoma can be a challenging diagnosis on biopsy specimens. Evaluation of the tumor periphery and nuclear features should lead to the correct diagnosis in most cases. Salivary duct carcinoma is an aggressive malignancy characterized by histologic resemblance to breast carcinoma, high-grade cytologic features, and expression of androgen receptor. Benign and malignant myoepithelial neoplasms have a broad morphologic spectrum, and immunohistochemistry is important in reaching the correct diagnosis.
authors.affiliation: Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USA. jonamch@umich.edu
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: McHugh
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Visscher
authors.forename: E Leon
authors.initials: EL
authors.lastname: Barnes
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000175:diagnosis*; D008949:Adenoma, Pleomorphic / Q000737:chemistry / Q000175:diagnosis*; D014408:Biomarkers, Tumor / Q000032:analysis; D002278:Carcinoma in Situ / Q000737:chemistry / Q000175:diagnosis*; D002296:Carcinosarcoma / Q000737:chemistry / Q000175:diagnosis*; D006801:Humans; D018987:Salivary Ducts / Q000473:pathology; D012468:Salivary Gland Neoplasms / Q000737:chemistry / Q000175:diagnosis*
chemical_list: D014408:Biomarkers, Tumor