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Cytokeratin immunoprofile of primary and metastatic adenoid cystic carcinoma of salivary glands: a report of two cases

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ABSTRACT

Distant metastases from salivary gland tumors are considered infrequent: the incidence of distant metastases ranges from 24% to 61% according to different histotypes and to the site of the primary mass. The most common site of distant metastases due to salivary gland malignancies is the lung. From the pathology point of view, cytokeratins (CK) are important differentiation markers in salivary gland tumors, which are often used for the diagnostic process. Their employment also may be useful to identify and confirm the diagnosis of their distant metastases. We report the expression of CK in two cases of primary and metastatic adenoid cystic carcinoma (ACC) and their CK profiles of the primary and metastatic masses. Both patients—one male and one female—were diagnosed with an ACC cribriform and tubular, respectively, with lung metastases. In case 1, the metastatic mass presented the same histotype and CK profile of the primary tumor. For case 2, the metastatic lung mass was distinct from the primary mass (a solid ACC) and presented a different CK profile. Although salivary gland metastatic disease presents a poor prognosis, both patients reported herein are alive despite the presence of the disease in long-term follow-up. Therefore, the modifications seen in the CK profiles do not appear to be predictive of tumor behavior and outcome. The use of a CK profile seems to be useful to identify the nature of a distant mass and its possible correlations with a primary salivary gland tumor.

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Photomicrography of the histopathological aspects of primary and metastatic adenoid cystic carcinoma. A and B - Primary cribriform adenoid cystic carcinoma (ACC) of the hard palate. A - Cribriform aspect of the primary mass composed of epithelial (luminal) cells and myoepithelial (abluminal) cells around a nerve bundle (perineural infiltration); B - Cribriform ACC: angiolymphatic spread (emboli) (both H&E, 250X); C - Lung metastatic mass from a salivary gland ACC: cribriform aspects of the metastatic mass intermingling the lung parenchyma (H&E, 250X).
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g02: Photomicrography of the histopathological aspects of primary and metastatic adenoid cystic carcinoma. A and B - Primary cribriform adenoid cystic carcinoma (ACC) of the hard palate. A - Cribriform aspect of the primary mass composed of epithelial (luminal) cells and myoepithelial (abluminal) cells around a nerve bundle (perineural infiltration); B - Cribriform ACC: angiolymphatic spread (emboli) (both H&E, 250X); C - Lung metastatic mass from a salivary gland ACC: cribriform aspects of the metastatic mass intermingling the lung parenchyma (H&E, 250X).

Mentions: A 42-year-old male presented a history of an operated ACC of the palate. The surgery comprised an extensive maxillectomy up to the infratemporal and pterygopalatine fossae. Histopathology revealed a cribriform ACC with perineural infiltration and angiolymphatic emboli (Figure 2A and 2B). The patient received radiotherapy at 45 Gy. After a 5-year follow-up, two masses (measuring 10 mm and 6 mm at their longest axis) were detected in the inferior lobule of the right lung, which was excised and diagnosed as metastatic salivary gland cribriform ACC (Figure 2C).


Cytokeratin immunoprofile of primary and metastatic adenoid cystic carcinoma of salivary glands: a report of two cases
Photomicrography of the histopathological aspects of primary and metastatic adenoid cystic carcinoma. A and B - Primary cribriform adenoid cystic carcinoma (ACC) of the hard palate. A - Cribriform aspect of the primary mass composed of epithelial (luminal) cells and myoepithelial (abluminal) cells around a nerve bundle (perineural infiltration); B - Cribriform ACC: angiolymphatic spread (emboli) (both H&E, 250X); C - Lung metastatic mass from a salivary gland ACC: cribriform aspects of the metastatic mass intermingling the lung parenchyma (H&E, 250X).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5304563&req=5

g02: Photomicrography of the histopathological aspects of primary and metastatic adenoid cystic carcinoma. A and B - Primary cribriform adenoid cystic carcinoma (ACC) of the hard palate. A - Cribriform aspect of the primary mass composed of epithelial (luminal) cells and myoepithelial (abluminal) cells around a nerve bundle (perineural infiltration); B - Cribriform ACC: angiolymphatic spread (emboli) (both H&E, 250X); C - Lung metastatic mass from a salivary gland ACC: cribriform aspects of the metastatic mass intermingling the lung parenchyma (H&E, 250X).
Mentions: A 42-year-old male presented a history of an operated ACC of the palate. The surgery comprised an extensive maxillectomy up to the infratemporal and pterygopalatine fossae. Histopathology revealed a cribriform ACC with perineural infiltration and angiolymphatic emboli (Figure 2A and 2B). The patient received radiotherapy at 45 Gy. After a 5-year follow-up, two masses (measuring 10 mm and 6 mm at their longest axis) were detected in the inferior lobule of the right lung, which was excised and diagnosed as metastatic salivary gland cribriform ACC (Figure 2C).

View Article: PubMed Central - PubMed

ABSTRACT

Distant metastases from salivary gland tumors are considered infrequent: the incidence of distant metastases ranges from 24% to 61% according to different histotypes and to the site of the primary mass. The most common site of distant metastases due to salivary gland malignancies is the lung. From the pathology point of view, cytokeratins (CK) are important differentiation markers in salivary gland tumors, which are often used for the diagnostic process. Their employment also may be useful to identify and confirm the diagnosis of their distant metastases. We report the expression of CK in two cases of primary and metastatic adenoid cystic carcinoma (ACC) and their CK profiles of the primary and metastatic masses. Both patients—one male and one female—were diagnosed with an ACC cribriform and tubular, respectively, with lung metastases. In case 1, the metastatic mass presented the same histotype and CK profile of the primary tumor. For case 2, the metastatic lung mass was distinct from the primary mass (a solid ACC) and presented a different CK profile. Although salivary gland metastatic disease presents a poor prognosis, both patients reported herein are alive despite the presence of the disease in long-term follow-up. Therefore, the modifications seen in the CK profiles do not appear to be predictive of tumor behavior and outcome. The use of a CK profile seems to be useful to identify the nature of a distant mass and its possible correlations with a primary salivary gland tumor.

No MeSH data available.


Related in: MedlinePlus