Metastases to the Parotid Gland: Study from a Tertiary Care CentreHead and Neck Pathology - Tập 16 - Trang 1034-1042 - 2022
Jayati Sarangi, Aanchal Kakkar, Diya Roy, Deepika Mishra, Alok Thakar, Suryanarayan V. S. Deo, Atul Sharma, Suman Bhasker
Metastases account for 6–25% of parotid tumors, often presenting dilemmas in their diagnosis. Parotid metastases diagnosed on histology/cytology were retrieved. MUC2, MUC5AC, androgen receptor immunohistochemistry was performed in select cases. Fifty-one samples were identified from 42 patients, including 14 aspirates, 7 biopsies and 30 parotidectomies. Previous history was available in 17 cases, 13 parotidectomies accompanied excision of the primary, and relevant clinical data was unavailable for 12 patients. Majority (81%) had head and neck primaries; eye and ocular adnexa were the commonest subsite (52.4%), and sebaceous carcinoma the commonest histology (33%). When history was unavailable, most metastases were initially diagnosed as poorly differentiated carcinoma/malignant tumor, or mucoepidermoid carcinoma on cytology. Intraparotid metastases encompass a wide spectrum, often mimicking primary salivary gland neoplasms, particularly on limited samples. Metastases should be considered when histological/cytological features are unusual; detailed clinical information and ancillary techniques aid in arriving at an accurate diagnosis.
Kallikrein-Related Peptidase mRNA Expression in Adenoid Cystic Carcinoma of Salivary Glands: A Polymerase Chain Reaction StudyHead and Neck Pathology - Tập 14 - Trang 577-587 - 2019
Zachary Kerr, Alyssa Hayter, Zia Khan, Mark Darling
Kallikrein-related peptidases (KLKs) are a group of 15 serine proteases implicated in a variety of biological processes. Aberrant expression of KLKs has been associated with the development of certain cancers. However, the role of KLKs in salivary tumors has not been extensively studied. This study evaluated the expression of KLKs in both adenoid cystic carcinoma (ACC) and normal salivary gland tissue. We isolated total RNA from 39 formalin-fixed, paraffin-embedded samples, which included 24 ACCs and 15 normal salivary gland tissues. Complementary DNA, synthesized by reverse transcription, was combined with gene specific kallikrein primers (KLK1–KLK15) to allow for quantitative real-time PCR. Data was normalized to a β-actin housekeeping gene. Relative quantification analysis was performed using the ΔCq method. KLK1–KLK15 expression was observed in both tissue types. However, KLK1, KLK8, KLK11, and KLK14 were found to be downregulated in ACC. We propose that this may represent a multi-parametric panel providing diagnostic and prognostic information.
Top 10 Differential Diagnoses for Desmoplastic MelanomaHead and Neck Pathology - Tập 17 - Trang 143-153 - 2023
Angel Fernandez-Flores, Rajendra Singh, David S. Cassarino
Desmoplastic melanoma is a rare subtype of melanoma mainly appearing on sun-exposed skin. Clinically, it is many times non-pigmented and therefore the diagnosis is often not suspected. Review article. In this paper we review the main histopathological, immunohistochemical, and molecular features of desmoplastic melanoma, as well as the top 10 morphologic differential diagnoses which should be considered in most cases. The histopathological pattern can be many times deceptive, mimicking a scar, a fibrous reaction, a fibrohistiocytic tumor such as a dermatofibroma, a vascular tumor such as angiosarcoma, a smooth muscle tumor such as leiomyosarcoma, or a neural tumor. Although an overlying atypical junctional melanocytic proliferation may be seen in most cases, it is absent in a significant percentage (up to 30%) of cases, making the diagnosis even more difficult in those instances. The range of diagnostic pitfalls is wide, which may present disastrous prognostic consequences. Desmoplastic melanoma is often a difficult diagnosis to make, as it frequently shows nonspecific clinical findings and overlapping histologic features with many other tumors. However, the potential clinical and prognostic consequences of misdiagnosis as another entity are great. Therefore, this diagnosis must always be kept in mind when encountering spindle cell tumors affecting the head and neck area.
Olfactory Neuroblastoma: A Case ReportHead and Neck Pathology - Tập 10 - Trang 256-260 - 2015
Heather R. Olmo, Steven Marc Stokes, Robert D. Foss
A 43-year-old female presented with persistent nasal congestion with intermittent epistaxis without resolution for the preceding 5 years. Clinical examination revealed a large pink rubbery mass, medial to the middle turbinate in the right nasal cavity extending to the choana. Radiographic images demonstrated a heterogeneously enhancing lobular soft tissue mass filling the right nasal cavity, causing lateral bowing of the right medial orbital wall and extending posteriorly to the right anterior ethmoid sinus. The clinical, radiographic, histologic, and immunohistochemical features of olfactory neuroblastoma are discussed.
Reframing Histological Risk Assessment of Oral Squamous Cell Carcinoma in the Era of UICC 8th Edition TNM StagingHead and Neck Pathology - Tập 15 Số 1 - Trang 202-211 - 2021
Naomi Rahman, Morna MacNeill, William Wallace, Brendan Conn
Abstract
Objectives
To assess whether application of the risk model originally proposed by Brandwein-Gensler, influences survival and disease progression in patients treated for oral squamous cell carcinoma (OSCCs)
Materials and Methods
Tumours from 134 T1 and T2 OSCC resections (7th edition) were scored independently by 3 histopathologists according to worst pattern of invasion (WPOI), lymphocytic host response (LHR) and perineural invasion (PNI) and categorised according to risk score. Local recurrence, locoregional recurrence, disease progression and overall survival were study endpoints. Interobserver variability of pathologist scoring was also assessed.
Results
Seventy-two patients (54%) were classified with low or intermediate risk and 62 (46%) patients were ‘high risk’. The inter-observer agreement was in moderate to strong agreement with the consensus scores (k range = 0.45–0.82). There was statistical significance between distant metastasis and ‘high risk’ tumours. Thirty tumours were upstaged to T3 in the 8th edition TNM staging, of which 83% had high risk scores. Overall risk score and TNM8 T stage has significant correlation with overall survival in comparison to the TNM 7 T stage.
Conclusion
‘High risk’ tumours were significantly associated with distant metastasis possibly due to the greater likelihood of aggressive features such as WPOI and PNI. Primary tumours are more likely to express high risk features with increasing T stage. None of the patients classified as ‘low risk’ died perhaps suggesting these tumours represent a rare variant of OSCC with excellent prognosis.
