Diagnostic utility of phosphorylated signal transducer and activator of transcription 5 immunostaining in the diagnosis of mammary analogue secretory carcinoma of the salivary gland: A comparative study of salivary gland cancers

Kawahara, Akihiko; Taira, Tomoki; Abe, Hideyuki; Takase, Yoshiaki; Kurita, Takashi; Sadashima, Eiji; Hattori, Satoshi; I, Imamura; Matsumoto, Shinji; Fujisaki, Hitomi; Sueyoshi, Kazunobu; Akiba, Jun; Kage, Masayoshi

doi:10.1002/cncy.21594

Cited by 32 publications

(19 citation statements)

References 31 publications

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“…(6) Background: extracellular material such as mucin or metachromatic material and macrophages are typically observed. In addition to these features, the usefulness of immunocytochemistry of mammaglobin, S-100 protein, or markers under investigation, such as DOG1, carbonic anhydrase VI, and p-STAT5, has been reported for the cytodiagnosis of MASC [18][19][20][21] .…”

Section: Discussionmentioning

confidence: 99%

Difficulty in the Cytodiagnosis of Mammary Analogue Secretory Carcinoma: Survey of 109 Cytologists with a Case Originating from a Minor Salivary Gland

Kai

Minesaki²,

Suzuki³

et al. 2017

Acta Cytologica

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Background: Mammary analogue secretory carcinoma (MASC) of the salivary gland shows morphologic similarities and shares an immunophenotype and characteristic ETV6-NTRK3 translocation with secretory carcinoma of the breast. We present a buccal case of MASC along with a survey-based debate about its cytologic diagnosis by fine-needle aspiration (FNA). Case: FNA of the buccal nodule of a 58-year-old Japanese man was initially performed by 3 cytologists who gave different assessments of the Papanicolaou classification (i.e., class II, III, and V). To investigate the potential for discrepant diagnosis of MASC on a larger scale, we distributed a survey with questions about the cytological diagnosis of the present case to cytologists at other institutions. A total of 109 cytologists completed the survey, providing varying assessments of the Papanicolaou classification: class I/II (14%), class III (53%), and class IV/V (33%). Most of the respondents (72%) could not identify a particular tumor or disease. Even the respondents who identified a particular tumor suggested widely differing diagnoses, from a benign lesion to various malignant tumors. Only 2 respondents correctly identified MASC. Conclusion: Our experience and the results of the survey suggest difficulty in the cytodiagnosis of MASC.

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Section: Discussionmentioning

confidence: 99%

Difficulty in the Cytodiagnosis of Mammary Analogue Secretory Carcinoma: Survey of 109 Cytologists with a Case Originating from a Minor Salivary Gland

Kai

Minesaki²,

Suzuki³

et al. 2017

Acta Cytologica

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“…43 When combined with the complete membranous and/or cytoplasmic DOG1 reactivity, SOX10 positivity can also be useful to support the diagnosis of AciCC. 63 In more challenging cases in which a specific diagnosis is required, FISH for the ETV6 gene rearrangement is also useful on as this rearrangement is specific for MASC in the setting of a primary salivary gland tumor. MASC, like AciCC, are also positive for SOX10 but are also usually strongly positive for S100 and mammaglobin in contrast to AciCC.…”

Section: Oncocytoid Neoplasm With Granular/ Vacuolated Cytoplasmmentioning

confidence: 99%

“…Although we do not have experience with Phosphorylated signal transducer and activator of transcription 5 (p-STAT5) IHC has been recently been reported to be positive in MASC (7 of 10 cases) but negative in other salivary gland tumors. 63 In more challenging cases in which a specific diagnosis is required, FISH for the ETV6 gene rearrangement is also useful on as this rearrangement is specific for MASC in the setting of a primary salivary gland tumor. 64 Less commonly MEC may demonstrate this pattern of an oncocytoid neoplasm with granular/vacuolated cytoplasm due to cytoplasmic mucus vacuoles and in these cases there is often a more prominent mucinous background.…”

Section: Oncocytoid Neoplasm With Granular/ Vacuolated Cytoplasmmentioning

confidence: 99%

Ancillary testing strategies in salivary gland aspiration cytology: A practical pattern‐based approach

