Table 1 |
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Differential diagnosis of juvenile pleomorphic adenoma of the cheek |
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Tumor |
Salient histological features |
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Carcinoma ex pleomorphic adenoma |
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Adenoid cystic carcinoma |
- Cribriform and pseudoglandular patterns of basaloid cells with hyalinized stroma - Frequent perineural invasion - Minimal nuclear pleomorphism - No squamous differentiation - No high grade dysplasia or squamous carcinoma in situ, no extensive necrosis |
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Polymorphous low grade adenocarcinoma |
- Uniform plump columnar cells with bland nuclei arranged in variable growth patterns (tubular, cribriform, papillary, solid, fascicular, microcystic, single file, pseudoadenoid cystic, strand-like, mixed) - Perineural invasion common around small nerves - Infiltrative borders |
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Basal cell adenoma |
- Elongated and branching canaliculi separated by hyaline stroma |
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Acinic cell carcinoma |
- Variable cell types (serous, clear, vacuolated, intercalated duct cells) arranged in solid, microcystic, papillary cystic and follicular patterns - few mitotic figures |
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Clear cell carcinoma-hyalinizing type |
-Trabeculae, cords, islands or nests of monomorphic clear cells surrounded by hyalinized bands with foci of myxohyaline stroma |
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Cystadenocarcinoma |
- Invasive, cystic growth pattern, 75% had - Conspicuous papillary component - Composed of small cuboidal cells, large cuboidal cells, tall columnar cells or mixture - Cystic spaces with hemorrhage and granulation tissue are frequent |
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Intraductal carcinoma |
- intraductal neoplasm with micropapillary, cribriform, solid, comedo or clinging patterns, with preservation of myoepithelial cells surrounding intraductal tumor |
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Mucoepidermoid carcinoma |
- Cords, sheets, clusters of mucous, squamous, intermediate and clear cells; low to high grade |
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Epithelial myoepithelial carcinoma |
- Both epithelial and myoepithelial components seen - Most tumor cells have myoepithelial features with clear cytoplasm or naked nuclei - Focally, there are ducts or tubules with an outer rim of myoepithelial cells and inner, dark ductal cells with scant eosinophilic cytoplasm and round, bland nuclei |
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Dalati and Hussein Diagnostic Pathology 2009 4:32 doi:10.1186/1746-1596-4-32 |
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