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Douglas R. Gnepp - One of the best experts on this subject based on the ideXlab platform.
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Low-grade Salivary Duct Carcinoma: description of 16 cases.
The American journal of surgical pathology, 2004Co-Authors: Margaret Brandwein-gensler, Roderick H W Simpson, Jos Hille, Beverly Y. Wang, Mark L. Urken, Ronald E. Gordon, Li Juan Wang, James R. M. Simpson, Douglas R. GneppAbstract:Low-grade Salivary Duct Carcinoma is a rare neoplasm. We report on 16 patients, with a median age of 64 years. All but one tumor arose from the parotid gland, including one tumor that arose in an intraparotid lymph node; one arose in the submandibular gland. Tumors consist of single to multiple dominant cysts, accompanied by adjacent intraDuctal proliferation. Cysts are lined by small, multilayered, proliferating, bland Ductal cells with finely dispersed chromatin and small nucleoli. Separate, smaller Ductal structures are variably filled by proliferating Ductal epithelium with cribriform, micropapillary, and solid areas. The overall appearance is very similar to breast atypical Ductal hyperplasia and low-grade Ductal Carcinoma in situ. Foci of definitive stromal invasion were seen in four tumors. Two tumors demonstrated transition from low- to intermediate- or high-grade cytology, with scattered mitotic figures and focal necrosis. S-100 revealed diffuse strong expression in all 9 cases studied. Myoepithelial markers (calponin) highlighted supportive myoepithelial cells rimming the cystic spaces, confirming the intraDuctal nature of most, or all, of six tumors studied. Nine tumors studied for Her2-neu antigen were uniformly negative. Follow-up was obtained on 13 of our 16 patients. All patients were disease-free after surgery 6 to 132 months (median 30 months). Low-grade Salivary Duct Carcinoma is a low-grade neoplasm with an excellent prognosis; it may be treated by conservative but complete resection. Its resemblance to atypical breast Ductal hyperplasia, or micropapillary/cribriform intraDuctal Carcinoma, distinguishes it from high-grade Salivary Duct Carcinoma, papillocystic acinic cell Carcinoma, and cystadenoCarcinoma.
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sarcomatoid Salivary Duct Carcinoma of the parotid gland
Human Pathology, 2000Co-Authors: Douglas R. Gnepp, John D Henley, Dan DayanAbstract:Salivary Duct Carcinoma (SDC) is a high-grade neoplasm known to histologically resemble high-grade Ductal Carcinoma in situ of the breast. We describe 3 cases of sarcomatoid Salivary Duct Carcinoma, a heretofore unreported variant of SDC. Each case was a composite of SDC and sarcomatoid Carcinoma and histologically similar to reported cases arising in the breast. The clinicopathologic features, including immunohistochemistry, of 3 cases were investigated. In the 3 men, ages 56, 68, and 70 years, the resected parotid tumors measured 1.5, 3.5, and 1.5 cm, respectively. Only the 3.5-cm tumor extended beyond the parotid gland into soft tissue. This patient died at 3 years with pulmonary metastases. The other patients were free of disease at 6 and 12 months. Histologically, each case was a composite of usual-type SDC and sarcomatoid Carcinoma. SDC showed typical cribriform architecture, whereas anaplastic, spindled cells constituted the sarcomatoid areas. Immunohistochemically, epithelial elements stained as follows: cytokeratin (AE1/AE3 & CAM 5.2) positive in 3 of 3 cases, EMA positive in 3 of 3 cases, vimentin negative in 3 of 3 cases, desmin negative in 3 of 3 cases, c- erb B-2 positive in 1 of 2 cases. Sarcomatoid elements stained as follows: AE1/AE3 negative in 3 of 3 cases, CAM 5.2 rare positive cell in 1 of 3 cases, EMA focally positive in 3 of 3 cases, vimentin positive in 3 of 3 cases, desmin negative in 3 of 3 cases, c- erb B-2 negative in 2 of 2 cases. Electron microscopy, performed in one case, showed scattered junctional complexes congruent with epithelial differentiation. Immunohistochemical results, EMA and CAM 5.2 positivity, and ultrastructural findings supported our belief that these unique biphasic tumors represented SDC with sarcomatoid Carcinoma. We conclude an element of sarcomatoid Carcinoma rarely may arise in association with SDC, and it is erroneous to diagnose such tumors as "carcinosarcoma."
