bromochloroacetic-acid and Carcinoma--Adenoid-Cystic

Submucosal glands (SMGs) present throughout human esophagus with clusters at either the upper third or lower third of the organ. SMGs tend to atrophy with age, and neoplasms arising in these glands are rare. In order to bring convenience to diagnosis, we summarize the histopathologic characteristics of all esophageal submucosal gland tumors (SGTs). Due to the morphological similarity, the nomenclature of salivary tumors is adopted for SGTs. However, there is great confusion about the definition and histogenesis of these tumors, especially the malignant subtypes. In the literature, esophageal mucoepidermoid carcinoma and adenoid cystic carcinoma usually adjoin the surface squamous epithelium and coexist with intraepithelial neoplasia or invasive squamous cell carcinoma (SCC). In addition, the typical gene alterations of salivary tumors have not been reported in these SGTs. Therefore, we propose to apply stringent diagnostic criteria to esophageal SGTs so as to exclude mimickers that are SCCs with various degree of SMG differentiation.

Topics: Aged, 80 and over; Atrophy; Carcinoma in Situ; Carcinoma, Adenoid Cystic; Carcinoma, Mucoepidermoid; Carcinoma, Squamous Cell; Esophageal Neoplasms; Esophagus; Humans; Keratins; Male; Mucin-5B; Neoplasms, Glandular and Epithelial; Retrospective Studies

Although clinical history and morphologic appearance should be the initial considerations when evaluating small round blue cell tumors of the sinonasal tract, the final diagnosis often hinges on immunohistochemical findings. Unfortunately, interpretation of stains in these tumors is fraught with numerous pitfalls and limitations. This article presents an approach to sinonasal small round blue cell tumors based on four common immunohistochemical patterns: cytokeratin positivity, squamous marker positivity, neuroendocrine marker positivity, and cytokeratin negativity.

Topics: Biomarkers, Tumor; Carcinoma, Adenoid Cystic; Carcinoma, Squamous Cell; Diagnosis, Differential; Humans; Keratins; Nasal Cavity; Papillomavirus Infections; Paranasal Sinus Neoplasms

Adenoid cystic carcinoma (ACC) commonly originates in the major salivary glands and respiratory tract, but extremely rarely in the oesophagus. We report the surgical and pathologic findings of a primary ACC of the oesophagus in a 59-year-old woman, and review the management options of this tumour.

Topics: Actins; Biomarkers, Tumor; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Esophageal Neoplasms; Female; Humans; Keratins; Middle Aged

Polymorphous low-grade adenocarcinoma (PLGA) and adenoid cystic carcinoma (ACC) have several overlapping histological patterns, including cribriform, tubular and solid patterns. The overlapping clinicopathological features of PLGA and ACC may result in a diagnostic pitfall. ACC has a much worse prognosis than PLGA, making differentiation important for therapeutic and prognostic purposes. Histopathological features remain the most reliable criteria to distinguish between these two tumours. Although PLGA and ACC have many features in common, PLGA is uncommon in the major salivary glands. Histopathological distinction is therefore mainly a problem in tumours of minor salivary gland origin where small biopsies often contribute to diagnostic difficulties. This paper reviews studies which have utilised several immunohistochemical markers in attempts to distinguish between PLGA and ACC, and also studies which have focussed on the two tumours individually. The potential discriminating value of immunohistochemistry between cases of PLGA and ACC still remains controversial.

Topics: Actins; Adenocarcinoma; Biomarkers, Tumor; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Diagnosis, Differential; Humans; Keratins; Mucin-1; Proliferating Cell Nuclear Antigen; S100 Proteins; Salivary Gland Neoplasms

Topics: Actin Cytoskeleton; Aged; Basement Membrane; Carcinoma, Adenoid Cystic; Cytoplasmic Granules; Humans; Immunohistochemistry; Keratins; Lung Neoplasms; Male; Microvilli; Mitochondria; S100 Proteins; Salivary Gland Neoplasms; Salivary Glands, Minor; Solitary Pulmonary Nodule; Tongue Neoplasms

Adenoid basal carcinoma of the uterine cervix is rare and its cell origin is still obscure. We report a case of adenoid basal carcinoma of the uterine cervix discovered incidentally in a 69-year-old woman who had been hysterectomized due to endometrial adenocarcinoma of the uterine corpus. Histologically, small round-to-oval cancer cell nests with peripheral cell palisading were seen budding from the basal cell layer of the uterine cervix showing carcinoma in situ. Immunohistochemically, the basaloid cells of the adenoid basal carcinoma were positive for keratins 14, 17 and 19 and resembled reserve cells of the cervical epithelium. The results of this study clearly demonstrated that adenoid basal carcinoma shows a phenotype similar to reserve cells of the uterine cervix. A review of the literature indicated that this tumor has a favorable prognosis and should be clearly separated from adenoid cystic carcinoma, which has a much poorer outcome.

Topics: Aged; Biomarkers, Tumor; CA-125 Antigen; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Carcinoma, Endometrioid; Female; Humans; Immunohistochemistry; Keratins; Neoplasms, Multiple Primary; Proliferating Cell Nuclear Antigen; Receptors, Estrogen; Tumor Suppressor Protein p53; Uterine Cervical Neoplasms; Uterine Neoplasms

Malignant cutaneous cylindroma is a rare tumor. It has been described in 26 cases, both in the solitary form and in the autosomal dominant inherited multiple tumor form. The authors present two new cases that occurred in one family with a history of multiple cylindromas.. Clinical and histopathologic data of both tumors were compared with those of 26 other cases in the literature. Immunohistochemical examinations were performed.. The malignant tumors were distinguished from the benign lesions by rapid growth, long-standing ulceration, or bleeding. Histopathologic examination showed a well-differentiated carcinoma in one patient and a poorly differentiated tumor in the other. In the latter, lymph node metastasis developed, and the patient died 2.5 years later. Histopathologic criteria of malignancy included cell pleomorphism, frequent mitoses and loss of jigsaw pattern, peripheral palisading, hyaline sheaths, and dual cell population.. These observations are in accord with those in the literature. Malignant cutaneous cylindroma developed more often in the multiple tumor form than in the single tumor form. Malignant cylindroma is an aggressive carcinoma with a tendency to local destructive growth and metastases.

Topics: Aged; Antigens, Neoplasm; Carcinoma; Carcinoma, Adenoid Cystic; Cell Transformation, Neoplastic; Cytoplasm; Female; Humans; Hyalin; Keratins; Lymphatic Metastasis; Male; Membrane Glycoproteins; Mucin-1; S100 Proteins; Skin Neoplasms

Malignant dermal cylindromas are very rare. We present a case of multiple cylindromas of the scalp with metastasis to a cervical lymph node. The morphology of the tumour was unusual in that it contained eccrine spiradenoma-like areas and foci of squamous differentiation with keratin formation. The immunohistochemical phenotype of the eccrine spiradenoma-like areas and the metastatic tumour was similar, but different from the areas of typical cylindroma. Although alleged "malignant" cylindromas have been reported, none have been described to have metastasized, whereas metastatic eccrine spiradenoma is well-documented. We reiterate that overlaps between dermal cylindroma and eccrine spiradenoma are more common than has been documented. In the rare event of metastases, it is the eccrine spiradenomatous component that is metastatic. We contend that there is no evidence that pure dermal cylindromas have metastasized.

Topics: Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Head and Neck Neoplasms; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; S100 Proteins; Scalp Dermatoses; Skin Neoplasms; Staining and Labeling

Topics: Adult; Breast Neoplasms; Carcinoid Tumor; Carcinoma, Adenoid Cystic; Carcinoma, Lobular; Chromogranin A; Diagnosis, Differential; Female; Humans; Hysterectomy; Keratins; Neoplasms, Multiple Primary; Ovarian Neoplasms; Sex Cord-Gonadal Stromal Tumors; Synaptophysin; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms

Adenoid basal hyperplasia is an underrecognized cervical lesion, resembling adenoid basal carcinoma, except the absence of deep invasion into the stroma. We report a series of 10 cases, all extending less than 1 mm from the basement membrane. Our results support the hypothesis that adenoid basal hyperplasia arises from reserve cells of the cervix. Lesions were found close to the squamocolumnar junction, in continuity with the nearby subcolumnar reserve cells. They shared the same morphology and immunoprofile using a panel of 4 antibodies (keratin 5/6, keratin 14, keratin 7 and p63) designed to differentiate reserve cells from mature squamous cells and endocervical columnar cells. We detected no human papillomavirus infection by in situ hybridization targeting high-risk human papillomavirus, which was concordant with the absence of immunohistochemical p16 expression. We demonstrated human papillomavirus infection in 4 (80%) of 5 adenoid basal carcinoma, which is in the same range as previous studies (88%). Thus, adenoid basal hyperplasia should be distinguished from adenoid basal carcinoma because they imply different risk of human papillomavirus infection and of subsequent association with high-grade invasive carcinoma. In our series, the most reliable morphological parameters to differentiate adenoid basal hyperplasia from adenoid basal carcinoma were the depth of the lesion and the size of the lesion nests. Furthermore, squamous differentiation was rare in adenoid basal hyperplasia and constant in adenoid basal carcinoma. Finally, any mitotic activity and/or an increase of Ki67 labeling index should raise the hypothesis of adenoid basal carcinoma.

Topics: Adult; Aged; Carcinoma, Adenoid Cystic; Carcinoma, Basal Cell; Cervix Uteri; Epithelial Cells; Female; Humans; Hyperplasia; Keratins; Middle Aged; Uterine Cervical Neoplasms

The purpose of this report is to present the clinical and histological features of a basaloid squamous cell carcinoma (BSCC) occurring in the retromolar trigone of a 59-year-old man and to relate its immunohistochemical characteristics.. BSCC is an aggressive distinct variant of squamous cell carcinoma (SCC) requiring recognition as a separate entity from SCC due to its peculiar behavior.. A clinical examination revealed a 12x07x07 mm nodular mass with a rubbery consistency, defined borders, covered by reddish mucosa and an absence of bleeding upon palpation. Histologically, nests and cords of closely packed, moderately pleomorphic basaloid cells with nuclear palisading along the periphery of the neoplastic nests surrounded by a fibrous stroma were found.. Since this tumor can mimic other neoplasms such as adenoid cystic carcinoma, neuroendocrine carcinoma, and basal cell adenocarcinoma, histological features are essential to differentiate between them. Furthermore, immunohistochemical testing can provide valuable diagnostic information that can have a profound impact on treatment options and the prognosis.. BSCC needs to be differentiated from other neoplasms as early as possible because of its adverse prognosis. Clinicians are advised to conduct a mucosal evaluation during oral examinations and take a thorough medical history which could ultimately save the life of a patient.

