Adenoid-cystic carcinoma

Kasamatsu A, Endo Y, Uzawa K, Nakashima D, Koike H, Hashitani S, et al. Identification of candidate genes associated with salivary adenoid cystic carcinomas using combined comparative genomic hybridization and oligonucleotide microarray analyses. Int J Biochem Cell Biol 2005 37 1869-80. 

Fig. 13.6 Triple staining of an adenoid cystic carcinoma for K14 (green a), (b) for K8/18 (red b) and for SMA (pink c). Note that the k 4+ cells differentiate to glandular and myoepithelial cells...

Adenoid cystic carcinoma Adenoid cystic carcinoma and... 

Hirabayashi, S. 1999. Immunohistochemical detection of DNA topoisomerase type II a and Ki-67 in adenoid cystic carcinoma and pleomorphic adenoma of the salivary gland. 7. Oral Pathol. Med. 25 131—136. 

Nordgard, S., Franzen, G., Boysen, M., and Halvorsen, T. B. 1997. Ki-67 as a prognostic marker in adenoid cystic carcinoma assessed with the monoclonal antibody MIB-1 in paraffin sections. Laryngoscope 707 531-536. 

Basaloid Squamous Cell Antibody Marker Carcinoma Adenoid Cystic Carcinoma Small Cell Neuroendocrine Carcinoma... 

The differential diagnosis for BSCC can be broad, especially in small biopsies where it can be difficult to appreciate all of the histologic features. Included in the differential diagnosis are the two most important mim-ickers adenoid cystic carcinoma and small cell neuroendocrine carcinoma.Immunohistochemical stains are particularly useful in resolving this differential diagnosis (Table 9.2). 

Strongly positive for p53. Adenoid cystic carcinomas with high-grade transformation and less commonly solid type adenoid cystic carcinoma can also show p53 staining. 

The differential diagnosis for basaloid squamous cell carcinoma (BSCC) includes adenoid cystic carcinoma and small cell neuroendocrine carcinoma. 

Microscopically, PAs are composed of varying proportions of epithelial and myoepithelial cells and a stroma that ranges from myxoid to hyaline to chondromyxoid. Although the tumor is usually easily recognized when excised intact, it may be difficult to separate from other tumors, especially polymorphous low-grade adenocarcinomas and adenoid cystic carcinomas, on small biopsies. Features that may be helpful are shown in Table 9.12. 4,199-202... 

TABLE 9.12 Differential Diagnosis of Pleomorphic Adenoma (PA), Polymorphous Low-Grade Adenocarcinoma (PLGA), and Adenoid Cystic Carcinoma (ACC) ... 

FIGURE 9.20 Adenoid cystic carcinoma demonstrating characteristic tubuiar and cribriform growth patterns. (H E, x200 originai... 

Adenoid cystic carcinoma (ACC), with few exceptions, is a low-grade tumor with a relentless clinical course, characterized by repeated local recurrences, late metastasis, and ultimate death over a course of 5 to 15 years. It is more common in females and occurs over a broad age range, though it is uncommon in individuals younger than 20 years of age. 

Adenoid cystic carcinoma has three growth patterns cribriform, tubular, and solid. 

These tumors can occasionally undergo dedifferentiation in a similar manner to adenoid cystic carcinoma. On immunostaining, the ductal cells are strongly positive for cytokeratins such as AEl-3 and CAM5.2. The myoepithelial component is usually strongly positive for typical myoepithelial cell markers such as p63, SMA, and calponin (see Table 9.13, Figs. 9.23 and 9.24). 

Klijanienko J, el-Naggar A, Ponzio-Prion A, et al. Basaloid squamous carcinoma of the head and neck. Immunohisto-chemical comparison with adenoid cystic carcinoma and squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 1993 119(8) 887-890. 

Holst VA, Marshall CE, Moskaluk CA, et al. KIT protein expression and analysis of c-kit gene mutation in adenoid cystic carcinoma. Mod Pathol. 1999 12(10) 956-960. 

Mino M, Pilch BZ, Faquin WC. Expression of KIT (GDI 17) in neoplasms of the head and neck an ancillary marker for adenoid cystic carcinoma. Mod Pathol. 2004 16(12) 1224-1231. 

Emanuel P, Wang B, Wu M, et al. p63 Immunohistochemistry in the distinction of adenoid cystic carcinoma from basaloid squamous cell carcinoma. Mod Pathol. 2005 18(5) 645-650. 

