Salivary gland tumors: immunohistochemical study of EGF, EGFR, ErbB-2, FAS and Ki-67.

OBJECTIVE: To analyze the expression of ErbB-1 (Her-1 or EGFR), ErbB-2 (Her-2 or neu), ErbB-3 (Her-3) and ErbB-4 (Her-4) and their correlation in 3 different types of salivary gland tumors. STUDY DESIGN: Immunohistochemical expression of epidermal growth factor (EGF), EGFR, ErbB-2, fatty acid synthase (FAS) and Ki-67 were analyzed in 41 pleomorphic adenoma (PA), in 30 mucoepidermoid carcinoma (MEC) and in 30 adenoid cystic carcinoma (ACC) and correlated with their histologic patterns. RESULTS: EGF was more common in MEC and PA, but MEC had a higher percentage of strongly positive cases. EGFRc and EGFRm were both more frequent in MEC and ACC. Higher scores of ErbB-2c were observed in PA, followed by MEC and ACC. In contrast, higher scores of ErbB-2m were more common in MEC as compared to ACC and PA. FAS was most commonly found in PA and MEC. Moreover, MEC showed the highest percentage of strongly positive cases. Ki-67 was higher in MEC and ACC than in PA. From a correlation of immunomarkers with the histologic patterns, it was observed that cribriform ACC presented more expression of EGFR and high grade MEC showed a higher percentage of ErbB-2, FAS and Ki-67. CONCLUSION: EGF, EGFR, ErbB-2 and FAS were commonly found and seem to be important in the tumorigenesis of salivary gland tumors, particularly in percentage of strongly positive cases. Ki-67 was higher in MEC and ACC than in PA. From a correlation of immunomarkers with the histologic patterns, it was observed that cribriform ACC presented more expression of EGFR and high grade MEC showed a higher percentage of ErbB-2, FAS and Ki-67. CONCLUSION: EGF, EGFR, ErbB-2 and FAS were commonly found and seem to be important in the tumorigenesis of salivary gland tumors, particularly in MEC. (Anal Quant Cytol Histol 2009;31:280-287)

Calcifications in a clear cell mucoepidermoid carcinoma: a case report with histological and immunohistochemical findings.

The aim of this study was to report an unusual case of mucoepidermoid carcinoma (MEC) in a 39-year-old woman. The tumor showed a prominent population of clear and intermediate basal cells. Clear cells rarely predominate over other cell types. Such cases are called clear cell variant of MEC. The case also revealed a variable amount of calcified material in the tumor mass. Calcifications are rare in clear cell MEC. These structures were periodic acid-Schiff positive and diastase resistant, excluding glycogen origin. Immunohistochemistry was performed, and the epidermoid component was positive for cytokeratin (CK)7, CK13, CK14, and CK19. The mucous and clear cells presented mild staining for CK7. Cytokeratins 7, 13, and 19 stained luminal cells, and intermediate cells exhibited positivity for CK7, CK14, and vimentin. The origin of the calcifications is speculated to be the result of dystrophic calcification of the amorphous eosinophilic material secreted by intermediate basal cells.

Salivary gland tumors in children and adolescents: a clinicopathologic and immunohistochemical study of fifty-three cases.

OBJECTIVE: Salivary gland tumors in children and adolescents are rare. Most papers are case reports or short series of cases. The aim of this study was to analyze clinicopathological and immunohistochemical data from a large series of salivary gland tumors affecting youngsters from a single institution. METHODS: From 1953 to 1997, 53 patients 18 years old or less with epithelial salivary gland tumors from the Hospital do Cancer A.C. Camargo were studied. Clinical and treatment data were obtained from the medical records and histological features were reviewed. Paraffin-embedded tissues were immunohistochemically analyzed for p53, PCNA, Ki-67, bcl-2, c-erbB-2, and CEA. RESULTS: Twenty-seven tumors (51%) were benign and 26 (49%) malignant. Pleomorphic adenoma (PA) was the most common tumor type (49%), followed by mucoepidermoid carcinoma (MEC, 39.6%). The tumors were more common in female and 50.9% of the cases affected the parotid, followed by 26.4% of intraoral involvement. Immunohistochemical analysis did not show correlation with prognosis of the tumors. Twenty (74%) of the 27 patients with benign tumors were alive without evidence of disease after a mean of 16.5 years of follow up; 6 were lost of follow up and 1 died by causes not related to the disease. Nineteen (73%) of the 26 patients with malignant tumors did not show tumoral recurrence after a mean follow up of 14.3 years, and 3 (11.5%) patients died of the disease. CONCLUSIONS: In 53 cases of epithelial salivary gland tumors in youngsters, half were malignant, with favorable prognosis. On this series, immunohistochemical expression of p53, PCNA, Ki-67, c-erbB-2, bcl-2, and CEA, were not correlated with prognosis.

Relationship between major and minor salivary gland mucoepidermoid carcinoma malignancy grading and presence of stromal myofibroblasts: immunohistochemical study.

