Extra-salivary gland presentations of adenoid cystic carcinoma: A report of three cases

Florentine, Barbara D.; Fink, Tania; Avidan, Sali; Braslavsky, Diana; Raza, Anwar; Cobb, Camilla J.

doi:10.1002/dc.20500

Cited by 21 publications

(28 citation statements)

References 21 publications

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“…ACC arises at sites where seromucinous or sweat gland epithelium is present and commonly affects the submandibular and minor salivary glands. Rarely can it occur at extra‐salivary locales like lacrimal glands, nasopharynx, maxillary antrum, tongue, larynx, tracheo‐bronchial tree, lung, breast, uterine cervix, ovary, Bartholin glands, oesophagus, prostate, external ear, and skin …”

Section: Introductionmentioning

confidence: 99%

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Adenoid cystic carcinoma: A study of 19 cases of salivary and extra‐salivary tumours diagnosed by fine needle aspiration cytology

Kundu

Handa

Punia

et al. 2018

Diagnostic Cytopathology

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Background Adenoid cystic carcinoma (ACC) arises at sites where seromucinous or sweat gland epithelium is present and commonly affects the salivary glands. Rarely it can occur at extra‐salivary locations. Methods A retrospective analysis of 19 cases of ACC diagnosed on fine needle aspiration cytology (FNAC) over a period of 15 y (2002‐2016) was made. Results Of 19 total cases, there were 10 salivary and 9 extra‐salivary ACCs. Extra‐salivary tumours were seen in 2 cases each in trachea, tongue and in one case each in bronchus, lung, subcutaneous tissue, maxillary antrum, and external auditory canal. The age ranged from 14‐80 y (mean: 49.5 y), 10 patients were male and 9 were female. The smears were highly cellular in 11 cases, moderately cellular in 5 cases while 3 cases were paucicellular. Multilayered dense clusters, tissue fragments, dispersed cells and cup‐shaped fragments were seen. Relatively uniform cells with high nuclear: cytoplasmic ratio, hyperchromatic nuclei, irregular margins, and nuclear moulding were observed. Variable sized hyaline globules, finger‐like hyaline material, hyaline cylinders, and hyaline cords were noted. The cytologic diagnosis of ACC was rendered in 13 cases while in 6 cases it was one of the differential diagnosis including monomorphic adenoma, membranous variant of basal cell adenoma, adnexal tumour, polymorphous adenocarcinoma, and pleomorphic adenoma (PA). Conclusions Cytologists must be aware of varied locations where ACC can occur. A diagnosis of ACC must not rely exclusively on the occurrence of hyaline globules but necessitates a close scrutiny of cellular and nuclear features to avoid diagnostic pitfalls.

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Section: Introductionmentioning

confidence: 99%

“…Lungs are the most common site for distant metastasis followed by bone. Less frequently, metastasis can involve liver, skin, optic disc, choroid, brain, spine, and kidney …”

Section: Introductionmentioning

confidence: 99%

Adenoid cystic carcinoma: A study of 19 cases of salivary and extra‐salivary tumours diagnosed by fine needle aspiration cytology

Kundu

Handa

Punia

et al. 2018

Diagnostic Cytopathology

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“…All of these features that recapitulate the histopathology of AdCC are helpful in correctly orienting the cytological diagnosis of this neoplasm. Sometimes, isolated hyaline globules can be observed (7, 20, 24, 26); singly dispersed cells are present on some smears (11, 26). The basement membrane material, forming globules that have a light blue appearance on PAP stain and bright magenta on MGG stain, is the characteristic feature of AdCC; diagnostic difficulties arise when they are not present on cytological material, as the pattern could mimic carcinoid tumor, SCLC, NSCLC, and reserve cell hyperplasia (19).…”

Section: Discussionmentioning

confidence: 99%

Cytology of Primary Salivary Gland-Type Tumors of the Lower Respiratory Tract: Report of 15 Cases and Review of the Literature

et al. 2017

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Primary pulmonary salivary gland-type tumors are rare neoplasms arising from the seromucinous submucosal glands of the lower respiratory tract (LRT), the most common of which are mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma. They are morphologically indistinguishable from their salivary gland counterpart and recognizing them is a challenge, especially on cytological specimens. We analyzed 15 cases of histologically proven primary salivary gland tumors of the LRT to identify cytomorphological features and define potential diagnostic clues that might assist cytopathologists in the preoperative diagnosis of these neoplasias. Three out of the four cases of adenoid cystic carcinomas showed the characteristic tridimensional cell clusters and hyaline globules, whereas the last one did not show malignant cells; only two cases of MEC presented the three characteristic cell types (i.e., squamous, intermediate, and mucin secreting) on cytology. Since these neoplasms are rare and do not have a completely specific set of cytological features, it is important for practicing cytopathologists to be aware of the possibility of encountering them, in specimens from patients with LRT masses, in order to render the correct diagnosis.

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“…Florentine et al (25) reported a patient who had metastatic bone disease from unknown primary as the initial diagnosis, and the patient's further medical history showed a record of early-stage adenoid cystic carcinoma (ACC) of the soft palate, which had been diagnosed and resected 3 months earlier. The bone histopathology was compatible with ACC.…”

Section: Discussionmentioning

confidence: 99%

Gene expression profiling and its use in adenocarcinomas of unknown primary origin: A case report

et al. 2015

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Abstract. Carcinomas of unknown primary origin account for 3-5% of all malignancies. The current literature suggests that metastatic dissemination is able to occur in the absence of primary tumor growth. In metastatic disease that is difficult to diagnose, the origin usually remains unknown even after an exhaustive evaluation of immunohistochemistry (IHC) markers. In the current study, a 49-year-old male presented with lymph nodes metastases of unknown origin. The excisional biopsy of an inguinal node revealed an adenocarcinoma growth pattern, but the IHC could not determine the primary origin. A gene profiling test was performed to complete the diagnosis and a salivary gland adenocarcinoma was diagnosed with 90% probability. Subsequently, the patient underwent appropriate chemotherapy for salivary gland adenocarcinoma, and exhibited an improved partial response. The present case study highlights the importance of an accurate diagnosis of the primary tumor and the use of all the current tools available in order to provide patients with the best treatment possible.

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Extra-salivary gland presentations of adenoid cystic carcinoma: A report of three cases

Cited by 21 publications

References 21 publications

Adenoid cystic carcinoma: A study of 19 cases of salivary and extra‐salivary tumours diagnosed by fine needle aspiration cytology

Adenoid cystic carcinoma: A study of 19 cases of salivary and extra‐salivary tumours diagnosed by fine needle aspiration cytology

Cytology of Primary Salivary Gland-Type Tumors of the Lower Respiratory Tract: Report of 15 Cases and Review of the Literature

Gene expression profiling and its use in adenocarcinomas of unknown primary origin: A case report

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