Topics: Adenocarcinoma; Carcinoma, Adenoid Cystic; Carcinoma, Neuroendocrine; Carcinoma, Squamous Cell; Carcinoma, Transitional Cell; Cell Nucleus; Diagnosis, Differential; Follow-Up Studies; Humans; Immunohistochemistry; Keratins; Ki-67 Antigen; Laminin; Male; Middle Aged; Mitosis; Mouth Neoplasms; Necrosis; Tumor Suppressor Protein p53

Primary intraosseous salivary gland tumors of the mandible are rare, with mucopidermoid carcinoma being the most frequent, followed by adenoid cystic carcinoma (ACC). We present a case of a central ACC involving the mandible of a 46-year-old man. He presented an indurated swelling on the vestibular aspect of the left mandibular body and ipsilateral paraesthesia of the lower lip. A panoramic radiography revealed a large radiolucent area, with irregular margins, involving the body and ramus of the left mandible, and CT scan confirmed that the lesion was confined within the mandibular bone. The histopathological features were of an ACC. CT scan also revealed multiple nodular lesions in both lungs suggestive of metastases. The patient was surgically treated by hemi-mandibulectomy. The patient is well with no evidences of recurrences in the mandible. The present case shows that the clinical and immunohistochemical profile of primary intraosseous ACC is similar to what is found in ACC involving the salivary glands.

Topics: beta Catenin; Cadherins; Carcinoma, Adenoid Cystic; Humans; Keratins; Male; Mandible; Mandibular Neoplasms; Middle Aged; Radiography; Treatment Outcome; Vimentin

We report a unique case of adenoid cystic carcinoma (ACC) of the maxillary sinus, with gradual histologic transformation from lower-grade ACC (cribriform and tubular types) to high-grade adenocarcinoma (HGA) showing a sequential histologic spectrum via solid-type ACC. A 74-year-old man presented with swelling and mild pain of the right cheek. CT scan showed a mass measuring approximately 4 cm, with marked bone destruction in the right maxillary sinus. A surgically resected specimen revealed that the tumor was comprised of three different components: HGA and solid-type ACC in the central portion and lower-grade ACC in the periphery. The tumor was discriminated from a dedifferentiated carcinoma or hybrid tumor. Autopsy specimens also demonstrated both solid-type ACC and HGA components in the lung and spleen. Immunohistochemically, positive staining of p53 protein was detected on both solid-type ACC and HGA cells, but cyclin D1 and HER2/neu was only seen in HGA cells. Solid-type ACC cells were immunoreactive for CD117 (c-kit), but lower-grade ACC and HGA cells were negative. This case suggests that the overexpression of CD117, p53 protein, cyclin D1, and HER2/neu might be involved in the progression from lower-grade ACC to solid-type ACC and HGA.

Topics: Actins; Adenocarcinoma; Aged; Carcinoma; Carcinoma, Adenoid Cystic; Disease Progression; Fatal Outcome; Humans; Immunohistochemistry; Keratins; Liver Neoplasms; Lung Neoplasms; Male; Maxillary Sinus Neoplasms; Muscle, Smooth; S100 Proteins; Tumor Suppressor Protein p53

Topics: Adenocarcinoma; Aged; Carcinoma, Adenoid Cystic; Female; Humans; Immunohistochemistry; Keratins; Ki-67 Antigen; Mucin-1; Neoplasms, Multiple Primary; Salivary Gland Neoplasms

Topics: Aged; Carcinoma, Adenoid Cystic; Cell Differentiation; Deubiquitinating Enzyme CYLD; Female; Hair Follicle; Humans; Keratins; Keratins, Hair-Specific; Keratins, Type II; Middle Aged; Skin Neoplasms; Tumor Suppressor Proteins

The differential diagnosis of salivary gland carcinoma is often difficult because of the confusing histopathological features of the different types of salivary gland carcinomas. The expression of MUC3, MUC5AC, MUC6, cytokeratin (CK)7 and CK20 was studied in 20 mucoepidermoid carcinomas (MEC), 20 adenoid cystic carcinomas (AdCC), and 11 acinic cell carcinomas (ACC). All the cases (51/51, 100%) were positive for CK7, but they were not positive for CK20. All the cases (100%) of the MEC were positive for MUC5AC, while all MEC (100%) were negative for MUC3. Only two cases (10%) were positive for MUC6. All cases (100%) of AdCC were negative for MUC3, MUC5AC and MUC6. Eight cases (73%) of ACC were positive for MUC3, but all the cases (100%) were negative for MUC5AC and MUC6. It is concluded that the positive expression of MUC5AC is very unique to MEC, and that the positive expression of MUC3 is very unique to ACC. These findings will be very useful for the differential diagnosis of the salivary gland carcinomas.

Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Carcinoma, Acinar Cell; Carcinoma, Adenoid Cystic; Carcinoma, Mucoepidermoid; Female; Humans; Immunohistochemistry; Intermediate Filament Proteins; Keratin-20; Keratin-7; Keratins; Male; Middle Aged; Mucin 5AC; Mucin-3; Mucins; Salivary Gland Neoplasms

Adenoid basal carcinoma (ABC) of the uterine cervix is a rare neoplasm with excellent prognosis. Differential diagnosis between ABC and an ABC-like lesion of adenosquamous cell carcinoma (ASC) of the cervix is important due to their contrasting prognosis. Reported herein are two cases of ABC that have been compared with seven ASC exhibiting ABC-like lesions from approximately 2600 resected uterine cervical malignancies diagnosed at Shikoku Cancer Center. The two ABC were incidentally found in the uterine cervix of 69-year-old and 59-year-old Japanese women due to cervical intraepithelial neoplasia grade 3 and to squamous cell carcinoma, respectively. The ABC consisted of infiltrating nests of basaloid cells with low nuclear atypia. The patients remained alive without recurrence for 9 years and 18 months, respectively. An ABC-like lesion was defined as basaloid cell nests simulating ABC, but with some features indicating malignant potential. However, the differential diagnosis was sometimes difficult because two of seven ABC-like lesions were originally diagnosed as ABC. Immunohistochemically, cytokeratin 7 was negative for the basaloid cells of two ABC, but positive for six of six ABC-like lesions of ASC, while cytokeratin 8 was positive for both ABC and ASC. This cytokeratin pattern might provide a good tool for distinguishing between ABC and an ABC-like lesion of ASC when the histological findings are equivocal.

Topics: Adult; Aged; Carcinoma, Adenoid Cystic; Carcinoma, Adenosquamous; Carcinoma, Basal Cell; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Keratin-7; Keratin-8; Keratins; Ki-67 Antigen; Middle Aged; Uterine Cervical Neoplasms

Recent biological studies have classified breast carcinomas into HER2-overexpressing, estrogen receptor-positive/luminal, basal- and normal-like groups. According to this new biological classification, the objectives of our study were to assess the clinical, morphologic and immunophenotypic characteristics of adenoid cystic carcinoma of the breast in order to classify this subtype of breast carcinoma. A total of 18 cases of adenoid cystic carcinoma were identified from the Institut Curie files. Clinical information was available for 16 patients with a median follow-up of 6.5 years. Morphologically, all tumors were graded according to the system defined by Kleer and Oberman (histologic and nuclear grade). Immunophenotype was assessed with anti-ER, PR, HER-2, KIT, basal (CK5/6) and luminal cytokeratins (CK8/18) and p63 antibodies. One out of 18 tumors was nuclear grade 1 (16%), nine were nuclear grade 2 (50%) and eight were nuclear grade 3 (44%). All cases were estrogen receptor, progesterone receptor and HER-2 negative. Epithelial cells were strongly positive around glandular lumina with one or both cytokeratins, identifying the coexistence of CK5/6+ cells, CK5/6 and CK8/18+ cells, CK8/18+ cells and p63+ cells. All cases (100%) were also KIT positive. In all, 15 patients were treated by surgery. Nine of them received adjuvant radiotherapy. Follow-up was available for 16 patients. In all, 14 patients were alive. Two of them, initially treated by surgery only, presented a local recurrence. Two patients died (one of them treated by radiation therapy only died from her disease). Our study shows that adenoid cystic carcinoma of the breast is a special, estrogen receptor, progesterone receptor, HER-2 negative and highly KIT-positive, basal-like breast carcinoma, associated with an excellent prognosis. This highly specific immunophenotype could be useful to differentiate adenoid cystic carcinoma of the breast from other subtypes of breast carcinoma such as cribriform carcinoma.

Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Breast Neoplasms; Carcinoma, Adenoid Cystic; Disease-Free Survival; Female; Humans; Immunoenzyme Techniques; Keratins; Middle Aged; Neoplasm Staging; Prognosis; Proto-Oncogene Proteins c-kit; Receptor, ErbB-2; Treatment Outcome

Two cases of a distinctive variety of basaloid squamous carcinoma (BSC) of the anal canal are described. Both occurred in female patients who presented with bleeding per rectum. Histologic evaluation of the tumors showed lobules and aggregates of medium-sized basaloid cells with distinctive peripheral palisading and focal areas of central, comedo-necrosis. Accompanying dysplasia of the overlying squamous mucosa was absent. However, the microscopic pattern was dominated by the presence of eosinophilic, hyaline, paucicellular basement membrane-like material around and within tumor nests. This appearance together with microcystic spaces simulated that of an adenoid cystic carcinoma. Immunohistochemistry of the tumors revealed the following profile: CK7, CK5/CK6, 34betaE12 positive, CK14 focally positive but CK20 negative. The following were all negative: EMA, CEA, smooth muscle and muscle-specific actin, calponin, and S-100. The tumor cells exhibited diffuse nuclear positivity with p63. The eosinophilic basement membrane hyaline material was positive for collagen type IV and also for laminin. BSC of the anal canal with an adenoid cystic pattern is an infrequently encountered and reported variant, although it is seen more often in the aerodigestive tract. There may be an increased propensity for BSC with an adenoid cystic pattern to metastasize to the liver, but the number of cases encountered are too small to be definitive. The histologic differential diagnosis is true salivary gland-type adenoid cystic carcinoma and basal cell adenocarcinoma. Immunohistochemistry and awareness of this unusual pattern of BSC will facilitate the correct diagnosis being reached.

