Sclerosing polycystic adenosis of the parotid gland: Diagnosis and management

Perottino, Flavio; Barnoud, R; Ambrun, A.; Poupart, M.; Pignat, J.-C.; Merrot, O.

doi:10.1016/j.anorl.2010.02.005

Cited by 16 publications

(14 citation statements)

References 9 publications

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“…Given the yield of cells with predominantly acinar differentiation, mild nuclear abnormalities and the absence of cytologic cyst-material, the differential diagnosis of an ACC on FNAC is problematic. The difficulties pertaining to the cytological differential diagnoses of SPA have been discussed and commented on by other investigators [3,4,6,8,11]. However, in contrast to the cytological findings, the histological features of SPA are in our opinion highly characteristic.…”

Section: Discussionmentioning

confidence: 86%

“…SPA was first described by Smith et al in 1996 in a series of 9 cases [1]. Since then just over 50 cases in a few larger series and several case reports have been published [2][3][4][5][6][7][8][9][10][11][12][13][14]. The most common site is the parotid gland with less frequent occurrence in the submandibular gland and intraoral minor salivary glands.…”

Section: Introductionmentioning

confidence: 99%

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Sclerosing Polycystic Adenosis of the Parotid Gland: Report of a Bifocal, Paucicystic Variant with Ductal Carcinoma in situ and Pronounced Stromal Distortion Mimicking Invasive Carcinoma

Petersson

Tan

Hwang

2011

Head and Neck Pathol

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We present a case (female patient, age 45 years) with a bifocal, paucicystic variant of sclerosing polycystic adenosis of the parotid gland with cribriform ductal carcinoma in situ (DCIS) and pronounced stromal distortion affecting the in situ component to such an extent that it gave a distinct impression of intralesional invasive adenocarcinoma. P63-and calponin-positive myoepithelial cells were present in the periphery of the acini and ducts in the benign component, somewhat discontinuously in the DCIS-component, and even in the periphery of the small irregular atypical cell nests that appeared infiltrative on the haematoxylin and eosin stained sections. Strong cytoplasmic immunoreactivity for GCDFP-15 was detected in the benign component with a variable, patchy and mostly weak positivity in the DCIS. More than 90% of the cells in the DCIS component displayed strong nuclear immunoreactivity for androgen receptors and 10% of the benign ducts showed positivity. Weak to moderate nuclear immunoreactivity for estrogen receptors was seen in 30% of cells in the benign ductal component whereas the DCIS was negative. Occasional cells in the adenosis-component were weakly positive for PR. The proliferative activity (Mib-1/Ki-67) was low (1-2%) in the benign component whereas increased proliferation was seen in the DCIS and in the areas with pseudoinfiltration which also featured atypical mitoses.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Sclerosing Polycystic Adenosis of the Parotid Gland: Report of a Bifocal, Paucicystic Variant with Ductal Carcinoma in situ and Pronounced Stromal Distortion Mimicking Invasive Carcinoma

Petersson

Tan

Hwang

2011

Head and Neck Pathol

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“…Apart from the seminal paper by Smith et al the largest series to date, comprising of 16 cases was published by Gnepp et al <50 cases have been published in the world English literature till date, despite the lesion being increasingly diagnosed. These cases are mostly diagnosed on histopathology and cytopathological features of SPA have been commented on in very few case reports and in only one case series …”

Section: Discussionmentioning

confidence: 99%

Sclerosing polycystic adenosis: A rare tumor misdiagnosed as retention cyst on fine needle aspiration cytology

Shilpi

Ansari

Bahadur

et al. 2017

Diagnostic Cytopathology

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Sclerosing polycystic adenosis (SPA) is a rare benign neoplasm of the salivary gland which resembles the fibrocystic disease of the breast clinically as well as morphologically. This entity has varied morphological presentation on fine needle aspiration. Only a few case reports and occasional case series are found in the literature describing its cytology. Here we are presenting a case of SPA in the parotid gland in a 13-year-old male patient who presented with a slow growing infra-auricular mass since one year without any other symptoms. Radiological investigation suggested a possibility of matted level II cervical lymph nodes. Fine needle aspiration of the same showed only crystalloids in a dirty background. Hence, a possibility of retention cyst was given and excision was advised. On histopathological examination, the mass was diagnosed as Sclerosing polycystic adenosis of the parotid gland. Since SPA is a rare entity with diverse morphological features, it is more likely to be misdiagnosed on cytology. Recognition of this benign entity is important since the differential diagnosis includes other more common benign and malignant salivary gland neoplasm particularly mucoepidermoid carcinoma and other tumors with cystic and oncocytic features. Repeat aspiration from multiple sites should be considered in cystic lesions of the salivary gland so that its varied cytological components can be yielded to help with the diagnosis. Diagn. Cytopathol. 2017;45:640-644. © 2017 Wiley Periodicals, Inc.

