Epithelial tumours of salivary glands

Epithelial tumours of salivary glands

Immunohistochemistry and differential diagnoses1

 

EMA / CEA

 

highlights glandular structures

in adenoid cystic carcinoma

in cellular pleomorphic adenoma (versus myoepithelioma)

in solid epithelial-myoepithelial carcinoma

in basal cell carcinoma

myoepithelial markers (calponin, actin)

demonstrate a myoepithelial component

residual myoepithelial islands around tumour cells in intraductal carcinoma

amylase

diagnosis of acinic cell tumour (limited sensitivity)

anti-mitochondrial antibodies

identification of oncocytic tumours, especially their clear cell varaints

oestrogen receptor / CEA

differentiation of a primary salivary ductal carcinoma (ER negative, CEA positive) from a metastatic ductal carcinoma of breast (ER variable, CEA negative)

neuroendocrine markers, CK20 and TTF-1

small cell carcinomas; subtyping and differentiation of primary from metastatic tumours.

thyroglobulin

to differentiate the follicular variant of acinic cell tumour (negative) from a metastatic thyroid carcinoma (positive)

 

The full range of salivary gland carcinomas are CK7-positive / CK20-negative.

 

 

AE1/AE3

CK7

CK20

 

Pleomorphic adenoma

24/242

24/242

0/242

Myoepithelioma

9/92

9/92

0/92

Papillary oncocytic cystadenoma

3/32

3/32

0/32

Oncocytoma

2/22

2/22, 9/104

0/22, 8/104

Adenoid cystic carcinoma

22/222

22/222, 25/253

0/222, 1/253

Mucoepidermoid carcinoma, low grade

9/92

9/92, 26/263

0/92, 2/263

Mucoepidermoid carcinoma, intermediate grade

5/52

5/52

0/52

Mucoepidermoid carcinoma, high grade

7/72

7/72

0/72

Polymorphous low-grade adenocarcinoma

21/212

21/212, 11/113

0/212, 0/113

Carcinoma ex pleomorphic adenoma

11/112

11/112, 3/33

0/112, 0/33

Acinic cell carcinoma

17/172

17/172

0/172

Epimyoepithelial carcinoma

7/72

7/72

0/72

Hyalinising clear cell carcinoma

1/12

1/12

0/12

Papillary cystadenocarcinoma

1/12

1/12

0/12

Salivary duct carcinoma

3/32

3/32

0/32

Oncocytic carcinoma

3/32

3/32

0/32

Clear cell carcinoma

 

2/23

0/23

Basal cell adenocarcinoma

 

2/23

0/23

Adenocarcinoma NOS

4/42

4/42, 3/33

0/42, 0/33

Squamous cell carcinoma

4/42

0/42

0/42

References

1 Diagnostic histopathology of tumors. Edited by CDM Fletcher. 2nd edition. Churchill Livingstone. Page 302.

2 Meer S,Altini M. CK7+/CK20- immunoexpression profile is typical of salivary gland neoplasia. Histopathology 2007; 51:26-32

3 Nikitakis NG, Tosios KI, Papanikolaou VS, et al. Immunohistochemical expression of cytokeratins 7 and 20 in malignant salivary gland tumors. Mod Pathol 2004; 17:407-15 FULL TEXT

4 Ozolek JA, Bastacky SI, Myers EN, et al. Immunophenotypic comparison of salivary gland oncocytoma and metastatic renal cell carcinoma. Laryngoscope 2005; 115:1097-100

This page last revised 6.8.2007.

©SMUHT/PW Bishop