Roderick H W Simpson - One of the best experts on this subject based on the ideXlab platform.
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Salivary Duct Carcinoma in situ of the parotid gland
Histopathology, 2008Co-Authors: Roderick H W Simpson, S. Desai, S PalmaAbstract:Aims: To describe three cases of purely in situ Salivary Duct Carcinoma, so as better to define the entity. Methods and results: Three primary tumours of the parotid gland are presented, in each case composed of cysts and Ducts and lined by high nuclear grade epithelial cells. All parts of each tumour were surrounded by a myoepithelial cell rim and there was no evidence of invasion. The tumour cells expressed immunohistochemical markers seen in invasive Salivary Duct Carcinoma of usual (high-grade) type. In two cases the androgen receptor (AR) reaction was strong, but there was no immunohistochemical expression of HER2 protein or gene amplification by in situ hybridization. In the remaining case, fewer nuclei stained for AR, but both HER2 protein and gene amplification were demonstrated. Conclusions: Salivary Duct Carcinoma in situ is morphologically similar to breast Ductal Carcinoma in situ and, although our cases are few, Salivary Duct Carcinoma in situ can possibly be subdivided into luminal and non-luminal cell types, as can analogous mammary neoplasms. The present study cannot determine whether low-grade cribriform cystadenoCarcinoma, architecturally similar but immunohistochemically different, is part of the spectrum of Salivary Duct Carcinoma in situ, or whether it represents a separate entity.
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Low-grade Salivary Duct Carcinoma: description of 16 cases.
The American journal of surgical pathology, 2004Co-Authors: Margaret Brandwein-gensler, Roderick H W Simpson, Jos Hille, Beverly Y. Wang, Mark L. Urken, Ronald E. Gordon, Li Juan Wang, James R. M. Simpson, Douglas R. GneppAbstract:Low-grade Salivary Duct Carcinoma is a rare neoplasm. We report on 16 patients, with a median age of 64 years. All but one tumor arose from the parotid gland, including one tumor that arose in an intraparotid lymph node; one arose in the submandibular gland. Tumors consist of single to multiple dominant cysts, accompanied by adjacent intraDuctal proliferation. Cysts are lined by small, multilayered, proliferating, bland Ductal cells with finely dispersed chromatin and small nucleoli. Separate, smaller Ductal structures are variably filled by proliferating Ductal epithelium with cribriform, micropapillary, and solid areas. The overall appearance is very similar to breast atypical Ductal hyperplasia and low-grade Ductal Carcinoma in situ. Foci of definitive stromal invasion were seen in four tumors. Two tumors demonstrated transition from low- to intermediate- or high-grade cytology, with scattered mitotic figures and focal necrosis. S-100 revealed diffuse strong expression in all 9 cases studied. Myoepithelial markers (calponin) highlighted supportive myoepithelial cells rimming the cystic spaces, confirming the intraDuctal nature of most, or all, of six tumors studied. Nine tumors studied for Her2-neu antigen were uniformly negative. Follow-up was obtained on 13 of our 16 patients. All patients were disease-free after surgery 6 to 132 months (median 30 months). Low-grade Salivary Duct Carcinoma is a low-grade neoplasm with an excellent prognosis; it may be treated by conservative but complete resection. Its resemblance to atypical breast Ductal hyperplasia, or micropapillary/cribriform intraDuctal Carcinoma, distinguishes it from high-grade Salivary Duct Carcinoma, papillocystic acinic cell Carcinoma, and cystadenoCarcinoma.
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Mucin-rich variant of Salivary Duct Carcinoma: a clinicopathologic and immunohistochemical study of four cases.