Topics: Anal Canal; Antibiotics, Antineoplastic; Antigens, CD20; Antimetabolites, Antineoplastic; Antineoplastic Agents; Anus Neoplasms; Biomarkers, Tumor; Carcinoma, Adenoid Cystic; Carcinoma, Basal Cell; Carcinoma, Basosquamous; Cell Nucleus; Cisplatin; DNA-Binding Proteins; Female; Fluorouracil; Follow-Up Studies; Genes, Tumor Suppressor; Humans; Immunohistochemistry; Keratins; Middle Aged; Mitomycin; Phosphoproteins; Radiotherapy; Time Factors; Trans-Activators; Transcription Factors; Treatment Outcome; Tumor Burden; Tumor Suppressor Proteins; Ultrasonography

Topics: Actins; Aged; Aged, 80 and over; Biomarkers, Tumor; Breast Neoplasms; Carcinoma, Adenoid Cystic; Female; Humans; Immunohistochemistry; Keratin-7; Keratins; Middle Aged; Proto-Oncogene Proteins c-kit

Dedifferentiated adenoid cystic carcinomas are a recently defined, rare variant of adenoid cystic carcinomas characterized histologically by two components: conventional low-grade adenoid cystic carcinoma and high-grade "dedifferentiated" carcinoma. We examined six cases and analyzed their clinicopathologic profiles, including immunohistochemical features and p53 gene alterations. The 6 patients (3 men and 3 women) had a mean age of 46.8 years (range, 34-70 y). The mean size of the tumors was 3.5 cm (range, 1.7-6 cm). The submandibular gland, maxillary sinus, and nasal cavity were involved in 2 cases each. Postoperatively, 5 patients had local recurrence and 5 developed metastatic disease. Five patients died of disease at a mean of 33.7 months after diagnosis (range, 6-69 mo), and one other was alive with disease at 60 months. Histologically, the conventional low-grade adenoid cystic carcinoma component of the tumors consisted of a mixture of cribriform and tubular patterns with scant solid areas. The high-grade dedifferentiated carcinoma component was either a poorly differentiated adenocarcinoma (4 cases) or undifferentiated carcinoma (2 cases). Three tumors were studied immunohistochemically. Myoepithelial markers were expressed in low-grade adenoid cystic carcinoma but not in the dedifferentiated component. In 2 cases, diffusely positive p53 immunoreactivity together with HER-2/neu overexpression was restricted to the dedifferentiated component. Loss of pRb expression was demonstrated only in the dedifferentiated component of the 1 other case. The Ki-67-labeling index was higher in the dedifferentiated component than in the low-grade adenoid cystic carcinoma component. Furthermore, molecular analysis of 2 cases demonstrated the loss of heterozygosity at p53 microsatellite loci, accompanied by p53 gene point mutation, only in the dedifferentiated carcinoma component of 1 case, which was positive for p53 immunostaining. These results indicate that dedifferentiated adenoid cystic carcinoma is a highly aggressive tumor. Because of frequent recurrence and metastasis, the clinical course is short, similar to that of adenoid cystic carcinomas with a predominant solid growth pattern. Limited evidence suggests that p53 abnormalities in combination with HER-2/neu overexpression or loss of pRb expression may have a role in dedifferentiation of adenoid cystic carcinoma.

Topics: Adult; Aged; Base Sequence; Carcinoma, Adenoid Cystic; Cell Differentiation; DNA Mutational Analysis; DNA, Neoplasm; Female; Humans; Immunohistochemistry; Keratins; Loss of Heterozygosity; Male; Middle Aged; Mucin-1; Mutation; Receptor, ErbB-2; S100 Proteins; Survival Analysis; Tumor Suppressor Protein p53

Basaloid squamous carcinoma (BSC) is an aggressive variant of squamous cell carcinoma (SCC) with a predilection for the upper aerodigestive tract. In the English literature, approximately 40 cases of BSC have been described in the oral cavity. BSC has frequently been confused with adenoid cystic carcinoma (ACC), basal cell adenocarcinoma, and undifferentiated SCC. The purpose of the investigation was to examine the histological features and immunohistochemical expression of differentiation-related substances, including cytokeratin (CK) subtypes, vimentin, S-100, chromogranin, laminin, and type IV collagen, for the characterization of biological features of these tumours. We studied three cases of BSC of the oral cavity, three cases of ACC, and one case of basal cell adenocarcinoma. Well-differentiated and undifferentiated SCCs were also studied for comparison. The BSCs showed many histopathologic similarities to cases previously reported. Among the CK subtypes analyzed, CK14 was the only subtype expressed by all basaloid cells of BSC. Potentially useful for the differential diagnosis was the finding of CKs 7 and 19 expression in the basaloid cells of ACC, and CKs 7 and 8 in basal cell adenocarcinoma. In BSCs, laminin and type IV collagen were found in the microcystic spaces between basaloid cells, but neither ACCs nor basal cell adenocarcinoma showed this feature. These data suggest that immunohistochemical findings are helpful in distinguishing BSC of the oral cavity from other histopathologically similar tumours.

Topics: Adenocarcinoma; Carcinoma, Adenoid Cystic; Carcinoma, Squamous Cell; Carcinoma, Transitional Cell; Diagnosis, Differential; Humans; Immunohistochemistry; Keratins; Mouth Neoplasms

Cytological features of a malignant spindle-cell variant and a benign tubular variant of adenomyoepithelioma were examined to improve diagnosis of this tumor. Fine-needle aspiration cytology, of both a malignant and a benign case, characterized cellular and cohesive cell clusters composed of epithelial and myoepithelial cells. The smears of the malignant case were rich in spindle-shaped myoepithelial cells, admixed with a few epithelial cells. In about a fourth of the clusters, atypical cells with enlarged hyperchromatic nuclei and prominent nucleoli comprised more than 20% of cells. The smears of the benign case were composed of tubular epithelial cells surrounding one to several layers of myoepithelial cells with clear cytoplasm. Mild atypia was occasionally noticed. A review of the literature showed that a cytological diagnosis of malignancy is not warranted, if nuclear atypia is not generally severe. Focal severe atypia is not definitively indicative of benignity or malignancy.

Topics: Actins; Aged; Biomarkers, Tumor; Biopsy, Needle; Breast Neoplasms; Carcinoma, Adenoid Cystic; Cell Nucleus; Female; Humans; Immunoenzyme Techniques; Keratins; Neoplasm Proteins; Neoplasms, Second Primary

Adenoid cystic carcinoma of the breast is a rare neoplasm that represents <1% of breast carcinomas. The tumors are histologically indistinguishable from examples in other sites, and they have a generally favorable prognosis. Several studies have investigated the possible correlation between histologic grade in adenoid cystic carcinoma (largely determined by cytology and growth pattern) and prognosis. Some earlier reports concluded that a solid variant of mammary adenoid cystic carcinoma had a more aggressive clinical course, but others did not confirm this impression. This report describes nine patients with a solid variant of mammary adenoid cystic carcinoma that has a striking basaloid appearance. All were women ranging in age from 37 to 83 years. A solitary mass was evident in all patients. Tumor size was 1.1-15 cm (mean 3.7 cm). The tumors exhibited a predominantly solid architecture comprised of basaloid appearing cells with moderate to marked nuclear atypia. Five tumors had >5 mitotic figures per 10 high power microscopic fields. Intercalated ducts were found in all tumors, being well formed in six and poorly formed in three. Immunohistochemical stains for cytokeratins, basement membranes, and vimentin were consistently positive. Surgery was performed in all cases consisting of excision in seven and mastectomy in two. Axillary lymph node metastases were found in two of six axillary dissections and four had negative lymph nodes. The lymph nodes were not examined in three patients. Follow-up information was available for seven patients. Six women had no evidence of disease after follow-up of 2-88 months (mean 32 months), one patient died of unknown causes, and one patient was lost to follow-up. It is concluded that the solid variant of mammary carcinoma with basaloid features is a histologically distinct tumor that is capable of axillary metastases. Long-term follow-up of a larger series of cases will be needed to determine whether the prognosis of these patients differs significantly from that of women with conventional adenoid cystic carcinoma. Presently, these patients are candidates for axillary staging by sentinel lymph node mapping or low axillary dissection if there is no clinical evidence of axillary metastases. Systemic adjuvant treatment would be prudent when axillary nodal metastases are present. Breast-conserving surgery with radiation is an option if negative margins can be achieved because this appears to be a unicentric form of carcinom

Topics: Adult; Aged; Aged, 80 and over; Breast Neoplasms; Carcinoma, Adenoid Cystic; Female; Follow-Up Studies; Humans; Immunohistochemistry; Keratins; Lymphatic Metastasis; Middle Aged; Prognosis; Vimentin

Topics: Actins; Aged; Biomarkers, Tumor; Biopsy, Needle; Breast Neoplasms; Carcinoma, Adenoid Cystic; Female; Humans; Keratins; Mastectomy, Modified Radical; S100 Proteins

Several aspects of sweat gland carcinomas (incidence, classification, diagnosis, and behavior) have not been definitively clarified and need to be studied further.. The clinicopathologic findings of a large series of sweat gland carcinomas, collected during a period of 15 years, are presented.. Sixty sweat gland carcinomas (41 porocarcinomas, 3 syringomatous carcinomas, 8 ductal carcinomas, 5 adenoid cystic carcinomas, and 3 mucinous carcinomas) were analyzed histologically and immunohistochemically.. Porocarcinomas were composed of eosinophilic and clear atypical cells arranged in solid-cystic lobular masses. These tumors were divided into 2 subgroups: horizontal porocarcinomas, showing a prominent intraepidermal component, and nodular porocarcinomas, which demonstrated predominant nodular growth. Syringomatous carcinomas presented keratinizing and nonkeratinizing cysts, dilated tubules (sometimes with a "tadpole" appearance), small neoplastic ducts, solid islands, and cellular cords. Ductal carcinomas were characterized by a prominent formation of tubules, solid islands, and cellular cords. Adenoid cystic carcinomas presented a characteristic pattern, showing basaloid monomorphous cells with moderately atypical nuclei, arranged in cribriform or solid islands and in tubular structures. Mucinous carcinomas were composed of moderately atypical cells with eosinophilic vacuolated cytoplasm, forming solid and cystic islands floating in large mucin pools. Immunohistochemically, cytokeratin was found in neoplastic cells in all cases, carcinoembryonic antigen was detected in 73% of cases, and actin-positive (myoepithelial) cells were not found.. Although numerous studies have been published in recent years, the histologic features, histogenesis, and classification of sweat gland carcinomas still remain controversial and need to be clarified by further studies.