Griffith

Siddiqui

Schmitt

2017

Diagnostic Cytopathology

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Fine needle aspiration of salivary gland tumors is a common preoperative triage as it is useful in determining which patients should undergo surgical resection and in guiding the extent of surgery in those cases deemed appropriate for resection. While a specific diagnosis can be achieved on a cytologic specimen in many cases, there is also a considerable amount of morphologic diversity that prevents such confident preoperative classification and in these cases it can be a challenge to confidently determine if a tumor is benign or malignant. Recently, a pattern based risk stratification approach was proposed for salivary gland cytology in which basaloid neoplasms are separated by stromal characteristics and oncocytoid neoplasms are separated primarily by background material such as mucus. In addition to potentially providing a stratification in risk of malignancy for salivary gland tumors, this approach is also useful to narrow differential diagnostic considerations and guide ancillary testing. In this review we use this proposed pattern based approach as a framework to discuss immunostains and fluorescence in situ hybridization studies which we find useful in our practice.

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“…pSTAT5 also has been suggested as a useful diagnostic marker for secretory carcinoma. 69 Immunohistochemistry for pan-TRK is positive in a subset of cases, 70 and nuclear staining discriminates secretory carcinoma with NTRK3 fusion Cancer Cytopathology August 2018 from its mimics. 71 Similar to its breast counterpart, tumors also are positive for GCDFP and GATA3, 55,72 and mostly are negative for ER and PR.…”

Section: Acinic Cell Carcinomamentioning

confidence: 99%

“…p63 positivity is noted in the majority of cases. pSTAT5 also has been suggested as a useful diagnostic marker for secretory carcinoma . Immunohistochemistry for pan‐TRK is positive in a subset of cases, and nuclear staining discriminates secretory carcinoma with NTRK3 fusion from its mimics .…”

Section: Introductionmentioning

confidence: 99%

Ancillary testing in salivary gland cytology: A practical guide

Krane

2018

Cancer Cytopathology

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Salivary gland cytology is challenging, and historically the role of ancillary testing has been limited. However, numerous molecular/genetic advances in the understanding of salivary gland neoplasms during the last decade have facilitated the development of many useful diagnostic markers, such as PLAG1 and HMGA2 immunohistochemistry for pleomorphic adenoma and ETV6 fluorescence in situ hybridization for secretory carcinoma. Numerous salivary gland neoplasms are characterized by specific molecular/genetic alterations, many of which can be identified on cytologic preparations by karyotype analysis, fluorescence in situ hybridization, or immunohistochemical surrogates. Next-generation sequencing also has potential diagnostic applications, although to the authors' knowledge it currently has no routine role in salivary cytology. The primary goal of salivary fine-needle aspiration (FNA) is to facilitate appropriate clinical management. Ancillary testing has greatly enhanced the ability for accurate classification as per The Milan System for Reporting Salivary Gland Cytopathology and allows for the definitive diagnosis of many salivary FNA specimens, and also may resolve diagnostic uncertainty for FNAs that may be classified in The Milan System for Reporting Salivary Gland Cytopathology categories of salivary gland neoplasm of uncertain malignant potential or suspicious for malignancy. This review provides an updated discussion of the molecular/genetic features of the more commonly encountered salivary neoplasms by FNA, and discusses the application of available diagnostic immunohistochemical and molecular tests in salivary gland cytology.

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Diagnostic utility of phosphorylated signal transducer and activator of transcription 5 immunostaining in the diagnosis of mammary analogue secretory carcinoma of the salivary gland: A comparative study of salivary gland cancers

Cited by 32 publications

References 31 publications

Difficulty in the Cytodiagnosis of Mammary Analogue Secretory Carcinoma: Survey of 109 Cytologists with a Case Originating from a Minor Salivary Gland

Difficulty in the Cytodiagnosis of Mammary Analogue Secretory Carcinoma: Survey of 109 Cytologists with a Case Originating from a Minor Salivary Gland

Ancillary testing strategies in salivary gland aspiration cytology: A practical pattern‐based approach

Ancillary testing in salivary gland cytology: A practical guide

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