The American journal of surgical pathology, 2003Co-Authors: Roderick H W Simpson, Alena Skalova, Anil Prasad, Jean E. Lewis, Leonor DavidAbstract:Salivary Duct Carcinoma is a relatively uncommon aggressive neoplasm, typically found in the parotid glands of older men. The histologic appearance is that of an in situ and invasive high-grade adenoCarcinoma, and it closely resembles Ductal Carcinoma of the breast. Several variants of the latter are very well known, but only papillary, sarcomatoid, and low-grade subtypes have so far been reported in Salivary Duct Carcinoma. This study describes the clinicopathologic and immunohistochemical findings in four examples of an additional previously undescribed variant, rich in mucin. Each tumor showed areas of typical Salivary Duct Carcinoma, but in addition there were lakes of epithelial mucin-containing malignant cells, i.e., mucinous (colloid) Carcinoma. All four tumors expressed androgen receptors, cytokeratins, epithelial membrane antigen, gross cystic disease fluid protein-15, and carcinoembryonic antigen, but S-100 protein, other myoepithelial markers, and estrogen and progesterone receptors were negative. The mucin antigen profile showed positivity for MUC2, MUC5B, and MUC6 in all cases but only rare staining with MUC5AC and MUC7. Strong immunohistochemical overexpression of HER2/neu was demonstrated in one tumor, together with amplification by fluorescence in situ hybridization; another case was weakly positive with just one antiserum, but the remaining two tumors were completely negative. Small quantities of mucin have often been described in Salivary Duct Carcinoma but not large extracellular mucinous lakes, which though prominent in the present series, were not as extensive as in mucinous adenoCarcinoma. The relatively poor clinical outcome of the patients in our study mirrored that seen in usual-type Salivary Duct Carcinoma and emphasizes the importance of differentiating mucin-rich Salivary Duct Carcinoma from pure mucinous (colloid) adenoCarcinoma, a tumor not fully defined, but possibly with a better prognosis.
John D Henley - One of the best experts on this subject based on the ideXlab platform.
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sarcomatoid Salivary Duct Carcinoma of the parotid gland
Human Pathology, 2000Co-Authors: Douglas R. Gnepp, John D Henley, Dan DayanAbstract:Salivary Duct Carcinoma (SDC) is a high-grade neoplasm known to histologically resemble high-grade Ductal Carcinoma in situ of the breast. We describe 3 cases of sarcomatoid Salivary Duct Carcinoma, a heretofore unreported variant of SDC. Each case was a composite of SDC and sarcomatoid Carcinoma and histologically similar to reported cases arising in the breast. The clinicopathologic features, including immunohistochemistry, of 3 cases were investigated. In the 3 men, ages 56, 68, and 70 years, the resected parotid tumors measured 1.5, 3.5, and 1.5 cm, respectively. Only the 3.5-cm tumor extended beyond the parotid gland into soft tissue. This patient died at 3 years with pulmonary metastases. The other patients were free of disease at 6 and 12 months. Histologically, each case was a composite of usual-type SDC and sarcomatoid Carcinoma. SDC showed typical cribriform architecture, whereas anaplastic, spindled cells constituted the sarcomatoid areas. Immunohistochemically, epithelial elements stained as follows: cytokeratin (AE1/AE3 & CAM 5.2) positive in 3 of 3 cases, EMA positive in 3 of 3 cases, vimentin negative in 3 of 3 cases, desmin negative in 3 of 3 cases, c- erb B-2 positive in 1 of 2 cases. Sarcomatoid elements stained as follows: AE1/AE3 negative in 3 of 3 cases, CAM 5.2 rare positive cell in 1 of 3 cases, EMA focally positive in 3 of 3 cases, vimentin positive in 3 of 3 cases, desmin negative in 3 of 3 cases, c- erb B-2 negative in 2 of 2 cases. Electron microscopy, performed in one case, showed scattered junctional complexes congruent with epithelial differentiation. Immunohistochemical results, EMA and CAM 5.2 positivity, and ultrastructural findings supported our belief that these unique biphasic tumors represented SDC with sarcomatoid Carcinoma. We conclude an element of sarcomatoid Carcinoma rarely may arise in association with SDC, and it is erroneous to diagnose such tumors as "carcinosarcoma."
Igor Barjaktarevic - One of the best experts on this subject based on the ideXlab platform.