Topics: Acrospiroma; Actins; Adenocarcinoma; Adenocarcinoma, Mucinous; Adenoma, Sweat Gland; Adult; Aged; Aged, 80 and over; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Child; Female; Humans; Immunoenzyme Techniques; Keratins; Male; Middle Aged; Neoplasm Recurrence, Local; Sweat Gland Neoplasms; Sweat Glands

Topics: Actins; Adult; Biopsy, Needle; Breast Neoplasms; Carcinoma, Adenoid Cystic; Female; Humans; Immunohistochemistry; Keratins; Mammography; Ultrasonography

Cribriform areas are common features of both adenoid cystic carcinoma and polymorphous low-grade adenocarcinoma. Both are malignant salivary gland tumors that share similar histologic patterns, but with marked distinct clinical behavior. This study was undertaken to improve the accuracy of the histopathology diagnostic process, using an immunohistochemical panel to differentiate adenoid cystic carcinoma from polymorphous low-grade adenocarcinoma, with special concern to the common cribriform areas shared by these tumors. Three-microm serial sections of these tumors were submitted to the streptavidin-biotin peroxidase immunotechnique against the monoclonal antibodies anticytokeratins 7, 8, 14 and 19, and anti-integrins beta1, beta3, and beta4. In the neoplastic lobules of adenoid cystic carcinoma cribriform type, the spaces were mainly surrounded by cells negative for the cytokeratins and integrins studied. In the solid type of adenoid cystic carcinoma, the microcystic areas were caused by spaces lined by neoplastic luminal cells positive for cytokeratins and presenting integrins concentrated in the apical pole of these cells. The cribriform areas of polymorphous low-grade adenocarcinoma were composed of cords of luminal cells, positive for cytokeratins and showing integrins disposed in a bipolar pattern. We concluded that cribriform areas of adenoid cystic carcinoma and polymorphous low-grade adenocarcinoma are histologically similar, although not identical. Indeed, their cellular composition is distinct and can be distinguishable from one another by the proteins of the cytoskeleton, by the integrins, or both.

Topics: Adenocarcinoma; Biomarkers, Tumor; Carcinoma, Adenoid Cystic; Diagnosis, Differential; Humans; Immunoenzyme Techniques; Integrins; Keratins; Salivary Gland Neoplasms

Our recent study of developing myoepithelial cells (MECs) in rat salivary glands demonstrated that developing MECs begin to express alpha-smooth muscle actin (alphaSMA) first and, thereafter, keratin 14. Therefore, it is unlikely that duct basal cells expressing keratin 14 alone are immature or undifferentiated MECs. In this study we carried out immunohistochemistry of pleomorphic adenomas and adenoid cystic carcinomas including normal salivary glands using monoclonal antibodies to keratin 14, smooth muscle proteins and keratin 19. The smooth muscle proteins examined included alphaSMA, h-caldesmon and h1-calponin; h1-calponin was observed in keratinocytes and nerve fibers, indicating that the protein is not specific to smooth muscle, whereas alphaSMA and h-caldesmon turned out to be highly specific markers for smooth muscle cells in normal tissues. In normal glands, MECs were positive for both keratin 14 and smooth muscle proteins (alphaSMA and h-caldesmon). Non-MEC cells were essentially devoid of smooth muscle proteins. Non-MEC duct basal cells expressed keratin 14 with or without keratin 19, and luminal cells keratin 19 with or without keratin 14. This suggests that the keratin 14-positive, smooth muscle proteins-negative duct basal cells are luminal cell progenitors. Luminal cells in tubular structures of both tumors were positive for keratin 19 with or without keratin 14. Nonluminal peripheral cells of pleomorphic adenomas were mostly positive for keratin 14, and a small fraction of them expressed smooth muscle proteins. Conversely, peripheral cells of adenoid cystic carcinomas were mostly positive for smooth muscle proteins, and some of them expressed keratin 14. These results strongly suggest (1) that the luminal cell progenitors transform into major constituents of pleomorphic adenoma cells with keratin 14 but not smooth muscle proteins, and (2) that the peripheral cells of adenoid cystic carcinoma are derived from undifferentiated MECs. Solid structures of pleomorphic adenomas were formed by proliferation of the peripheral cells. MECs were observed only occasionally in the periphery. Solid and cribriform structures of adenoid cystic carcinomas were formed by proliferation of the luminal cells. MECs were observed in the periphery and around the pseudocyst.

Topics: Actins; Adenoma, Pleomorphic; Adult; Aged; Antibodies, Monoclonal; Calcium-Binding Proteins; Calmodulin-Binding Proteins; Calponins; Carcinoma, Adenoid Cystic; Female; Humans; Immunoenzyme Techniques; Immunohistochemistry; Keratin-14; Keratins; Male; Microfilament Proteins; Middle Aged; Muscle, Smooth; Salivary Gland Neoplasms

A panel of antibodies composed of the cytokeratins (CKs), vimentin, and actin was applied to 114 minor salivary gland tumors to evaluate its diagnostic value. The results revealed that luminal cells of intercalated duct-like structures, such as those seen in pleomorphic adenoma, basal cell adenoma, adenoid cystic carcinoma, and epithelial-myoepithelial carcinoma, expressed CKs 7, 8, 14, and 19. The outer cells of these structures exhibited vimentin or vimentin plus muscle-specific actin, but rarely CK14, which is seen particularly in pleomorphic adenoma, in the tubular type of basal cell adenoma, and seldom in the tubular type of adenoid cystic carcinoma. Modified myoepithelial cells of pleomorphic adenoma and myoepithelioma exhibited a variable immunoprofile. CKs 7 and 8 were also observed in acinar cell adenocarcinoma and polymorphous low-grade adenocarcinoma with vimentin in the latter. CK13 was expressed only by canalicular adenoma and mucoepidermoid carcinoma cells. This study showed that the panel of antibodies employed is effective in distinguishing among salivary gland tumors.

Topics: Actins; Adenocarcinoma; Adenoma; Adenoma, Pleomorphic; Carcinoma; Carcinoma, Acinar Cell; Carcinoma, Adenoid Cystic; Carcinoma, Mucoepidermoid; Immunohistochemistry; Keratins; Myoepithelioma; Salivary Gland Neoplasms; Vimentin

We report a unique case of a salivary gland type of "hybrid carcinoma" arising within a Bartholin's gland adenoma. The tumor was characterized by large areas of an epithelial-myoepithelial carcinoma similar to that of the salivary gland with a peripheral infiltrative pattern of an adenoid cystic carcinoma (ACC).

Topics: Adenoma; Bartholin's Glands; Biopsy; Carcinoma, Adenoid Cystic; Epithelium; Female; Humans; Immunohistochemistry; Keratins; Lymph Node Excision; Middle Aged; Neoplasms, Multiple Primary; S100 Proteins; Salivary Gland Neoplasms; Vulvar Neoplasms

Hybrid tumours of the salivary gland are rare neoplasms that have been described only in the parotid and palate. Their recognition is important particularly when the component tumours have different biological behaviours. The occurrence of a submandibular hybrid tumour has not been reported.. We describe a case of a 36-year-old woman with a hybrid carcinoma composed of salivary duct adenocarcinoma and adenoid cystic carcinoma of the right submandibular gland. There was no evidence of a pre-existing or concurrent pleomorphic adenoma. The presence of the two components was verified by differential immunohistochemical staining using a panel of cytokeratin, vimentin, smooth muscle actin and S100. The patient subsequently developed metastases to the pelvis, lumbar, vertebra and wrist. The clinical course in this patient was consistent with the behaviour of the salivary duct adenocarcinoma component.. The histogenesis of hybrid tumours is largely unknown, but in this case it may represent diverging differentiation of luminal tumour cells. Because some histological features of different salivary gland tumours overlap, immunohistochemistry is a valuable tool especially when used to delineate the components of a hybrid tumour.

Topics: Actins; Adenocarcinoma; Adult; Carcinoma, Adenoid Cystic; Female; Humans; Immunohistochemistry; Keratins; Neoplasms, Multiple Primary; S100 Proteins; Submandibular Gland Neoplasms; Vimentin

Adenoid cystic carcinoma (ACC) of the breast, although quite uncommon, is histologically distinct and has an excellent prognosis. Our purpose was to characterize molecular markers of cellular differentiation and polarity to define better the role that these combined features might play in the excellent prognosis of ACC in this site.. We performed immunohistochemical stains for expression of vimentin (VM), cytokeratin (CK), smooth muscle actin (SMA), laminin (LAM), E-cadherin (E-cad), beta-catenin (beta-cat) and fodrin in 14 examples of ACC. Two types of intercellular lumens and defining lining cells were detected: true epithelial lumens were lined by CK positive cells that maintained the normal glandular luminal cells with an intact polarity and basolateral membrane compartment indicators: fodrin, E-cad and beta-cat. The second type of intercellular space was a pseudolumen, surrounded by myoepithelial cells that were strongly positive for VM and SMA, and lined by LAM. Double staining for VM and CK, VM and SMA, and CK and SMA detected occasional cytoplasmic co-expression of these markers in the myoepithelial cell compartment, but VM and SMA did not stain epithelial lumenal cells.. ACC of the breast is characterized by the presence of two types of intercellular lumens, one conserving basolateral markers of normal polarity (epithelial) with the other containing basement membrane material (abutted by myoepithelial cells). Dominance of VM staining may be a hallmark of ACC, along with maintained epithelial and myoeithelial compartments. This status of advanced, normal differentiation despite local invasion may be responsible for lack of distant metastasis.

Topics: Actins; Adult; Aged; Aged, 80 and over; beta Catenin; Breast Neoplasms; Cadherins; Carcinoma, Adenoid Cystic; Carrier Proteins; Cell Differentiation; Cell Polarity; Cytoskeletal Proteins; Female; Humans; Immunohistochemistry; Keratins; Laminin; Microfilament Proteins; Middle Aged; Prognosis; Trans-Activators; Vimentin

Basaloid squamous cell carcinoma (BSCC) is a recently recognized variant of squamous cell carcinoma (SCC) with a predilection to occur in the tongue base, hypopharynx, and supraglottic larynx. In smal biopsy specimens, these tumors can be difficult to distinguish from small cell undifferentiated carcinoma (SCUC) and adenoid cystic carcinoma (ACC). Monoclonal antibodies reactive with cytokeratin (AE1/AE3, 34betaE12, Cam 5.2) as well as a variety of other cellular antigens (vimentin, actin, desmin, chromogranin, synaptophysin, CD57, neuron-specific enolase [NSE], and S100) were used in an immunoperoxidase method with paraffin-embedded tissue to phenotypically characterize 23 cases of BSCC, 10 cases of SCUC, and 15 cases of ACC. The neoplastic cells in 22 of the 23 cases of BSCC reacted with the high-molecular-weight cytokeratin antibody 34betaE12, whereas no reactivity was seen in any of the 10 cases of SCUC. This pattern of 34betaE12 reactivity more consistently differentiated BSCC from SCUC than did reactivity with the neuroendocrine markers chromogranin, synaptophysin, CD57, and NSE. These findings show that immunoperoxidase stains performed on paraffin-embedded tissue are potentially useful in establishing a diagnosis of basaloid squamous cell carcinoma.