OBJECTIVE: Mucoepidermoid carcinoma (MEC) is the most common malignant salivary tumour, classified as low, intermediate and high grade. Myofibroblasts are the main stromal component and are included as prognostic factor in some tumours. The aim of this study was to evaluate the myofibroblasts in the stroma of MEC with possible relationship to malignancy grading. METHODS: Twenty-five cases of MEC (six low grade, 11 intermediate grade, four high grade and four metastasis) were stained for vimentin, desmin and smooth muscle actin (SMA) for the identification of myofibroblasts. Transforming growth factors (TGFbeta1 and TGFbetaRII) were also assessed in our study. RESULTS: Myofibroblasts were present in all cases, in amounts varying according to histological grading. TGFbeta1 was positive in squamous cells of intermediate grade tumours, and in the stroma of only four cases. TGFbetaRII was positive in most squamous and intermediate cells, regardless of malignancy grading. CONCLUSIONS: Our study showed that the analysis of neoplastic stroma must be added to the studies of neoplastic cells to draw a better picture leading to tumour diagnosis and prognosis.

Cytokeratin expression in central mucoepidermoid carcinoma and glandular odontogenic cyst.

Central mucoepidermoid carcinoma (MEC) is an entity whose origin is still controversial. Glandular odontogenic cyst (GOC) is a recently described lesion whose relationship to low-grade central MEC has been reported in the literature. Our aim was to assess the cytokeratin (CK) profile of central MEC and GOC, and compare the results with CK expression in salivary gland MEC and odontogenic cysts and tumors. Eighty-five cases, including 6 central MECs, 23 salivary gland MECs, 10 GOCs, 34 odontogenic cysts and 12 ameloblastomas, were studied through immunohistochemistry using eleven monoclonal anti-CK antibodies. All central MECs expressed CKs 5, 7, 8, 14, and 18 and all GOCs expressed CKs 5, 7, 8, 13, 14, and 19. Comparing CK expression from GOC and central MEC we found differences in CKs 18 (30% vs 100%) and 19 (100% vs 50%). Central MEC and GOC are probably distinct entities with CK profiles similar to lesions of glandular and odontogenic origins, respectively, and expression of CKs 18 and 19 could be useful in their differential diagnosis.

Immunohistochemical distinction of high-grade mucoepidermoid carcinoma and epidermoid carcinoma of the parotid region.

The correct diagnosis of high-grade mucoepidermoid (MEC), which is composed of solid islands of intermediate and squamous cells, may be challenging, due to its similarity to other tumours, mainly with squamous cell carcinoma (SCC). The present report employed immunohistochemical technique against different cytokeratins (CKs), in order to differentiate these two entities. : Six high-grade MEC and six SCC of the parotid region, retrieved from the files of both Oral Pathology Department of the School of Dentistry of University of São Paulo and Pathology Department of A.C. Camargo Hospital, were submitted immunohistochemical technique against Cks 7,8, 10, 13, 14 and 19. : High-grade MEC was positive for Cks 7, 8, 13, 14 and 19. The cases of SCC showed strong positivity for CK14, and CK10 was present only in focal areas. Our results highlight the use of CKs (especially CK14) to differentiate high-grade MEC and SCC.

[Bcl-2 gene protein expression in salivary gland tumors]. / Expresión de la proteína del gen Bcl-2 en tumores de glándulas salivales.

BACKGROUND: Salivary gland tumors have heterogeneous pathological features. Oncogene Bcl-2 product expression inhibits apoptosis and therefore is important for tumor proliferation. AIM: To assess the immunohistochemical gene Bcl-2 protein expression in salivary gland tumors. MATERIAL AND METHODS: Twenty seven salivary gland tumors were selected from the archives of the Pathology Department of Temuco Regional Hospital. There were 20 pleiomorphic adenomas, 4 cystic adenoid carcinomas and three mucoepidermoid carcinomas. Immunohistochemical gene Bcl-2 protein expression was determined in paraffin included pathological slices. RESULTS: All pleiomorphic adenomas expressed the protein, specially in tubulo ductal structures, solid and trabecular areas. All cystic adenoid carcinomas expressed the protein in myoepithelial cells. Two mucoepidermoid carcinomas were positive, only in the epidermoid areas. CONCLUSIONS: immunohistochemical gene Bcl-2 protein was expressed in virtually all benign and malignant salivary gland tumors. This observation suggest an important role of this protein in the development of these tumors.

[Determination of DNA content in salivary gland tumors]. / Determinación del contenido de ADN en tumores de glándulas salivales.

BACKGROUND: DNA content determination is a useful tool in the characterization of different malignant tumors. AIM: To measure DNA content in cells of salivary gland tumors as adjunct to histological diagnosis, correlating morphologic and biological features of these tumors. MATERIAL AND METHODS: From the archives of the Pathology service of a general hospital, 21 salivary gland tumors, 15 pleomorphic adenomas, 3 mucoepidermoid carcinomas and 3 cystic adenoid carcinomas were selected. DNA content was determined in the histological samples using a flow cytometric DNA analysis. RESULTS: All pleomorphic adenomas had a normal or diploid DNA content. Fifty percent of malignant tumors had an aneuploid DNA content (1 mucoepidermoid carcinoma and 2 cystic adenoid carcinomas). CONCLUSIONS: DNA determination may help in the histological diagnosis of salivary gland tumors. The presence of aneuploidy suggests malignity.