title: Morphological heterogeneity of oral salivary gland carcinomas: a clinicopathologic study of 41 cases with long term follow-up emphasizing the overlapping spectrum of adenoid cystic carcinoma and polymorphous low-grade adenocarcinoma.
abstract: We analyzed 41 oral salivary gland carcinomas from consecutive 290 salivary gland carcinoma database (14%) with emphasis on the histological spectrum and clinical outcome of adenoid cystic carcinoma (ACC) and polymorphous low-grade adenocarcinoma (PLGA). The cohort included 14 ACCs, 14 mucoepidermoid carcinomas (MECs), 8 PLGAs, 3 adenocarcinomas, not otherwise specified and 2 acinic cell carcinomas. Mean age was 48, 58 and 61 yrs for ACC, MEC and PLGA, respectively. Eight patients (19.5%) died of tumor at a mean interval of 66.5 months. ACC and PLGA showed similar mean age, gender distribution, predominant palatal localization, nodal metastasis, perineural invasion and MIB-1 index. However, ACC tended to show higher tumor stage and residual tumor (R1/R2) more frequently than PLGA, but this was statistically not significant. ACC and PLGA showed overlapping architectural patterns. However, ACCs displayed well organized basal-luminal differentiation, highlighted by CK5/CK7 immunostaining. In contrast, PLGA showed a disorganized histological and immunohistological pattern. C-Kit expression (CD117) was common in ACC, generally mirroring that of CK7 and virtually lacking in PLGA. Kaplan-Meier analysis demonstrated a similar clinical course for ACC and PLGA with 5 years survivals of 87% and 80%, respectively. Fluorescence in situ hybridization (FISH) performed on all 290 salivary carcinomas confirmed the specificity of the translocation t (11; 19) for MEC and its absence in all other carcinomas including ACC and PLGA. Our results emphasize the diversity of oral salivary gland carcinomas and the overlapping clinicopathological features of ACC and PLGA.
authors.affiliation: Department of Pathology, University of Erlangen, Germany. Abbas.agaimy@uk-erlangen.de
authors.forename: Stephan
authors.initials: S
authors.lastname: Schwarz
authors.forename: Maximilian
authors.initials: M
authors.lastname: Müller
authors.forename: Tobias
authors.initials: T
authors.lastname: Ettl
authors.forename: Philipp
authors.initials: P
authors.lastname: Stockmann
authors.forename: Johannes
authors.initials: J
authors.lastname: Zenk
authors.forename: Abbas
authors.initials: A
authors.lastname: Agaimy
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000235:genetics / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D018267:Carcinoma, Acinar Cell / Q000473:pathology; D003528:Carcinoma, Adenoid Cystic / Q000235:genetics / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D018277:Carcinoma, Mucoepidermoid / Q000473:pathology; D002454:Cell Differentiation; D002880:Chromosomes, Human, Pair 11; D002888:Chromosomes, Human, Pair 19; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D053208:Kaplan-Meier Estimate; D053555:Keratin-5 / Q000032:analysis; D053552:Keratin-7 / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis; D012468:Salivary Gland Neoplasms / Q000737:chemistry / Q000235:genetics / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D013997:Time Factors; D014178:Translocation, Genetic; D044767:Ubiquitin-Protein Ligases / Q000032:analysis; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; C503940:KRT5 protein, human; C507497:KRT7 protein, human; D053555:Keratin-5; D053552:Keratin-7; C513496:MIB1 ligase, human; D044767:Ubiquitin-Protein Ligases; D019009:Proto-Oncogene Proteins c-kit