Topics: Aged; Aged, 80 and over; Antibodies, Neoplasm; Biomarkers, Tumor; Carcinoma, Adenoid Cystic; Carcinoma, Basosquamous; Carcinoma, Small Cell; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Otorhinolaryngologic Neoplasms

This unusual case is that of a middle-aged man exhibiting a tumor diathesis including a basal cell adenocarcinoma with features of adenoid cystic carcinoma arising in minor salivary gland of lip in association with multiple primary malignant cylindromas of skin. The labial lesion showed invasive tubules, solid epithelial sheets and cribriform structures. It did not exhibit PAS positive juxta-tubular basement membrane material. The skin lesions all showed features of a highly infiltrative cylindromatous carcinoma with two cell types, peripheral palisading and prominent PAS positive juxta-tubular basement membrane material. Immunocytochemical studies of the lip lesion and one of the skin lesions showed similarities, including positive staining for high and low molecular weight keratins and S-100 with negative staining for CEA. The precious descriptions of tumor diatheses involving dermal cylindromas and dermal analogue tumors of salivary glands and the distinctions with the present study are noted. If benign and even malignant cylindromas were described in the literature to be associated with basal cell adenocarcinoma of the major salivary glands, our case is unique by its association with this rare malignant tumor in a minor salivary gland.

Topics: Adenocarcinoma; Adult; Carcinoma, Adenoid Cystic; Disease Susceptibility; Humans; Keratins; Lip; Male; S100 Proteins; Salivary Gland Neoplasms; Scalp; Skin Neoplasms

Applying immunohistochemical procedures for the detection of eight different cytokeratin (CK) polypeptides and other differentiation markers, we compared the staining patterns of normal cutaneous structures with those of benign adnexal tumors (n = 65). Syringomas exhibited a marker pattern highly reminiscent of that seen in normal dermal eccrine ducts (EMA in peripheral cells, CK 10 in intermediate cells, and CK 6, CK 19, and CEA in luminal cells). Nodular hidradenomas exhibited complex patterns suggesting relationship between tumor cells, including clear cells, and normal secretory coil cells (CK 7, CK 8, CK 19, and EMA); however, dermal-duct and epidermoid differentiation were also detectable. In both cylindromas and spiradenomas, zonal staining patterns were apparent: modified myoepithelial cells were positive for smooth-muscle-type actin, while the luminal cells mainly expressed ductal markers (CK 6 and CK 19) and, less prominently, secretory-coil markers including CK 7. Eccrine poromas exhibited a widespread reaction for CK 5/6 and EMA, analogous to peripheral dermal duct cells, but focal maturation toward inner-ductal and secretory-coil cells was also demonstrable. The staining pattern observed in trichoepitheliomas resembled that of the outer but not the inner root sheath. In conclusion, the detailed marker profiles obtained in the present study have broadened our understanding of the differentiation and nature of these highly singular tumor types.

Topics: Adenoma; Adenoma, Sweat Gland; Antibodies, Monoclonal; Binding, Competitive; Biomarkers, Tumor; Carcinoma, Adenoid Cystic; Cell Differentiation; Epidermal Cells; Epidermis; Humans; Immunohistochemistry; Keratins; Neoplasms, Basal Cell; Reference Values; Skin Neoplasms; Sweat Glands; Syringoma

Brooke-Spiegler syndrome is characterized by the development of multiple trichoepitheliomas and cylindromas. In addition, multiple spiradenomas have been observed in this autosomal-dominant inherited disease. We report a 53-year-old woman with multiple cylindromas on the head and neck and multiple trichoepitheliomas on the face. Additionally, she had had since birth a plaque on the right side of her neck containing two nodules with features of both cylindroma and trichoepithelioma. Immunohistochemical investigations revealed in the basaloid cells of trichoepithelioma an expression of CK 5/6, CK 14, CK 17, CK 19 and vimentin. The cells of the cylindroma lacked vimentin but expressed additionally CK 7, CK 8 and CK 18. The occurrence of cylindroma and trichoepithelioma in a single nevoid plaque from a patient with Brooke-Spiegler syndrome implies an alteration in the stem cells of the folliculosebaceous-apocrine unit and could be characteristic of the disorder.

Topics: Antibodies, Monoclonal; Carcinoma, Adenoid Cystic; Eyebrows; Female; Humans; Immunohistochemistry; Keratins; Middle Aged; Neck; Neoplasms, Basal Cell; Neoplasms, Multiple Primary; Scalp; Skin Neoplasms; Syndrome

Adenoid cystic carcinoma (ACC) is a rare but distinctive salivary gland-type malignant neoplasm that arises infrequently as a primary tumor in the lung.. The clinical and pathologic features in 16 cases of primary ACC of the lung were reviewed, and immunohistochemical stains on paraffin sections were performed in 7 cases.. The patients' ages ranged from 29 to 79 years (mean age, 54 years); 11 were men and 5 were women. Clinically, most patients were seen initially with obstructive symptoms, including cough, wheezing, shortness of breath, and hemoptysis. Eight tumors were in the left lung and eight in the right lung. The lesions were treated by pneumonectomy in seven patients, lobectomy in six, and lobectomy plus chemotherapy in two. One patient was treated with chemotherapy alone after undergoing a diagnostic biopsy that revealed advanced disease. Grossly, most lesions were described as endobronchial and measured from 0.9 to 4.0 cm in greatest dimension; two cases, however, showed poorly circumscribed infiltrative tumors. Histologically, three main growth patterns were identified admixed in various proportions: cribriform (cylindromatous), tubular, and solid. Immunohistochemical study in six of seven cases showed a prominent myoepithelial cell component, as evidenced by immunoreactivity for keratin, actin, and S-100 protein in numerous tumor cells. Clinical follow-up ranging from 2 to 15 years in six patients showed that three were alive and well without evidence of recurrence or metastases at 5, 10, and 12 years, respectively, and three were alive with recurrence at 2, 5, and 15 years, respectively. Three other patients died of unrelated conditions at 2, 7, and 9 years, respectively, after diagnosis. Two patients in the study were seen initially with metastatic spread at the time of initial diagnosis and died 2 months and 1 year later with widespread metastases to lymph nodes, liver, spleen, kidney, and bone despite intensive chemotherapy.. Disease stage at the time of diagnosis may play an important role in predicting the clinical outcome of patients with these tumors. Despite their generally slow and indolent growth in other locations, ACC arising in the lung may in certain cases be more aggressive.

Topics: Adult; Aged; Carcinoma, Adenoid Cystic; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Immunohistochemistry; Keratins; Lung Neoplasms; Male; Middle Aged

Canalicular adenoma is a newly recognized salivary gland adenoma that may be confused with malignant salivary gland tumors. To better characterize this neoplasm, six examples were investigated with a panel of immunohistochemistry antibodies including anti-keratin (AE1/AE3), anti-epithelial membrane antigen, anti-carcinoembryonic antigen, anti-vimentin, anti-S-100, anti-muscle specific actin, and anti-glial fibrillary acid protein. All canalicular adenomas stained in a similar fashion showing positive staining with anti-keratin, anti-vimentin, and anti-S-100 (6 of 6 cases each). Rare focal staining with anti-epithelial membrane antigen and anti-glial fibrillary acid protein was noted (1 of 6 cases each). This immunohistochemistry staining pattern was compared with those of ameloblastoma, polymorphous low-grade adenocarcinoma, and adenoid cystic carcinoma. Immunohistochemistry may be useful in the distinction of canalicular adenoma from other salivary gland tumors.

Topics: Actins; Aged; Ameloblastoma; Antibodies, Monoclonal; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Carcinoma, Ductal, Breast; Carcinoma, Lobular; Diagnosis, Differential; Female; Glial Fibrillary Acidic Protein; Humans; Immunoenzyme Techniques; Keratins; Lip Neoplasms; Male; Membrane Glycoproteins; Middle Aged; Mouth Mucosa; Mucin-1; Mucins; Neoplasm Proteins; S100 Proteins; Salivary Gland Neoplasms; Salivary Glands, Minor; Vimentin

Adenoid cystic carcinoma of the skin was studied. Histologically, tumor cells were arranged in a tubular and a cribriform pattern, mainly int he reticular dermis. Immunohistochemically, epithelial membrane antigen was reactive with the tumor cells, but S-100 protein, vimentin, and carcino-embryonic antigen were not. On electron microscopy, we confirmed the findings of previous reports; tumor cells were arranged to form luminal structures; most of them were pseudolumina containing fine mucin granules, basal laminae, and collagen fibers, but some were true lumina with numerous microvilli and junctional complexes. New findings of this study were bizarre-shaped, electron-dense, net-like structures within the true lumina which were considered to be a type of mucin.

Topics: Aged; Antigens, Neoplasm; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Collagen; Cytoplasm; Cytoplasmic Granules; Facial Neoplasms; Humans; Immunohistochemistry; Keratins; Male; Membrane Glycoproteins; Microvilli; Mucin-1; S100 Proteins; Skin Neoplasms; Vimentin

Brooke-Spiegler syndrome is an autosomal dominantly inherited disease characterized by the development of multiple trichoepitheliomas and cylindromas. Among other neoplasms that may also occur in Brooke-Spiegler syndrome are basal cell carcinomas and spiradenomas. Spiradenomas and cylindromas have so many features in common that they have been regarded as variants of the same neoplasm. This assumption was supported by the occurrence of both types of lesions in Brooke-Spiegler syndrome. We report a case of Brooke-Spiegler syndrome in which spiradenomas were found in the immediate vicinity of trichoepitheliomas and in continuity with follicles. Because of the embryonic relationship between follicles and apocrine glands, these features indicate that spiradenomas are apocrine neoplasms. We conclude that Brooke-Spiegler syndrome is an inherited disease that affects the folliculosebaceous apocrine unit.

Topics: Adenoma, Sweat Gland; Adult; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Cell Nucleus; Cytoplasm; Facial Neoplasms; Female; Humans; Keratins; Neoplasms, Multiple Primary; Neoplastic Syndromes, Hereditary; S100 Proteins; Skin Neoplasms

Specimens from five cases of adenoid cystic carcinoma of the external auditory canal were studied by immunohistochemical staining, and findings were compared with those from adjacent non-neoplastic tissues containing ceruminous glands. In the ceruminous gland, cytokeratin showed diffuse positive staining, while myoepithelial cells were stained for smooth muscle actin, desmin, S-100 protein and vimentin. The epithelial markers used were cytokeratin, carcinoembryonic antigen and secretory component and stained at various densities the inner cells of the tubular component and duct-lining cells in the cribriform component of tumor tissues. In contrast, the muscular markers, smooth muscle actin and desmin, and the mesenchymal marker, vimentin, were positive in the outer cells of the tubular component and in the cyst-lining cells of the cribriform component. S-100 protein immunoreactivity showed paradoxical results; positive findings occurred in the myoepithelial cells of the ceruminous glands and in the inner cells of the tubular component and duct-lining cells of the cribriform component of the tumor. Present findings demonstrate that adenoid cystic carcinoma of the external auditory canal had dual epithelial and myoepithelial differentiation and can mimic the ceruminous glands of the auditory canal.

