title: Plasmacytoid-Type Cellular Differentiation in Polymorphous Low-Grade Adenocarcinoma.
abstract: BACKGROUND
  Polymorphous low-grade adenocarcinoma (PLGA) occurs more frequently in minor salivary glands. The diagnosis of PLGA, in general, is not difficult but in occasional tumors showing limited invasion or in small biopsy specimens, PLGA may be confused with cellular pleomorphic adenoma (PA). Plasmacytoid cells, a usual component of PAs, have been considered helpful for correct tumor identification.
  
  
  OBJECTIVE
  The aim of this study was to verify the frequency (if any) of plasmacytoid-type cellular differentiation (PD) in PLGA.
  
  
  METHODS
  Thirty-two cases of PLGA were reviewed. PD was recognized in 2 cases (6.25%), in which immunohistochemical expression of AE1/AE3, CK7, CK14, vimentin, α-SMA, p63, S-100, calponin, GFAP, and Ki-67 was evaluated.
  
  
  RESULTS
  The 2 cases presented conventional areas of PLGA and variable quantities of cells with PD forming aggregates in the stroma and lining ductal structures. Cells with PD showed positivity for AE1/AE3, CK7, S-100, and vimentin and were negative for CK14, calponin, and GFAP in both cases. In case 1, cells with PD did not present α-SMA and p63 positivity whereas in case 2 they were positive, but for α-SMA such reactivity was restricted to cells forming solid aggregates.
  
  
  CONCLUSIONS
  Although PD in PLGA is rare, it is necessary to be aware of this possibility, particularly in small incisional biopsies and in PLGA with limited invasion, to avoid confusion with cellular PA.
authors.affiliation: Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil.
authors.forename: Harim Tavares
authors.initials: HT
authors.lastname: Dos Santos
authors.affiliation: Rio de Janeiro Federal University, Rio de Janeiro, Brazil.
authors.forename: Bruno Augusto Benevenuto
authors.initials: BA
authors.lastname: de Andrade
authors.affiliation: Medical Science Faculty, University of Campinas (UNICAMP), Campinas, Brazil.
authors.forename: Erika Said Abu
authors.initials: ES
authors.lastname: Egal
authors.affiliation: Medical Science Faculty, University of Campinas (UNICAMP), Campinas, Brazil.
authors.forename: Edson Robles Castilla
authors.initials: ER
authors.lastname: Filho
authors.affiliation: Medical Science Faculty, University of Campinas (UNICAMP), Campinas, Brazil.
authors.forename: Fernanda Viviane
authors.initials: FV
authors.lastname: Mariano
authors.affiliation: Medical Science Faculty, University of Campinas (UNICAMP), Campinas, Brazil aaltemani@uol.com.br.
authors.forename: Albina
authors.initials: A
authors.lastname: Altemani
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology*; D008949:Adenoma, Pleomorphic / Q000175:diagnosis / Q000473:pathology; D014408:Biomarkers, Tumor / Q000032:analysis; D002454:Cell Differentiation; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D012468:Salivary Gland Neoplasms / Q000175:diagnosis / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor
keywords: plasmacytoid cell; polymorphous low-grade adenocarcinoma