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Primary Salivary Duct Carcinoma of the lung, mucin-rich variant
Human pathology, 2015Co-Authors: Gregory A. Fishbein, Brandon S. Grimes, Rena R. Xian, Jay M. Lee, Igor BarjaktarevicAbstract:Primary Salivary gland-type lung cancer is a heterogeneous group of neoplasms arising from the seromucinous glands of the respiratory tract. Histopathologically, they are identical to Salivary gland neoplasms of the head and neck. While mucoepidermoid Carcinoma and adenoid cystic Carcinoma are overwhelmingly the most common subtypes found in the lung, reports of uncommon subtypes can be found in the literature. We report a case of a 73-year-old woman with primary lung Salivary Duct Carcinoma, mucin-rich variant--an exceedingly rare subtype of an already rare malignant Salivary-type neoplasm. One case of primary lung Salivary Duct Carcinoma has been reported in the literature; however, the mucin-rich variant has never been described in the lung. Furthermore, the tumor in our case bears a rare BRAF G464V mutation. To our knowledge, this is the first reported case of a BRAF G464V mutation detected in a Salivary Duct Carcinoma or any other Salivary-type neoplasm.
Jean E. Lewis - One of the best experts on this subject based on the ideXlab platform.
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sarcomatoid variant of Salivary Duct Carcinoma
American Journal of Clinical Pathology, 2004Co-Authors: Toshitaka Nagao, Thomas A Gaffey, Hiromi Serizawa, Keiichi Iwaya, Akinori Watanabe, Tomoyuki Yoshida, Kazuto Yamazaki, Masato Sageshima, Jean E. LewisAbstract:Salivary Duct Carcinoma (SDC) is an uncommon, high-grade tumor. We present 8 cases of sarcomatoid SDC, which has been defined recently as a rare variant of SDC. The 8 patients (5 men, 3 women) had a mean age of 63.6 years. Histologically, all tumors were characterized by a biphasic neoplasm composed of both SDC and sarcomatoid elements. In 3 cases, sarcomatoid components showed osteosarcomatous heterologous differentiation. A residual pleomorphic adenoma was detected in 5 tumors. The sarcomatoid component showed focal immunoreactivity for cytokeratin in 4 cases and epithelial membrane antigen in all 8 cases. Diffuse p53 immunostaining was detected in 3 cases, and it was coexpressed in both components. Our observations support the histogenetic theory of a common origin of the Carcinomatous and sarcomatoid populations. Of the 13 patients, including our 8, reported to have sarcomatoid SDC arising in a major Salivary gland and for whom long-term follow-up data were available, 7 have died of disease (mean survival, 15.6 months). These results indicate that sarcomatoid SDC is a highly aggressive tumor, similar to conventional SDC.
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Mucin-rich variant of Salivary Duct Carcinoma: a clinicopathologic and immunohistochemical study of four cases.
The American journal of surgical pathology, 2003Co-Authors: Roderick H W Simpson, Alena Skalova, Anil Prasad, Jean E. Lewis, Leonor DavidAbstract:Salivary Duct Carcinoma is a relatively uncommon aggressive neoplasm, typically found in the parotid glands of older men. The histologic appearance is that of an in situ and invasive high-grade adenoCarcinoma, and it closely resembles Ductal Carcinoma of the breast. Several variants of the latter are very well known, but only papillary, sarcomatoid, and low-grade subtypes have so far been reported in Salivary Duct Carcinoma. This study describes the clinicopathologic and immunohistochemical findings in four examples of an additional previously undescribed variant, rich in mucin. Each tumor showed areas of typical Salivary Duct Carcinoma, but in addition there were lakes of epithelial mucin-containing malignant cells, i.e., mucinous (colloid) Carcinoma. All four tumors expressed androgen receptors, cytokeratins, epithelial membrane antigen, gross cystic disease fluid protein-15, and carcinoembryonic antigen, but S-100 protein, other myoepithelial markers, and estrogen and progesterone receptors were negative. The mucin antigen profile showed positivity for MUC2, MUC5B, and MUC6 in all cases but only rare staining with MUC5AC and MUC7. Strong immunohistochemical overexpression of HER2/neu was demonstrated in one tumor, together with amplification by fluorescence in situ hybridization; another case was weakly positive with just one antiserum, but the remaining two tumors were completely negative. Small quantities of mucin have often been described in Salivary Duct Carcinoma but not large extracellular mucinous lakes, which though prominent in the present series, were not as extensive as in mucinous adenoCarcinoma. The relatively poor clinical outcome of the patients in our study mirrored that seen in usual-type Salivary Duct Carcinoma and emphasizes the importance of differentiating mucin-rich Salivary Duct Carcinoma from pure mucinous (colloid) adenoCarcinoma, a tumor not fully defined, but possibly with a better prognosis.