Topics: Actins; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Cerumen; Desmin; Ear Canal; Ear Neoplasms; Epithelium; Exocrine Glands; Female; Humans; Hyalin; Immunohistochemistry; Keratins; Male; Middle Aged; Mucins; S100 Proteins; Sebaceous Glands; Secretory Component; Vimentin

Basal cell hyperplasia classically has been described as having bland cytologic features. During the past 2 years, we have seen 12 cases (11 in consultation) with atypical features that were confused with adenocarcinoma of the prostate. Eleven of these 12 cases contained prominent nucleoli mimicking carcinoma; in the 12th case, nuclei were enlarged, hyperchromatic, and moderately pleomorphic. Immunohistochemistry with antibodies against high-molecular-weight cytokeratin (34 beta E12) was performed in nine of the cases, verifying their basal cell nature. Additional findings in these cases were necrotic intraluminal secretions (two cases), immature squamous metaplasia (two cases), peculiar hyaline cytoplasmic globules (two cases), adenosis (one case), markedly atypical nuclei of uncertain nature occurring elsewhere in the specimen (one case), and intraluminal blue mucin (two cases). We analyzed nine cases of typical basal cell hyperplasia, all of which showed classic features of basal cell hyperplasia with benign cytology. Both atypical and classical basal cell hyperplasia were frequently infiltrated by lymphocytes such that the cytologic changes could not be attributable to inflammation. Atypical basal cell hyperplasia must be differentiated from ordinary adenocarcinoma of the prostate, prostatic intraepithelial neoplasia, and basaloid carcinoma (adenoid cystic carcinoma) of the prostate.

Topics: Adenocarcinoma; Aged; Aged, 80 and over; Carcinoma, Adenoid Cystic; Diagnosis, Differential; Follow-Up Studies; Humans; Immunohistochemistry; Keratins; Male; Prostate; Prostatic Hyperplasia; Prostatic Neoplasms; Time Factors

We studied seven examples of the solid variant of adenoid cystic carcinoma of the uterine cervix in postmenopausal women who presented with vaginal bleeding and a large ulcerated or polypoid cervical mass. The tumors lacked the characteristic cribriform pattern of conventional adenoid cystic carcinoma. The neoplastic cells were small, undifferentiated, or basaloid and grew in cords, nests, trabeculae, and nodules. Foci of squamous cell carcinoma were seen in three tumors and areas of necrosis in four. A characteristic feature was the production of abundant periodic acid-Schiff's procedure (PAS)-positive basement membrane material that was immunoreactive for collagen IV and that in some areas compressed tumor cells. Electron microscopy on three cases showed globules and cylinders of redundant basal lamina. The tumor cells were joined by desmosomes and contained bundles of tonofilaments. Material similar to basement membrane material appeared to be intracytoplasmic in two tumors. No neurosecretory granules or myoepithelial cells were found. Four deaths were tumor related. Two patients are currently alive, but with local recurrence or metastases; another is alive and well 19 months after surgery. We believe that the solid variant of adenoid cystic carcinoma of the cervix is a distinctive neoplasm that should be separated from small cell carcinomas with or without endocrine features, adenoid basal cell carcinoma, and squamous cell carcinoma.

Topics: Aged; Basement Membrane; Carcinoma, Adenoid Cystic; Cell Nucleus; Collagen; Cytoplasm; Female; Humans; Immunoenzyme Techniques; Keratins; Membrane Glycoproteins; Microscopy, Electron; Middle Aged; Mucin-1; Necrosis; Staining and Labeling; Uterine Cervical Neoplasms

In a group of 245 cases of primary carcinoma of the esophagus the authors found three cases of adenoid cystic carcinoma (ACC). Clinical and pathologic data of those patients (one female and two male; age range, 49-74 years) were analyzed. Tumors were localized in the middle third of the esophagus. One patient lived 15 months after surgery. Another is a case of early ACC who has been living 4.5 years after surgery and is without specific symptoms. The third patient had not had surgery and died 13 months after the onset of dysphagia. An autopsy showed only a locally invasive tumor growing into the surroundings of the esophagus, and regional lymph node metastases without distant parenchymal metastases. These findings support pathologic and biologic similarities between ACC of the esophagus and ACC of the salivary glands. There are synchronous tumors of the esophagus and the vital localization which makes the prognosis of ACC of the esophagus worse than ACC of the salivary glands.

Topics: Aged; Antigens, Neoplasm; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Collagen; Esophageal Neoplasms; Female; Humans; Hyalin; Immunohistochemistry; Keratins; Laminin; Lymphatic Metastasis; Male; Membrane Glycoproteins; Middle Aged; Mucin-1; S100 Proteins

Among a series of 76 adenoid cystic carcinomas (ACC), 51 cases with cibriform or trabecular patterns were selected for an immunohistochemical study. These tumors were composed of three types of cells: basaloid, myoepithelial and ductal luminal acinous or tubular cells with a variable amount of each cell type from one case to another. Monoclonal antibodies (MoAb) against keratins (PKK1, KL1, K8.12, K8.13, K4.62 anti-cytokeratins antibodies) and against vimentin were used. Tubular cells were characteristically marked by anti-cytokeratins MoAb, but with a great heterogeneity of keratin distribution. In myoepithelial cells, keratin was absent or slightly positive and vimentin was present, with co-expression of the two types of filaments in some cells. Like myoepithelial cells, basaloid cells were positive to anti-vimentin antibody and negative or slightly positive to anti-keratin antibodies, with sometimes a co-expression of vimentin and keratin filaments in the same cell. Histogenesis of adenoid cystic carcinomas was discussed. Progenitor intercalated duct reserve cells may change into ductal luminal and myoepithelial tumor cells. Otherwise, basaloid cells, arising also from intercalated duct reserve cells, are able to acquire some secretory organites.

Topics: Antibodies, Monoclonal; Carcinoma, Adenoid Cystic; Humans; Immunohistochemistry; Intermediate Filament Proteins; Keratins; Salivary Gland Neoplasms; Vimentin

We performed an immunohistochemical study that compared a primary adenoid cystic carcinoma (ACC) of the skin with two salivary gland ACC. All three tumors stained positively and in identical fashion for epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), broad-spectrum keratins, and low-molecular-weight keratins. Both EMA and CEA were localized to the luminal surfaces and the secreted contents of the tubular structures and the ductlike structures of the cribriform formations. The staining reactions for both types of keratin were more intense in the cells lining the tubular structures and the ductlike structures of the cribriform formations. One of the two salivary ACCs stained positively for S-100 protein; the other was positive for vimentin. The cutaneous ACC was negative for both antigens. Leu-7 antigen was not detected in either type of ACC. These results show that primary cutaneous ACC and salivary ACC have similar immunohistochemical staining patterns for a number of antigens. We believe this similarity is due to the fact that these antigens are shared by the sweat glands and salivary glands, which are considered to be the respective sites of origin for these two types of tumors.

Topics: Adult; Antigens, Neoplasm; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Female; Humans; Immunoenzyme Techniques; Keratins; Killer Cells, Natural; Male; Membrane Glycoproteins; Middle Aged; Mucin-1; S100 Proteins; Salivary Gland Neoplasms; Skin Neoplasms; Staining and Labeling; Vimentin

Using different monoclonal anti-cytokeratin antibodies (broad spectrum, cytokeratin 7, 8, 18, 19) and the antibody A55-A/A9 until now characterized only by immunohistology the staining of ductal structures and some cells within the lobulae of dermal cylindromata was demonstrated. In regard to the cytokeratin polypeptide patterns of the adnexes in uninvolved skin an exact histogenetic correlation by our findings is not possible, but the pattern is consistent with the conception of the glandular origin of the tumours.

Topics: Antibodies, Monoclonal; Carcinoma, Adenoid Cystic; Humans; Intermediate Filaments; Keratins; Skin Neoplasms

Sixteen polymorphous low-grade adenocarcinomas were reviewed and compared with 17 adenoid cystic carcinomas and with 21 other histologically similar minor salivary gland neoplasms. The polymorphous low-grade adenocarcinomas were for the most part distinctive in their microscopic appearance. Typically they exhibited infiltrative growth by small uniform cells in single-layered ducts. A syncytium of tumor cells was also characteristic, although solid and cribriform patterns were seen, making definitive diagnosis difficult with some tumors. Immunohistochemical staining for S-100 protein, glial fibrillary acidic protein, actin, vimentin, and keratins resulted in relatively distinctive antigenic profiles for the tumors studied. Of significance was strong S-100 protein and weak actin staining of polymorphous low-grade adenocarcinomas, moderate actin staining of adenoid cystic carcinomas, moderate glial fibrillary acidic protein staining of monomorphic adenomas and pleomorphic adenomas, and nonreactivity of monomorphic adenomas for vimentin. It is believed that the immunoprofiles could be useful in the microscopic diagnosis of salivary gland tumors. The identification of antigens found normally in myoepithelial and epithelial cells supports the concept that these tumors are derived from pluripotential reserve cells.

Topics: Actins; Adenocarcinoma; Adult; Aged; Aged, 80 and over; Carcinoma, Adenoid Cystic; Female; Glial Fibrillary Acidic Protein; Humans; Immunoenzyme Techniques; Immunohistochemistry; Keratins; Male; Middle Aged; Molecular Weight; S100 Proteins; Salivary Gland Neoplasms; Salivary Glands, Minor; Vimentin

Basaloid-squamous carcinoma of the larynx, pharynx and base of tongue and the so-called adenoid cystic carcinoma of the oesophagus are rare but distinctive tumours associated with a grave prognosis. They occur most commonly in elderly males and present at an advanced stage. Our study of four such laryngeal tumours and five such oesophageal tumours shows that they are histologically and immunohistochemically identical, providing support for the idea that they are the same tumour type. They show a biphasic pattern in which basaloid tumour is intimately associated with a neoplastic squamous component which can be invasive or in situ. The basaloid component is in the form of invasive lobules with frequent comedo-necrosis and hyalinization. The constituent cells possess pale pleomorphic nuclei with frequent mitoses. Immunoreactivity for cytokeratin in the basaloid component is remarkable for its absence or weak and focal nature. Review of the literature shows that only a few cases of 'adenoid cystic carcinoma' of the oesophagus are bona fide examples of adenoid cystic carcinoma as it occurs in the salivary glands, while the others are identical to basaloid-squamous carcinoma of the upper aerodigestive tract. Their distinction is important because genuine adenoid cystic carcinoma is much less aggressive than basaloid-squamous carcinoma.

