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Dedifferentiation in adenoid cystic carcinoma.

Bavle RM, D'Mello S, Makarla S, Hosthor SS - J Oral Maxillofac Pathol (2013)

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Pathology, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India.

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Areas were seen undergoing adenocarcinomatous change with basaloid tumor cells arranged in anastomosing cords with intervening thin fibrovascular connective tissue [Figure 6]... In our case, classical adenoid cystic carcinoma areas comprising of ductal structures, cribriform pattern and islands of epi-myoepithelial cells were seen juxtaposed with areas of dedifferentiation exhibiting adenocarcinomatous features such as anastomosing cords of anaplastic cells, atypical mitoses, comedo necrosis and neoplastic cells with hyperchromatic and vesicular nuclei having multiple nucleoli... Areas are characterized by multiple cystic structures with glandular formations and small nests of intermediate, mucous and few epidermoid cells Nuclei of the tumor cells are uniformly bland Mitotic figures are rare Such areas blend as conventional MEC areas with areas showing large anaplastic de-differentiated areas But in our case, dedifferentiated areas were in the form of anastomosing cords and sheets of basaloid anaplastic cells... Multiple cysts separated by fibrous stroma with hemorrhage and inflammation due to rupture of cysts Intra-cystic papillary projections with or without delicate branching with fibrovascular cores focally is seen Limited areas of ductal structures or solid nests Cystic lining cells are small cuboidal and predominantly bland Our case showed predominantly solid and cribriform areas, ductal structures and areas of high grade transformation composed of anaplastic cells with basaloid morphology... Absence of intracystic papillary projections... Adenocarcinoma NOS Several architectural patterns are appreciated like solid sheets, papillary, cystic, cribriform, cords, lobules and trabeculae Diverse tumor cell types including cuboidal, oval, polygonal, oncocytoid, clear cell, mucinous, sebaceous and melanoma-like cells are seen Tumor necrosis, perineural and vascular invasion are common Lacks characteristic features of other salivary gland adenocarcinomas Has limited foci resembling specific tumor entities Histopathologically our case showed classic areas of adenoid cystic carcinoma with cribriform, epi-myoepithelial islands and targetoid pattern... High grade areas showed anastomosing cords composed of basaloid anaplastic cells... High grade Salivary duct carcinoma Mixture of two components: intraductal and invasive Roman-bridge architecture of tumor cell arranged in ductal spaces Central comedo necrosis in the tumor islands Prominent desmoplastic reaction in the invasive component Large pleomorphic nuclei with abundant and granular cytoplasm Frequent lymphovascular and perineural invasion This case presented with classic areas of adenoid cystic carcinoma without any roman-bridge formation.

No MeSH data available.


Nests of cells exhibiting indistinct cytoplasmic borders and hyperchromatic nuclei. One island with cells exhibiting vesicular nucleus also seen (H&E stain, ×200)
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Figure 5: Nests of cells exhibiting indistinct cytoplasmic borders and hyperchromatic nuclei. One island with cells exhibiting vesicular nucleus also seen (H&E stain, ×200)

Mentions: Microscopically, connective tissue stroma composing of lesional cells arranged in cords, nests, islands, cribriform pattern and in ductal structures with central eosinophilic coagulum was seen [Figure 1]. Classical areas of tumor cells arranged in epimyoepithelial islands were evident [Figure 2]. Areas of perineural and perivascular invasion were noted [Figure 3]. The neoplastic cells appeared uniform and basaloid with hyperchromatic nuclei. However other lesional areas showed solid transformation of the numerous cords, nests, islands and cribriform areas [Figure 4]. Some islands showed squamous metaplasia-like areas [Figure 5]. Areas were seen undergoing adenocarcinomatous change with basaloid tumor cells arranged in anastomosing cords with intervening thin fibrovascular connective tissue [Figure 6].


Dedifferentiation in adenoid cystic carcinoma.

Bavle RM, D'Mello S, Makarla S, Hosthor SS - J Oral Maxillofac Pathol (2013)

Nests of cells exhibiting indistinct cytoplasmic borders and hyperchromatic nuclei. One island with cells exhibiting vesicular nucleus also seen (H&E stain, ×200)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927361&req=5

Figure 5: Nests of cells exhibiting indistinct cytoplasmic borders and hyperchromatic nuclei. One island with cells exhibiting vesicular nucleus also seen (H&E stain, ×200)
Mentions: Microscopically, connective tissue stroma composing of lesional cells arranged in cords, nests, islands, cribriform pattern and in ductal structures with central eosinophilic coagulum was seen [Figure 1]. Classical areas of tumor cells arranged in epimyoepithelial islands were evident [Figure 2]. Areas of perineural and perivascular invasion were noted [Figure 3]. The neoplastic cells appeared uniform and basaloid with hyperchromatic nuclei. However other lesional areas showed solid transformation of the numerous cords, nests, islands and cribriform areas [Figure 4]. Some islands showed squamous metaplasia-like areas [Figure 5]. Areas were seen undergoing adenocarcinomatous change with basaloid tumor cells arranged in anastomosing cords with intervening thin fibrovascular connective tissue [Figure 6].

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Pathology, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Areas were seen undergoing adenocarcinomatous change with basaloid tumor cells arranged in anastomosing cords with intervening thin fibrovascular connective tissue [Figure 6]... In our case, classical adenoid cystic carcinoma areas comprising of ductal structures, cribriform pattern and islands of epi-myoepithelial cells were seen juxtaposed with areas of dedifferentiation exhibiting adenocarcinomatous features such as anastomosing cords of anaplastic cells, atypical mitoses, comedo necrosis and neoplastic cells with hyperchromatic and vesicular nuclei having multiple nucleoli... Areas are characterized by multiple cystic structures with glandular formations and small nests of intermediate, mucous and few epidermoid cells Nuclei of the tumor cells are uniformly bland Mitotic figures are rare Such areas blend as conventional MEC areas with areas showing large anaplastic de-differentiated areas But in our case, dedifferentiated areas were in the form of anastomosing cords and sheets of basaloid anaplastic cells... Multiple cysts separated by fibrous stroma with hemorrhage and inflammation due to rupture of cysts Intra-cystic papillary projections with or without delicate branching with fibrovascular cores focally is seen Limited areas of ductal structures or solid nests Cystic lining cells are small cuboidal and predominantly bland Our case showed predominantly solid and cribriform areas, ductal structures and areas of high grade transformation composed of anaplastic cells with basaloid morphology... Absence of intracystic papillary projections... Adenocarcinoma NOS Several architectural patterns are appreciated like solid sheets, papillary, cystic, cribriform, cords, lobules and trabeculae Diverse tumor cell types including cuboidal, oval, polygonal, oncocytoid, clear cell, mucinous, sebaceous and melanoma-like cells are seen Tumor necrosis, perineural and vascular invasion are common Lacks characteristic features of other salivary gland adenocarcinomas Has limited foci resembling specific tumor entities Histopathologically our case showed classic areas of adenoid cystic carcinoma with cribriform, epi-myoepithelial islands and targetoid pattern... High grade areas showed anastomosing cords composed of basaloid anaplastic cells... High grade Salivary duct carcinoma Mixture of two components: intraductal and invasive Roman-bridge architecture of tumor cell arranged in ductal spaces Central comedo necrosis in the tumor islands Prominent desmoplastic reaction in the invasive component Large pleomorphic nuclei with abundant and granular cytoplasm Frequent lymphovascular and perineural invasion This case presented with classic areas of adenoid cystic carcinoma without any roman-bridge formation.

No MeSH data available.