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“…The cytopathological/fine needle aspiration (FNA) features of SPA have been characterized or commented on in seven case reports [3,4,6,8,11,17,19] and in one series (4 out of 16 patients) [5]. The investigators have reported the presence of ''syncytial epithelial ducts with apocrine changes'', oncocytic cells in a frequently ''cystic-type background'', i.e., foamy histiocytes and proteinaceous material.…”

Section: Cytopathologymentioning

confidence: 99%

“…SPA was first described by Smith et al [1] in a series comprising 9 cases. Since then, just over 50 cases in a few, mostly small series and several case reports, in a total of 19 original studies, have been published [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Apart from the seminal paper by Smith et al, the largest series to date was published by Gnepp et al [5] and comprises 16 cases.…”

Section: Introductionmentioning

confidence: 99%

Sclerosing Polycystic Adenosis of Salivary Glands: A Review with Some Emphasis on Intraductal Epithelial Proliferations

Petersson

2013

Head and Neck Pathol

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Sclerosing polycystic adenosis (SPA) is a rare condition of salivary glands. The most common site is the parotid gland (80 % of cases). SPA shows no gender predilection and occurs over a wide age spectrum (9-84 years). SPA is mostly unifocal, but may rarely be multifocal. Histologically, SPA are sharply circumscribed mostly unencapsulated lesions composed of acinar and ductal components with variable cytomorphological characteristics, including foamy, vacuolated, apocrine, mucous, clear/ballooned, squamous, columnar and oncocyte-like cells. Characteristic for SPA is the presence of large acinar cells with abundant eosinophilic cytoplasmic granules. The stroma is densely collagenized, frequently harbouring a variably intense chronic inflammatory infiltrate and may contain fat. Rarely the stroma is myxoid. Some degree of intraductal epithelial proliferations have been reported in at least 50 % of cases. The proportion of cases with epithelial proliferations that fulfill criteria for high-grade ductal carcinoma in-situ is \10 %. Immunohistochemically, both ductal and acinar cells are positive for broad spectrum cytokeratins. There is variable immunoreactivity for epithelial membrane antigen and S-100 protein. CEA, p53 and HER2 is reportedly negative. Gross cystic disease fluid protein-15 is strongly expressed in the acinar component. There is consistent but variable expression of estrogen and progesterone receptors. The proliferative index (Ki-67) is low (1-2 %) in the benign (acinar and ductal) components. Using HUMARA methodology (non-random inactivation of X-chromosomes), six cases with atypical epithelial proliferations have been shown to be clonal processes. Recurrences have been reported in up to 19 % of cases.

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Sclerosing polycystic adenosis of the parotid gland: Diagnosis and management

Abstract: Sclerosing polycystic adenosis of the parotid gland is a rare and recently described entity presenting several analogies to the much more frequent cystic mastitis. Although benign and well-delimited, it requires complete exeresis of the parotid, due to a non-negligible risk of recurrence.

Cited by 16 publications

References 9 publications

Sclerosing Polycystic Adenosis of the Parotid Gland: Report of a Bifocal, Paucicystic Variant with Ductal Carcinoma in situ and Pronounced Stromal Distortion Mimicking Invasive Carcinoma

Sclerosing Polycystic Adenosis of the Parotid Gland: Report of a Bifocal, Paucicystic Variant with Ductal Carcinoma in situ and Pronounced Stromal Distortion Mimicking Invasive Carcinoma

Sclerosing polycystic adenosis: A rare tumor misdiagnosed as retention cyst on fine needle aspiration cytology

Sclerosing Polycystic Adenosis of Salivary Glands: A Review with Some Emphasis on Intraductal Epithelial Proliferations

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