Topics: Actins; Aged; Antibodies; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Carcinoma, Basosquamous; Diagnosis, Differential; Digestive System Neoplasms; Esophageal Neoplasms; Female; Humans; Immunohistochemistry; Keratins; Laryngeal Neoplasms; Male; Middle Aged; Pharyngeal Neoplasms; Prognosis; S100 Proteins; Vimentin

In an attempt to determine if both pleomorphic adenomas and adenoid cystic carcinomas are derived from myoepithelial cells, 23 pleomorphic adenomas, 22 adenoid cystic carcinomas, and 17 normal salivary glands were examined immunohistochemically by using monoclonal antibodies directed against actin (HUC1-1, 1A4), keratin (AE-1, 34 beta E 12), and vimentin (V9). In normal salivary glands, the myoepithelial cells demonstrated a positive reaction to the monoclonal antibodies against actin and only rarely reacted with those against vimentin. No reaction to those against keratin was noted. In pleomorphic adenomas, cells that histologically resembled myoepithelial cells displayed a positive reaction to HUC1-1 in 60.9% and to 1A4 in 65.2%. In adenoid cystic carcinoma, 59.1% of cases demonstrated a positive reaction to both HUC1-1 and 1A4. These results supported the hypothesis that the majority of pleomorphic adenomas and adenoid cystic carcinomas arise from cells of myoepithelial origin.

Topics: Actins; Adenoma, Pleomorphic; Antibodies, Monoclonal; Carcinoma, Adenoid Cystic; Humans; Immunoenzyme Techniques; Keratins; Muscle, Smooth, Vascular; Salivary Gland Neoplasms; Vimentin

An immunohistochemical study of keratin was performed in forty-five cases of adenoid cystic carcinoma of salivary gland, the results were as follows: keratin was distributed in the duct system of normal salivary gland, but the acini were negative. The distribution of keratin were varied in different patterns of adenoid cystic carcinoma. The amount of synthesis of keratin was many in tubular type of high differentiated carcinoma, but, in basaloid solid type of low differentiated carcinoma, the synthesis of keratin was less; the content of keratin in cribriform and trabecular type was between the tubular type and basaloid solid type, and the former had more keratin than the latter.

Topics: Carcinoma, Adenoid Cystic; Female; Humans; Immunohistochemistry; Keratins; Male; Prognosis; Salivary Gland Neoplasms

The neoplastic cells present in a sialadenoma pappiliferum were found by immunoperoxidase method and immunofluorescent staining technique to co-express 3 different types of intermediate-sized filaments (IFs) defined by monoclonal antibodies to cytokeratin, vimentin and desmin. When other salivary gland tumors such as 18 pleomorphic adenomas, 15 adenolymphomas, 2 oxyphilic adenomas, 7 mucoepidermoid tumors, 5 acinic cell tumors, 8 adenoid cystic carcinomas and 6 adenocarcinomas were examined immunohistochemically for the expression of IFs, no tumors with all 3 types of IFs observed in sialadenoma papilliferum were found.

Topics: Adenocarcinoma; Adenolymphoma; Adenoma, Pleomorphic; Carcinoma; Carcinoma, Adenoid Cystic; Desmin; Fluorescent Antibody Technique; Humans; Immunoenzyme Techniques; Intermediate Filaments; Keratins; Papilloma; Salivary Gland Neoplasms; Vimentin

13 cases of salivary glands and 30 of salivary gland tumors were studied by ABC method with 6 monoclonal antibodies to intermediate filaments and one to microfilament. The results showed that the distribution of intermediate filaments in salivary glands had their regularity. According to the reaction to the antibodies, these tumors could be divided into 3 groups and 3 subgroups. The findings also suggested that in the salivary gland tissue the epithelial cells which mainly contained the 54 Kd keratin and the epithelial cells which mainly contained 57/66 Kd keratin were the origin of the salivary gland tumors. The actin-positive myoepithelial cells might play a role in some tumor formation.

Topics: Actins; Adenoma, Pleomorphic; Antibodies, Monoclonal; Carcinoma; Carcinoma, Adenoid Cystic; Humans; Immunohistochemistry; Intermediate Filaments; Keratins; Parotid Gland; Salivary Gland Neoplasms; Salivary Glands

Six cases of adenoid cystic carcinoma (ACC) of the breast were reviewed. Immunohistochemical studies were carried out for actin, S-100 protein, EMA, keratin, CEA, vimentin, NSE, alpha-lactalbumin, and lysozyme. Fine needle aspiration biopsy smears of five patients were also reexamined. Patients were treated by tumorectomy, quadrantectomy, or modified radical mastectomy. Axillary dissection was carried out in five cases, with negative lymph nodes in all. Five patients are alive without evidence of disease from 1 year 10 months to 13 years 4 months following surgery. One patient died 7 1/4 years after mastectomy, without evidence of disease. Histologically, a diagnostic biphasic cellular pattern was seen in all cases. In addition, several unusual features were encountered in some cases: squamous metaplasia, stromal myxoid pseudocartilaginous foci, and well-formed neoplastic ducts. Actin and/or S-100 protein were variably positive in all cases. The reaction was usually present in occasional basaloid cells predominantly at the periphery of neoplastic structures. Keratin, EMA, and CEA immunostaining disclosed ductal type cells in all cases. Vimentin was positive in four cases, usually in many basaloid cells. Aspiration cytology was suspicious in two cases and yielded a definitive diagnosis of ACC in three cases. Cytologic diagnosis was based on cellular morphology and on the presence of characteristic globoid structures. Immunohistochemical results show that in ACC dual myoepithelial-ductal differentiation occurs but is relatively limited. Most of the tumor cells are not differentiated ("indifferent" cells) and often express strong vimentin positivity. Such cells are regarded as precursor cells for either differentiated element. Unusual metaplastic changes in breast ACC suggest a possible relation with pleomorphic adenoma-type tumors, and this might be of prognostic significance.

Topics: Actins; Aged; Biopsy, Needle; Breast Neoplasms; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Female; Humans; Immunohistochemistry; Keratins; Membrane Glycoproteins; Middle Aged; Mucin-1; Phosphopyruvate Hydratase; S100 Proteins; Vimentin

Adenoid cystic carcinoma (ACC) and adenoid basal carcinoma (ABC) of the uterine cervix are rare tumors that have often been regarded as a single entity. We studied 28 cases of these neoplasms, with 14 cases in each category. Most patients were over 60 years of age, and there was a high proportion of black women. The majority of the women with ACC presented with postmenopausal bleeding and had an obvious mass on pelvic examination. Despite the tumors' architectural similarity to ACC of the salivary gland, microscopic examination of the cervical carcinomas showed necrosis, a high mitotic rate, and greater nuclear pleomorphism. In all but one of the cases, the tumor cells were negative for S-100 protein on immunoperoxidase staining--a finding that provides evidence against a myoepithelial component. However, S-100-positive dendritic cells were present in the stroma of the tumors and among the neoplastic cells. The patients with ABC were usually asymptomatic, without a gross abnormality of the cervix. Microscopic examination disclosed small nests of basaloid cells, almost always beneath, and often arising from, in situ or small invasive squamous cell carcinomas. In contrast to ABC, ACC was often complicated by local recurrence or distant metastasis. We conclude that ACC of the uterine cervix differs from ACC of salivary gland origin and is also distinct clinically and pathologically from cervical ABC.

Topics: Aged; Aged, 80 and over; Carcinoembryonic Antigen; Carcinoma in Situ; Carcinoma, Adenoid Cystic; Carcinoma, Squamous Cell; Female; Humans; Keratins; Membrane Glycoproteins; Middle Aged; Mucin-1; Neoplasms, Multiple Primary; S100 Proteins; Uterine Cervical Neoplasms

The staining patterns of normal sweat glands and sweat gland-derived neoplasms using 2 monoclonal antibodies to keratins (Dako-CK1, Cam 5.2) has been assessed. Based on findings in normal glands, the differentiation of these benign neoplasms is considered, with positive evidence for apocrine and eccrine differentiation, and in the latter, differentiation to ductal or secretory type epithelia. This easily applied technique (indirect immunoperoxidase) is suitable for use in routinely processed tissue and employs 2 commercially available monoclonal antibodies. The findings may be of assistance in general surgical reporting of problematic cases.

Topics: Adenoma, Sweat Gland; Antibodies, Monoclonal; Carcinoma, Adenoid Cystic; Humans; Immunoenzyme Techniques; Keratins; Sweat Gland Neoplasms; Sweat Glands

Adenoid cystic carcinoma is a specific variant of adenocarcinoma with a characteristic cribriform appearance. The tumor may arise from salivary glands and various other sites, but the origin and cellular composition of this unique neoplasm have been controversial. A potential use of immunohistochemistry is to provide additional information on the origin of various cellular components of tumors by comparing them with corresponding normal tissues. Immunohistochemical distributions of carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), keratin, low molecular weight keratin (54 kd), S100 protein, muscle-specific actin, laminin, and type IV collagen were evaluated in 20 adenoid cystic carcinomas arising in major and minor salivary glands. Anti-CEA, anti-EMA, anti-keratin, and anti-S100 antibodies strongly stained cells lining true lumina. Muscle-specific actin, a marker for myoepithelial cells, was found in lining cells of pseudocysts, in tumor cells proper, and in nonluminal cells with a tubular growth pattern. A monoclonal antibody against 54 kd keratin stained almost all cells in the neoplasms. In pseudocysts, replicated basal lamina reacted with antisera to laminin and to type IV collagen. The present study demonstrates that there are at least two populations of tumor cells in adenoid cystic carcinoma: luminal cells that express CEA and EMA, thus indicating their ductal character, and nonluminal cells that express muscle-specific actin characteristic of myoepithelium.

Topics: Adult; Aged; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Female; Humans; Immunoenzyme Techniques; Immunohistochemistry; Keratins; Male; Middle Aged; S100 Proteins; Salivary Gland Neoplasms; Salivary Glands; Staining and Labeling

The expression and distribution of cytokeratins and vimentin in fifteen malignant salivary neoplasms were examined by immunocytochemical techniques using, five monoclonal antibodies (mAbs) against different epitopes of Cytokeratins (CKs) (mAbs PKK1, PKK2, and PKK3, identifying CKs 8, 18 and 19, CKs 7, 17 and 19, and CK 18, respectively) and Vimentin (mAbs V9 and V24). Antibody PKK1 gave strong reactions in all neoplasms showing the similarity of these tumours to other digestive system adenocarcinomas. Three general staining patterns of the neoplasms were recognized with respect to the reactivity of mAbs PKK2, PKK3, and V9. Mucoepidermoid cancer, salivary duct carcinoma and a clear cell carcinoma had a higher relative content of CKs 7, 17 and 19 than of CK 18. Adenoid cystic carcinoma showed the same CK pattern but in the periphery of the tumour cords vimentin was readily detected. In two acinic cell carcinomas, the relative content of CK 18 was higher than that of CKs 7, 17 and 19. Furthermore vimentin was expressed in the tumour cells. However, one mucoepidermoid carcinoma showed vimentin expression and two acinic cell carcinomas were vimentin negative and more reactive for PKK2 than PKK3. Pecularities in CK expression were seen: squamous areas of mucoepidermoid carcinomas were stained by mAb PKK3 although CK 18 is not present in normal squamous epithelia or in squamous cell carcinomas of tongue and skin. In conclusion, the different salivary neoplasms can be distinguished on basis of IFP content. Such a differentiation fits with current theories of histogenesis, i.e. vimentin is seen in tumours presumed to arise from intercalated duct reserve cells, whilst the vimentin negative neoplasms would be expected to arise in excretory duct reserve cells.

