Unicystic high-grade intraductal carcinoma of the parotid gland: cytological and histological description with clinic–pathologic review of the literature

Andrea Palicelli, Paola Barbieri, Narciso Mariani, Paola Re, Stefania Galla, Raffaele Sorrentino, Francesca Locatelli, Nunzio Salfi, Guido Valente

Research output: Contribution to journalArticle

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Abstract

Intraductal carcinoma of the salivary glands is a rare, not well-characterized tumor. We reviewed the literature and report the first case of a high-grade unicystic intraductal carcinoma of the parotid. Formalin-fixed/paraffin-embedded blocks were sectioned and stained for hematoxylin and eosin and immunostains (CAM5.2, EMA, CK5, p53, p63, SMA, S100 protein, DOG1, mammaglobin, AR, ER, PR, Her-2, and Ki67). A 72-year-old man showed a painless nodule (2 cm) in the right parotid region. A ‘tumor of uncertain malignant potential’ (low grade) was diagnosed by fine-needle aspiration cytology (FNAC). Preoperative magnetic resonance imaging revealed a well-delimited, oval cyst without evidence of parenchymal invasion (T1-scans: homogeneously isointense with hypointense thin peripheral ring; T2-scans: strongly hyperintense). Histological examination confirmed a unilocular cyst lined by a multistratified epithelium arranged in solid, pseudopapillary, cribriform, and ‘incomplete cribriform/microcystic’ patterns. Tumor cells were CAM5.2+, EMA+, mammaglobin+, AR+, p63+ (focal), CK5+ (focal), p53 (+, 20%), ER-, PR-, S100 protein-, DOG1-, and Her-2-. A continuous peripheral layer of p63+/CK5+/SMA+ myoepithelial cells proved the ‘in situ’ nature of the tumor. The evidence of focal severe nuclear atypia, high mitotic index (12 mitoses/10HPFs), and high proliferation index (40%) favored a high-grade intraductal carcinoma. Preoperative FNAC and clinic–pathologic correlation are very helpful. Discrepancy in dysplasia grade between FNAC and resected specimen can occasionally occur (especially in case of focal high-grade features). Total sampling should exclude invasive areas or other cystic malignancies.

Original languageEnglish
Pages (from-to)771-776
Number of pages6
JournalAPMIS
Volume126
Issue number9
DOIs
Publication statusPublished - Sep 1 2018

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Carcinoma, Intraductal, Noninfiltrating
Parotid Gland
Fine Needle Biopsy
Cell Biology
S100 Proteins
Neoplasms
Cysts
Parotid Region
Mitotic Index
Hematoxylin
Eosine Yellowish-(YS)
Salivary Glands
Paraffin
Formaldehyde
Epithelium
Magnetic Resonance Imaging

Keywords

  • cyst
  • Intraductal carcinoma
  • low-grade cribriform cystadenocarcinoma
  • parotid
  • salivary duct carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Immunology and Allergy
  • Microbiology (medical)

Cite this

Unicystic high-grade intraductal carcinoma of the parotid gland : cytological and histological description with clinic–pathologic review of the literature. / Palicelli, Andrea; Barbieri, Paola; Mariani, Narciso; Re, Paola; Galla, Stefania; Sorrentino, Raffaele; Locatelli, Francesca; Salfi, Nunzio; Valente, Guido.

In: APMIS, Vol. 126, No. 9, 01.09.2018, p. 771-776.

Research output: Contribution to journalArticle

Palicelli, A, Barbieri, P, Mariani, N, Re, P, Galla, S, Sorrentino, R, Locatelli, F, Salfi, N & Valente, G 2018, 'Unicystic high-grade intraductal carcinoma of the parotid gland: cytological and histological description with clinic–pathologic review of the literature', APMIS, vol. 126, no. 9, pp. 771-776. https://doi.org/10.1111/apm.12882
Palicelli, Andrea ; Barbieri, Paola ; Mariani, Narciso ; Re, Paola ; Galla, Stefania ; Sorrentino, Raffaele ; Locatelli, Francesca ; Salfi, Nunzio ; Valente, Guido. / Unicystic high-grade intraductal carcinoma of the parotid gland : cytological and histological description with clinic–pathologic review of the literature. In: APMIS. 2018 ; Vol. 126, No. 9. pp. 771-776.
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