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Plasmacytoid myoepithelioma of minor salivary glands: report of case with emphasis in the immunohistochemical findings.

Santos EP, Cavalcante DR, Melo AU, Pereira JC, Gomes MZ, Albuquerque RL - Head Face Med (2011)

Bottom Line: Myoepitheliomas are most common in young adults between the ages of 30 and 50 and there are very few cases reported in individuals less than 18 years of age.The tumor was composed of plasmacytoid myoepithelial cells.We report this case because of the rarity of this tumor, especially in adolescents.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Dentistry, School of Dentistry, University Tiradentes, Aracaju, SE, Brazil. esau_pinheiro@hotmail.com

ABSTRACT
Myoepithelioma is a rare benign tumor of the salivary glands and is usually seen in the parotid gland and the minor salivary glands. It was once considered to be a type of pleomorphic adenoma (PA), but myoepitheliomas are today believed to be relatively aggressive tumors. Myoepitheliomas are most common in young adults between the ages of 30 and 50 and there are very few cases reported in individuals less than 18 years of age. We report a case of myoepithelioma located in the hard palate in a 15-year-old Brazilian male. The tumor was composed of plasmacytoid myoepithelial cells. An analysis of the immunohistochemical profile of the tumor cells showed positivity for vimentin, S-100 protein, and glial fibrillary acidic protein (GFAP), but not for smooth muscle actin (α-SMA) and cytokeratin 14 (CK14). We report this case because of the rarity of this tumor, especially in adolescents. We also discuss the histological parameters of the differential diagnosis of this tumor as well as its immunohistochemical profile.

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Histopathology findings. Histological sections stained in HE. (a) Well-circumscribed proliferation of sheets, islands, and strings of myoepithelial cells (40×); (b) Strong hyalinization of the connective tissue and foci of hemorrhage seen amidst the tumoral cells (Hematoxyin/Eosin, 40×) (c) Detail of the round-shaped myoepithelial cells showing eccentric nucleus (100×); (d) Tumoral plasmacytoid cells arranged in a pseudo-cribriform pattern within myxomatous background (100×).
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Figure 2: Histopathology findings. Histological sections stained in HE. (a) Well-circumscribed proliferation of sheets, islands, and strings of myoepithelial cells (40×); (b) Strong hyalinization of the connective tissue and foci of hemorrhage seen amidst the tumoral cells (Hematoxyin/Eosin, 40×) (c) Detail of the round-shaped myoepithelial cells showing eccentric nucleus (100×); (d) Tumoral plasmacytoid cells arranged in a pseudo-cribriform pattern within myxomatous background (100×).

Mentions: Incisional biopsy was performed and the surgical specimen was sent for histopathological analysis. Histological sections of the specimen revealed a salivary gland neoplasm whose parenchyma consisted of plasmacytoid cells with eccentric round nuclei and eosinophilic (hyaline) cytoplasm, predominantly arranged in islands and sheets of tumoral cells. Less commonly, the tumoral cells were organized in anastomosing strings mimicking a pseudo-cribriform arrangement. Foci of hemorrhage and hemosiderin pigmentation were also found. The stroma showed strong hyalinization of the connective tissue with focal areas of myxoid changes (Figure 2). Immunohistochemically, the cytoplasm of the plasmacytoid cells was positive for S-100 protein and vimentin (Figures 3a and 3b) and negative for smooth muscle actin (α-SMA) (Figure 3d) and cytokeratin 14 (CK14). Focal reactivity for glial fibrillary acidic protein (GFAP) was observed in some areas (Figure 3c). The overall picture suggested the diagnosis of PM. The definitive treatment in this situation was surgical excision, extending down to the periosteum and including the overlying mucosa. The patient continues to be under rigorous follow-up and no recurrence has been detected so far.


Plasmacytoid myoepithelioma of minor salivary glands: report of case with emphasis in the immunohistochemical findings.

Santos EP, Cavalcante DR, Melo AU, Pereira JC, Gomes MZ, Albuquerque RL - Head Face Med (2011)

Histopathology findings. Histological sections stained in HE. (a) Well-circumscribed proliferation of sheets, islands, and strings of myoepithelial cells (40×); (b) Strong hyalinization of the connective tissue and foci of hemorrhage seen amidst the tumoral cells (Hematoxyin/Eosin, 40×) (c) Detail of the round-shaped myoepithelial cells showing eccentric nucleus (100×); (d) Tumoral plasmacytoid cells arranged in a pseudo-cribriform pattern within myxomatous background (100×).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3285037&req=5

Figure 2: Histopathology findings. Histological sections stained in HE. (a) Well-circumscribed proliferation of sheets, islands, and strings of myoepithelial cells (40×); (b) Strong hyalinization of the connective tissue and foci of hemorrhage seen amidst the tumoral cells (Hematoxyin/Eosin, 40×) (c) Detail of the round-shaped myoepithelial cells showing eccentric nucleus (100×); (d) Tumoral plasmacytoid cells arranged in a pseudo-cribriform pattern within myxomatous background (100×).
Mentions: Incisional biopsy was performed and the surgical specimen was sent for histopathological analysis. Histological sections of the specimen revealed a salivary gland neoplasm whose parenchyma consisted of plasmacytoid cells with eccentric round nuclei and eosinophilic (hyaline) cytoplasm, predominantly arranged in islands and sheets of tumoral cells. Less commonly, the tumoral cells were organized in anastomosing strings mimicking a pseudo-cribriform arrangement. Foci of hemorrhage and hemosiderin pigmentation were also found. The stroma showed strong hyalinization of the connective tissue with focal areas of myxoid changes (Figure 2). Immunohistochemically, the cytoplasm of the plasmacytoid cells was positive for S-100 protein and vimentin (Figures 3a and 3b) and negative for smooth muscle actin (α-SMA) (Figure 3d) and cytokeratin 14 (CK14). Focal reactivity for glial fibrillary acidic protein (GFAP) was observed in some areas (Figure 3c). The overall picture suggested the diagnosis of PM. The definitive treatment in this situation was surgical excision, extending down to the periosteum and including the overlying mucosa. The patient continues to be under rigorous follow-up and no recurrence has been detected so far.

Bottom Line: Myoepitheliomas are most common in young adults between the ages of 30 and 50 and there are very few cases reported in individuals less than 18 years of age.The tumor was composed of plasmacytoid myoepithelial cells.We report this case because of the rarity of this tumor, especially in adolescents.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Dentistry, School of Dentistry, University Tiradentes, Aracaju, SE, Brazil. esau_pinheiro@hotmail.com

ABSTRACT
Myoepithelioma is a rare benign tumor of the salivary glands and is usually seen in the parotid gland and the minor salivary glands. It was once considered to be a type of pleomorphic adenoma (PA), but myoepitheliomas are today believed to be relatively aggressive tumors. Myoepitheliomas are most common in young adults between the ages of 30 and 50 and there are very few cases reported in individuals less than 18 years of age. We report a case of myoepithelioma located in the hard palate in a 15-year-old Brazilian male. The tumor was composed of plasmacytoid myoepithelial cells. An analysis of the immunohistochemical profile of the tumor cells showed positivity for vimentin, S-100 protein, and glial fibrillary acidic protein (GFAP), but not for smooth muscle actin (α-SMA) and cytokeratin 14 (CK14). We report this case because of the rarity of this tumor, especially in adolescents. We also discuss the histological parameters of the differential diagnosis of this tumor as well as its immunohistochemical profile.

Show MeSH
Related in: MedlinePlus