Seethala RR, Hunt JL, Baloch ZW, et al. Adenoid cystic carcinoma with high-grade transformation a report of 11 cases and a review of the literature. Am J Surg Pathol. 2007 31(11) 1683-1694. 

Nagao T, Gaffey TA, Serizawa H, et al. Dedifferentiated adenoid cystic carcinoma a clinicopathologic study of 6 cases. Mod Pathol. 2003 16(12) 1265-1272. 

Vargas V, Sudilovsky D, Kaplan MJ. Mixed tumor, polymorphous low-grade adenocarcinoma and adenoid cystic carcinoma of the salivary gland pathogenic implications and differential diagnosis by Ki-67 (Mib 1), Bel 2 and S-100 immunohistochem-istry. Appl Immunohistochem. 1997 5 8-16. 

Darling MR, Schneider JW, Phillips VM. Polymorphous low-grade adenocarcinoma and adenoid cystic carcinoma a review and comparison of immunohistochemical markers. Oral Oncol. 2002 38(7) 641-645. 

Beltran D, Faquin WC, Gallagher G, et al. Selective immunohis-tochemical comparison of polymorphous low-grade adenocarcinoma and adenoid cystic carcinoma. J Oral Maxillofac Surg. 2006 64(3) 415-423. 

Alcedo JC, Fabrega JM, Arosemena JR, et al. Imatinib mesylate as treatment for adenoid cystic carcinoma of the salivary glands report of two successfully treated cases. Head Neck. 2004 26(9) 829-831. 

Wick MR, Swanson PE. Primary adenoid cystic carcinoma of the skin a clinical, histologic, and immunohistochemical comparison with adenoid cystic carcinoma of salivary glands, and adenoid basal cell carcinoma. Am J Dermatopathol. 1986 8 2-... 

ADENOID CYSTIC CARCINOMA Most reported esophageal adenoid cystic carcinomas are basaloid SCCs true adenoid cystic carcinomas of the esophagus are extremely rare. Esophageal salivary gland-type adenoid cystic carcinomas stain diffusely and strongly with CAM5.2 and AE1/AE3. 34bE12 and CEA stain the ductal-type cells, whereas S-100, actin, and vimentin stain the basaloid-type cells. 

FIGURE 14.5 Differential staining patterns of basaloid-patterned esophageal carcinomas. ACC, adenoid cystic carcinoma BSCC, basaloid squamous cell carcinoma HG NEC, high-grade neuroendocrine carcinoma. 

Most adenoid cystic-like carcinomas are basaloid squamous cell carcinomas. True adenoid cystic carcinomas of the esophagus are extremely rare. 

Tsang WY, Chan JK, Lee KC, et al. Basaloid-squamous carcinoma of the uppet aerodigestive tract and so-called adenoid cystic carcinoma of the oesophagus the same mmour type Histopathology. 1991 19 35-46. 

This tumor is similar to its counterpart in salivary glands in both morphology and immunophenotype and may arise in the cervix or vulvovaginal soft tissue. It is a dual-cell population tumor growing in cribriform, tubular, and/or solid patterns. The major cell type is a basaloid polygonal cell with modified myoepithelial features, and it is positive for p63 and smooth muscle actin. The minor cell type is an epithelial cell forming tiny ductules that may be inconspicuous. These cells express keratin and CD 117. Distinction from basaloid squamous carcinoma is based on the distinct morphology of adenoid cystic carcinoma because overlap exists in immunostains p63 is diffusely expressed in basaloid squamous carcinoma, as opposed to adenoid cystic carcinoma, in which p63 is confined to basaloid cells and not epithelium of the ductules CDl 17 can be expressed at low levels in basaloid squamous carcinoma. ... 

This uncommon tumor of bland basaloid cells without mitoses is arranged in palisaded clusters and nests, and it grows in an infiltrative, scattered pattern in the cervical stroma. Squamous metaplasia can occur. The tumor may coexist with other tumors such as squamous cell carcinoma, adenoid cystic carcinoma, or neuroendocrine carcinoma. The basaloid cells express keratin, p63, and pl6 (Fig. 18.12).84-86... 

Ferry JA, Scully RE. Adenoid cystic carcinoma and adenoid basal carcinoma of the uterine cervix. A study of 28 cases. Am J Surg Pathol. 1988 12 134-144. 

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