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Keratin
Published in Masahiko Mori, Histochemistry of the Salivary Glands, 2019
One type of monomorphic adenoma or epithelial myoepithelial carcinoma-like neoplasm was found. The tumor cells were composed of eosinophilic cells with double layers without lumens, and with differentiated spindle tumor cells in the center (Figure 36 a). Myoepithelial carcinomas have a characteristic appearance consisting of two types; the cytoplasm of luminal cells stained with eosin (intercalated origin), and outer cells manifesting a clear cytoplasm (myoepithelial). This type of tumor expressed different features as do epithelial-myoepithelial carcinomas. Keratin (KL1, K8.12) was only expressed in spindle tumor cells in central regions, and it was negative in eosinophilic tumor cells. Other monoclonal keratins were unstained in the two different tumor cell types (Figure 36 b). Previous studies have revealed that in epithelial-myoepithelial carcinomas, luminal tumor cells stain for keratin, and the keratin staining resembles staining of tubulo-ductal structures of pleomorphic adenomas.103–106
Head and Neck Pathology
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Ram Moorthy, Adrian T. Warfield, Max Robinson
The basic components of a PSA are ductal elements and myoepithelial cells embedded in a chondromyxoid matrix. The appearances vary widely both between PSAs and within the same tumour. A panoply of other changes may be superimposed or even predominate, for example, metaplastic changes (squamous, lipomatous, osseous, neuroid, angiomatoid), degeneration (cystic change, infarction, mineralization, hyalinization, elastosis), specific growth patterns (e.g. adenoid cystic carcinoma-like, clear cell, epithelial-myoepithelial carcinoma-like, basaloid, giant cell, spindle cell, acinar, plasmacytoid, oncocytoid) and crystal deposition. This heterogeneity can occasionally make diagnosis difficult, especially from limited samples derived from FNAB or core biopsies.
Uncommon Endobronchial Neoplasms
Published in Philip T. Cagle, Timothy C. Allen, Mary Beth Beasley, Diagnostic Pulmonary Pathology, 2008
Primary endobronchial neoplasms with histological features of epithelial-myoepithelial carcinoma (EMC) of the salivary glands were initially reported by Hayes et al. (22) and Nistal et al. (23). To date, only 22 cases have been reported in the literature (24–27). They have been variably reported as epithelial myoepithelial tumor, adenomyoepithelioma, and EMC. Like their salivary gland counterpart, bronchial EMC is an indolent neoplasm with rare cases with distant metastases. Due to the potentially malignant behavior, the term EMC is preferred. Grossly, the tumors are white to gray, exophytic, and measure 1 to 5 cm in greatest dimension. Histologically, the base of the polypoid tumor is often between two cartilaginous rings. The neoplastic proliferation consists of epithelial cells that formed tubules and sheets of myoepithelial cells with clear cytoplasm surrounding the tubules. Like their salivary gland counterparts, the inner epithelial cells mark positively with cytokeratin and are negative for S100 and actin. In contrast, the outer myoepithelial cells are positive for S100 and actin and negative for cytokeratin. The cases that have demonstrated aggressive behavior show predominance of the spindle-cell component, high mitotic count, necrosis, and significant nuclear pleomorphism.
Targeting human EGFR 2 (HER2) in salivary gland carcinoma
Published in Expert Review of Anticancer Therapy, 2023
Michael Wotman, Adel El-Naggar, Renata Ferrarotto
Among the distinct SGC histologies, SDC shares morphologic and molecular features with high-grade mammary ductal carcinoma and is the subtype in which genomic and proteomic HER2 alterations have been more frequently identified [20–23]. The estimated prevalence of HER2 positivity in SDC was reported to be 43% in a meta-analysis of 3,372 patients [24]. Moreover, 37% of patients were 3+ on IHC scoring, 24% had low HER2 expression levels (1 or 2+), and 39% were positive for gene amplification. With a propensity for regional and distant spread, SDC has poor survival outcomes, even after aggressive curative-intent therapy with surgery and adjuvant radiotherapy [25]. The reported median overall survival (OS) duration and five-year OS rate of SDC patients are 3–4 years and 30%-40%, respectively [26–29]. HER2 overexpression and/or amplification has been identified more rarely in other histologies (Figure 1). In the same meta-analysis mentioned above, the authors reported HER2 positivity rates of 39% in carcinoma ex pleomorphic adenoma, 17% in squamous cell carcinoma, 13% in adenocarcinoma, not otherwise specified, 6.7% in poorly differentiated carcinoma, and 5.5% in mucoepidermoid carcinoma (MEC). On the other hand, HER2 positivity was unusual in myoepithelial carcinoma (4.3%), epithelial-myoepithelial carcinoma (1.8%), acinic cell carcinoma (0.45%), and adenoid cystic carcinoma (0.15%).
A rare case of epithelial-myoepithelial carcinoma arising ex pleomorphic adenoma of the lacrimal gland: case report and review of the literature
Published in Orbit, 2022
Nicholas Van Rooij, Alexander R. Newman, Vipul Vyas, Timothy J. Sullivan
Epithelial-myoepithelial carcinoma (EMC) is a low-grade salivary gland tumour, which is very rarely reported in the lacrimal gland. Hybrid carcinomas such as EMC comprise two histological subtypes of carcinoma within the same topographic field. Hybrid tumours constitute less than 1% of all salivary gland tumours, with eight cases of lacrimal gland EMC reported.1 The diagnosis of EMC is histological, demonstrating a biphasic dual morphology of luminal cuboidal ductal epithelial cells and outer myoepithelial cells with clear cytoplasm. Patient prognostication and optimal management of these tumours provides a challenge for clinicians due to their inherent rarity. We describe the first case of EMC arising within a pleomorphic adenoma in the Australian population. The study adhered to the tenets of the Declaration of Helsinki (2013). The patient provided written consent to produce the manuscript.
Programmed death ligand-1 expression is associated with stage and histological grade of parotid carcinoma
Published in Acta Oto-Laryngologica, 2020
Masaaki Higashino, Ryo Kawata, Shuji Nishikawa, Tetsuya Terada, Shin-Ichi Haginomori, Yoshitaka Kurisu, Yoshinobu Hirose
The subjects in this study were 127 patients with parotid carcinoma who underwent surgery at the Department of Otorhinolaryngology, Head and Neck Surgery, Osaka Medical College between September 1999 and June 2017. They consisted of 68 men and 59 women with a mean age of 58 years (range: 14–85 years). The median observation period was 38 months (range: 2–213 months). The histological diagnosis was mucoepidermoid carcinoma in 33 patients, acinic cell carcinoma in 19 patients, adenoid cystic carcinoma in 17 patients, carcinoma ex pleomorphic adenoma in 17 patients, salivary duct carcinoma in 10 patients, basal cell carcinoma in 10 patients, epithelial-myoepithelial carcinoma in 9 patients, squamous cell carcinoma in 4 patients, myoepithelial carcinoma in 2 patients, cystadenocarcinoma in 2 patients, lymphoepithelial carcinoma in 2 patients, adenocarcinoma NOS in 1 patient, and synovial sarcoma in 1 patient. When classified by stage, there were 21 patients in Stage I, 49 patients in Stage II, 16 patients in Stage III, and 41 patients in Stage IV. The tumor showed a low-grade malignancy in 11 patients, while it was intermediate-grade in 72 patients and high-grade in 44 patients in Table 1. The classification of histological grade followed “AFIP Atlas of Tumor Pathology, Tumors of the Salivary Gland” [6]. As well, the WHO classificication 2017 is almost similar to AFIP classification [4].