Obligate basal cell component in salivary oncocytoma facilitates distinction from acinic cell carcinoma.

Abstract

The differential diagnosis between benign salivary oncocytoma (ONC) and low-grade malignant acinic cell carcinoma (ACC) can be difficult due to a significant histomorphological overlap of the structural and cytological presentation of both tumor types. To the best of our knowledge a comprehensive study comparing (immuno-)histological markers in cases of difficult differential diagnosis between ONC and ACC has not yet been performed. We investigated a panel of different immunohistochemical (CK5/6, CK14, CK7, CK18, p63 and Ki67) and histochemical (PAS, alpha-amylase) markers in 12 cases of ONC and 19 cases of ACC. The statistically significant stronger expression of CK7 in ONC and stronger expression of PAS and alpha-amylase in ACC in routine practice each is hampered by a pronounced overlap between both tumor groups. The obligate presence of an additional small basal cell component in all cases of ONC, demonstrable with p63 and CK5/6, enables a straightforward distinction from ACC, being constantly devoid of a basal cell component. Unexpectedly, CK14 is not a suitable marker for a reliable proof of these basal cells. The detection of this basal cell component in ONC in routine Hematoxylin-eosin stain is difficult and in some cases not possible; therefore, immunohistochemistry with p63 or CK5/6 is recommended for selected cases.

• Authors: Christoph Weiler, Simone Reu, Pamela Zengel, Thomas Kirchner, Stephan Ihrler
• Journal: Pathology, research and practice (Pathol Res Pract) Vol. 205 Issue 12 Pg. 838-42 ( 2009) ISSN: 1618-0631 [Electronic] Germany
• PMID: 19646823 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers, Tumor
• KRT5 protein, human
• Keratin-5
• Keratin-6
• TP63 protein, human
• Trans-Activators
• Transcription Factors
• Tumor Suppressor Proteins

Topics

• Adenoma, Oxyphilic (chemistry, pathology)
• Adult
• Aged
• Aged, 80 and over
• Biomarkers, Tumor (analysis)
• Carcinoma, Acinar Cell (chemistry, pathology)
• Diagnosis, Differential
• Female
• Humans
• Immunohistochemistry
• Keratin-5 (analysis)
• Keratin-6 (analysis)
• Male
• Middle Aged
• Predictive Value of Tests
• Salivary Gland Neoplasms (chemistry, pathology)
• Trans-Activators (analysis)
• Transcription Factors
• Tumor Suppressor Proteins (analysis)