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Seminario de Patología de Cabeza y Cuello
Llucia Alos
Hospital Clínico, Universidad de Barcelona
Clinical history
• A 76 year-old woman complained of a painless,
slowly growing tumour in the right parotid gland.
Surgical resection of the lesion was performed.
S100
S100
actin
actin
Ki67
Case 8: Diagnosis
Salivary gland low-grade cribriform
cystadenocarcinoma
Terminology used
N cases
Delgado et al.
Cancer 1996
Low-grade salivary duct carcinoma 10
Brandwein et al.
Am J Surg Pathol
2004
Low-grade salivary duct carcinoma
16
Weinreb et al.
Am J Surg Pathol
2006
Low-grade intraductal carcinoma
3
Kusafuka et al.
Med Mol Morphol
2010
Low-grade salivary duct carcinoma
1
Low-grade cribriform cystadenocarcinoma clinicopathological data
• Elderly patients (7th decade or older) without gender predilection
• Most cases arise in parotid gland; 3 cases in intraparotid lymph node; 1 case in submandibular gland
• Tumours usually measure between 1 and 2 cm in diameter
• Treatment: surgical resection. Good prognosis.
Low-grade cribriform cystadenocarcinoma
Histology • Cribriform and cystic pattern. Micropapillae and true papillae.
• Intraductal growth. Few cases with stromal focal invasion
• Low-grade cytology. Apocrine features.
• Few cases have been reported with focal intermediate and high-grade transformation
Immunohistochemistry • Strong and diffuse positivity for s100 protein
• Estrogen, progesterone and androgen receptors are usually negative
• HER-2/neu immunostain is negative
Low-grade cribriform cystadenocarcinoma
differential diagnoses
• Cystadenocarcinoma
• Acinic cell carcinoma (papillary-cystic pattern)
• Mammary secretory analogue carcinoma
• (High-grade) salivary duct carcinoma
dd. Cystadenocarcinoma
Cystic, papillary
Infiltrating pattern
dd. Cystadenocarcinoma
dd. Cystadenocarcinoma
dd. Cystadenocarcinoma
dd. Acinic cell carcinoma
dd. Acinic cell carcinoma
dd. Acinic cell carcinoma, papillary cystic pattern
dd. mammary analogue secretory carcinoma
of salivary glands
Skalova et al. Am J Surg Pathol 2010; 34:599-608
dd. mammary analogue secretory carcinoma
of salivary glands
Skalova et al. Am J Surg Pathol 2010; 34:599-608
dd. mammary analogue secretory carcinoma
of salivary glands
Skalova et al. Am J Surg Pathol 2010; 34:599-608
dd. mammary analogue secretory carcinoma
of salivary glands
Skalova et al. Am J Surg Pathol 2010; 34:599-608
translocation t(12;15) (p13;q25)
ETV6-NTRK fusion gene
dd. Salivary duct carcinoma dd.(High-grade) salivary duct carcinoma
dd. (High-grade) salivary duct carcinoma
dd.(High-grade) salivary duct carcinoma
Ductal salivary gland carcinoma
Immunophenotype
*High Ki67 labeling
*HER-2/neu strongly positive
*Expression of androgen receptors
*S100 protein negative Ki67
Androgen receptors HER-2/neu
