title: Clinical utility of myb rearrangement detection and p63/p40 immunophenotyping in the diagnosis of adenoid cystic carcinoma of minor salivary glands: a pilot study.
abstract: OBJECTIVE
  MYB rearrangement is observed in approximately 28% to 86% of adenoid cystic carcinomas (ACCs). Also, ACC features a p63+/p40+ immunophenotype in greater than 90% of cases, compared with p63+/p40- polymorphous low-grade adenocarcinoma (PLGA). Our aim was to investigate the incidence of (1) MYB rearrangement and (2) p63/p40 immunoreactivity in ACC and PLGA of minor salivary glands (MSGs).
  
  
  METHODS
  Seven cases of ACC as well as five of PLGA were evaluated by using a MYB (6 q23.3) break-apart fluorescence in situ hybridization (FISH) probe. In addition, all cases were immunohistochemically stained with p63 and p40 antibodies.
  
  
  RESULTS
  All five successfully hybridized ACCs featured MYB rearrangement, whereas PLGAs did not show MYB rearrangement. Interestingly, one case of PLGA demonstrated a single intact copy of MYB in greater than 88% of the neoplastic cells. All ACCs exhibited consistent p63+/p40+ staining, whereas PLGAs demonstrated a p63+/p40- immunophenotype.
  
  
  CONCLUSIONS
  (1) MYB rearrangement is encountered in ACCs but not PLGAs of MSGs; (2) MYB aberrations, for example, monosomy or deletion, can be seen in PLGAs; (3) combined p63/p40 immunostaining can be used to differentiate ACC from PLGA in incisionally biopsied specimens; and (4) performance of either FISH or p63/p40 immunohistochemistry is expected to be able to confirm the diagnosis of ACC or PLGA in small intraoral biopsies, since both techniques appeared to be diagnostically accurate in this pilot study.
authors.affiliation: Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Prokopios P
authors.initials: PP
authors.lastname: Argyris
authors.affiliation: Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Wetzel
authors.affiliation: Cytogenetics Research Core Laboratory, Medical Genome Facility, Mayo Clinic, Rochester, MN, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Greipp
authors.affiliation: Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Rebecca N
authors.initials: RN
authors.lastname: Wehrs
authors.affiliation: Cytogenetics Research Core Laboratory, Medical Genome Facility, Mayo Clinic, Rochester, MN, USA.
authors.forename: Darlene L
authors.initials: DL
authors.lastname: Knutson
authors.affiliation: Cytogenetics Research Core Laboratory, Medical Genome Facility, Mayo Clinic, Rochester, MN, USA.
authors.forename: Sara M
authors.initials: SM
authors.lastname: Kloft-Nelson
authors.affiliation: Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Joaquín J
authors.initials: JJ
authors.lastname: García
authors.affiliation: Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, Minneapolis, MN, USA. Electronic address: Koutl001@umn.edu.
authors.forename: Ioannis G
authors.initials: IG
authors.lastname: Koutlas
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D003528:Carcinoma, Adenoid Cystic / Q000235:genetics* / Q000473:pathology; D005260:Female; D015321:Gene Rearrangement; D020570:Genes, myb; D006801:Humans; D016056:Immunodominant Epitopes / Q000032:analysis; D007150:Immunohistochemistry; D016130:Immunophenotyping; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008565:Membrane Proteins / Q000032:analysis; D008875:Middle Aged; D010446:Peptide Fragments / Q000032:analysis; D010865:Pilot Projects; D012468:Salivary Gland Neoplasms / Q000235:genetics* / Q000473:pathology; D012470:Salivary Glands, Minor / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; C081876:CKAP4 protein, human; D016056:Immunodominant Epitopes; D008565:Membrane Proteins; C495942:P40, iodinated C-terminal peptide, human; D010446:Peptide Fragments