Advances in salivary gland pathology

• Published in: Histopathology Vol. 51; no. 1; pp. 1 - 20
• Main Authors: Cheuk, W, Chan, J K C
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.07.2007; Blackwell
• Subjects: Biological and medical sciences; Biomarkers, Tumor - genetics; Biomarkers, Tumor - metabolism; Cell Transformation, Neoplastic - genetics; Cell Transformation, Neoplastic - metabolism; Cell Transformation, Neoplastic - pathology; Disease Progression; Gene Expression Regulation, Neoplastic; Humans; immunohistochemistry; Immunohistochemistry - trends; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; molecular genetics; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; salivary gland neoplasm; Salivary Gland Neoplasms - genetics; Salivary Gland Neoplasms - metabolism; Salivary Gland Neoplasms - pathology; Salivary Glands - metabolism; Salivary Glands - pathology; tumour progression; Immunohistochemistry; molecular genetics; Anatomic pathology; tumour progression; Digestive system; Tumor progression; Salivary gland; Genetics; Tumor; salivary gland neoplasm
• ISSN: 0309-0167; 1365-2559
• DOI: 10.1111/j.1365-2559.2007.02719.x

This review summarizes the new findings on salivary gland pathology under the following categories: immunohistochemistry; molecular genetics; newly recognized tumour types; known tumour entities with new findings; and progression of salivary gland tumours. In the application of immunohistochemistry, CD117 can aid in highlighting the luminal cell component of various salivary gland tumours, whereas p63 or maspin can aid in highlighting the abluminal cell component. A high Ki67 index remains the most useful marker to predict adverse outcome in salivary gland carcinoma. Specific chromosomal translocations are recognized in pleomorphic adenoma (with translocation involving PLGA1 or HMGA2 gene) and mucoepidermoid carcinoma (with MECT1–MAML2 gene fusion). Newly recognized entities include: sclerosing polycystic adenosis (with recent molecular evidence supporting its neoplastic nature), sclerosing mucoepidermoid carcinoma with eosinophilia, keratocystoma, adenoma with additional stromal component (lymphadenoma, lipoadenoma and adenofibroma), cribriform adenocarcinoma of the tongue and signet ring adenocarcinoma of minor salivary gland. Known tumour entities with new findings include: salivary duct carcinoma (with newly recognized mucinous, micropapillary and sarcomatoid variants), intraductal carcinoma (with controversies in terminology), mucoepidermoid carcinoma (with newly proposed grading parameters and oncocytic variant), epithelial–myoepithelial carcinoma (with newly recognized morphological variants), small cell carcinoma (with most cases being related to Merkel cell carcinoma), extranodal marginal zone B‐cell lymphoma (with specific chromosomal translocation) and chronic sclerosing sialadenitis (being a component of IgG4‐related sclerosing disease). Progression of salivary gland tumours can take the form of malignant transformation of a benign tumour, progression from low‐grade to high‐grade carcinoma, dedifferentiation, or stromal invasion of an in situ carcinoma.