Topics: Adenocarcinoma; Adolescent; Aged; Antibodies, Monoclonal; Carcinoma; Carcinoma, Adenoid Cystic; Female; Humans; Keratins; Male; Middle Aged; Salivary Gland Neoplasms; Vimentin

Twelve cases of adenoid cystic carcinoma of the trachea and main-stem bronchus were histologically analyzed, and the results were examined with reference to the growth pattern of the tumor and the prognosis. The tumors were histologically classified into tubular, cribriform, and solid subtypes. Three histologic grades were established: grade I, tumors with tubular and cribriform subtypes but without solid subtype; grade II, tumors with tubular and cribriform subtypes in which the solid subtype comprised less than 20% of the area; grade III, tumors in which the solid subtype comprised more than 20% of the area. Three gross infiltrating types were established: type I, entirely intraluminal; type II, predominantly intraluminal; type III, predominantly extraluminal. In most cases histologic grade correlated with gross tumor type; that is, grades, I, II, and III were grossly types I, II, and III, respectively. The tumors infiltrating along the tracheobronchial wall were of the tubular or cribriform subtype, but not of the solid subtype. In two patients who died of distant metastasis, the histologic studies revealed the solid subtype. Immunohistochemical analysis demonstrated that the tubular subtype was the most differentiated form and the solid subtype, the most undifferentiated form. The histologic subtype of adenoid cystic carcinoma of the tracheobronchial tree was an important factor in the growth pattern of the tumor and the prognosis.

Topics: Adult; Aged; Bronchial Neoplasms; Carcinoma, Adenoid Cystic; Female; Humans; Immunohistochemistry; Keratins; Lactoferrin; Male; Middle Aged; S100 Proteins; Secretory Component; Tracheal Neoplasms

A total of 34 cases (eccrine poroma: 2, cylindroma: 2, eccrine spiradenoma: 4, syringocystadenoma papilliferum: 1, hydroadenoma papilliferum: 1, clear cell hydroadenoma: 7, mixed tumour: 16) of sweat gland tumours of the skin were described in terms of immunohistochemical distribution of keratins using polyclonal anti-keratin antiserum (TK, detecting 41-56 KDa keratins) and monoclonal antibodies (KL1, 55-57 KDa; PKK1, 40, 45, 52.5 KDa). Keratin expression in eccrine poroma, spiradenoma and syringocystadenoma was similar to that in the ductal segment of normal sweat glands. Cylindroma showed usually slight staining for kertins. Tumour cells of hydroadenomas showed not so prominent staining for any of the keratins; however, histologically, tumour cells indicated marked variation, and the degree of keratin proteins also was different among these histological variants. Mixed tumours of the skin were strongly decorated with anti-keratin antibodies along the luminal surface cells of typical structures, while no staining occurred in outer side cells. Luminal tumour cells may be differentiated from secretory coil cells, whereas outer side cells may have a myoepithelial origin, as outer layer cells found in pleomorphic adenoma of salivary glands.

Topics: Adenoma, Sweat Gland; Antibodies, Monoclonal; Carcinoma, Adenoid Cystic; Humans; Keratins; Staining and Labeling; Sweat Gland Neoplasms; Sweat Glands

Basal cell hyperplasia (BCH) is an uncommon proliferative lesion of the prostate gland. We studied ten cases of BCH, one case of an unusual adenoid basal cell tumor (ABT), and one case of a prostatic adenoid cystic carcinoma (ACC), using a panel of antibodies to define the histogenesis of these lesions. Monoclonal antibodies (MoAb) directed against a cytokeratin, which selectively stains basal cells (34 beta E12), and against muscle-specific actin, which stains myoepithelial cells (HHF35), were used. In addition, antibodies directed against prostatic acid phosphatase (PAP), prostate-specific antigen (PSA), S-100 protein, and vimentin were used. In the normal prostate, epithelial cells reacted positively with 34 beta E12, PAP, and PSA, and negatively with the actin, S-100 protein, and vimentin antibodies. In BCH, positive staining was seen for 34 beta E12, PSA, and PAP, with no reactivity for actin, S-100 protein, and vimentin. In ABT and ACC, positive reactivity was demonstrated for all antibodies except actin and vimentin. These findings indicate that the basaloid cells of BCH, ABT, and ACC are derived from basal cells of the normal prostate gland and suggest a continuum among the three lesions. The presence of S-100 protein in ABT and ACC may be related to the lack of this antigen's specificity for myoepithelial cells. The absence of reactivity with the HHF35 MoAb supports our belief that the S-100 positivity does not necessarily indicate myoepithelial cell differentiation.

Topics: Acid Phosphatase; Actins; Carcinoma, Adenoid Cystic; Carcinoma, Basal Cell; Humans; Immunoenzyme Techniques; Keratins; Male; Prostatic Hyperplasia; Prostatic Neoplasms; S100 Proteins; Vimentin

Two cases of an esophageal carcinoma with an adenoid cystic differentiation are presented. The first was diagnosed histologically as typical adenoid cystic carcinoma, and the other as being a basal cell carcinoma with an adenoid cystic differentiation. We further investigated these tumors and normal esophageal specimens to determine their histological origin by immunohistochemical staining with either polyclonal or monoclonal antibodies to different classes of human keratin. It was found that both tumors were similar in their reactivities with the anti-keratin antibodies to basal cells of the surface squamous epithelia, but not to the cells composing the esophageal glands, suggesting that they were of basal cell origin.

Topics: Aged; Antibodies, Monoclonal; Carcinoma, Adenoid Cystic; Carcinoma, Basal Cell; Esophageal Neoplasms; Humans; Keratins; Male; Staining and Labeling

To investigate the cellular differentiation of adenoid cystic carcinomas (ACC), a comparative immunohistochemical study of 12 normal salivary glands and eight specimens of ACC was performed. Antibodies were used against S100 protein (S), keratins (K) of various molecular weights, vimentin (V), muscle-specific actin (A), epithelial-membrane antigen, human milk fat globules, and collagen type IV. A panel of four of these antibodies (SKVA) was identified as the most helpful in characterizing cells in normal salivary glands and ACC. The immunophenotypes depended on the histologic patterns of ACC. Cells in morphologically recognizable duct structures in the cribriform and trabecular areas expressed a phenotype similar to that of the intercalated duct. Cell layers around pseudocysts and occasional cellular islands had an immunophenotype suggesting myoepithelial-cell differentiation. The most clear cut epithelial/myoepithelial bilaminar differentiation was present in areas with a trabecular pattern, in which the layers facing the stroma and the central ductal elements had SKVA phenotypes of myoepithelial and ductal differentiation, respectively. In areas with a reticular pattern, most of the cells showed ductal differentiation. Many of the cells in the cribriform and basaloid regions were immunophenotypically undifferentiated. These results indicate that ACC consists of undifferentiated cells and of cells that are differentiating toward ducts, predominantly intercalated ducts, and toward myoepithelium. These findings support previous observations by electron microscope.

Topics: Actins; Antibodies; Breast Neoplasms; Bronchial Neoplasms; Carcinoma, Adenoid Cystic; Cell Differentiation; Collagen; Histocytochemistry; Keratins; Lymphatic Metastasis; Membrane Proteins; Molecular Weight; Mucin-1; Phenotype; S100 Proteins; Salivary Gland Neoplasms; Salivary Glands; Skin Neoplasms; Submandibular Gland Neoplasms; Vimentin

Intermediate filaments are composed of 5 groups which follow the classic histogenetic division of tissue. The application of antibodies against the 5 groups for the analysis of salivary gland tumours reveals the presence of keratin in normal and neoplastic epithelial tissue. All carcinomas e.g. adenocarcinomas, acinic cell tumours, mucoepidermoid tumours and squamous cell carcinomas were positive for keratin. Vimentin was regularly found in the cells of the stroma. A special distribution pattern of intermediate filaments was found in pleomorphic adenomas and in adenoid cystic carcinomas. These tumours display the presence of two systems, keratin and vimentin filaments. The application of antibodies against intermediate filaments is useful for differential diagnosis of salivary gland tumours and for histogenetic analysis of special tumour groups.

Topics: Adenocarcinoma; Adenolymphoma; Adenoma, Pleomorphic; Antibodies; Carcinoma, Adenoid Cystic; Carcinoma, Squamous Cell; Cytoskeleton; Humans; Intermediate Filaments; Keratins; Salivary Gland Neoplasms; Vimentin

Myoepithelial and basal cells were identified by a monoclonal antibody raised against keratin. This antibody (CK B1) which detects myoepithelial cells in normal salivary glands, labels spindle shaped and polygonal cells in pleomorphic adenomas. Most cells in adenoid cystic carcinomas and some basal cells in adenolymphomas were also positive for this antibody. The oncocytic epithelium of adenolymphoma was negative. An inverse reaction was seen with an antibody against cytokeratin 18. The antibody CK B1 seems to be of interest for the detection of myoepithelial/basal cells in salivary glands and salivary gland tumours.

Topics: Adenolymphoma; Adenoma; Antibodies, Monoclonal; Carcinoma, Adenoid Cystic; Humans; Keratins; Salivary Gland Neoplasms

Specific antibodies against basement membrane associated, connective tissue components: type IV and V collagens, laminin, fibronectin and heparan sulphate proteoglycan were used to study the basement membrane-like structures in cylindroma lesions. All these components were immunohistochemically demonstrated as a band surrounding islands of epithelial cells and all except fibronectin also inside the islands. Antibodies to keratin filaments stained most of the cells inside the epithelial islands confirming the epithelial origin of the cells.

Topics: Basement Membrane; Carcinoma, Adenoid Cystic; Chondroitin Sulfate Proteoglycans; Collagen; Female; Fibronectins; Fluorescent Antibody Technique; Genes, Dominant; Heparan Sulfate Proteoglycans; Heparitin Sulfate; Humans; Keratins; Laminin; Middle Aged; Skin Neoplasms

One hundred cutaneous tumors were investigated immunohistopathologically for the expression of intermediate filament (IF) proteins. Epithelial tumors, such as basocellular and squamous cell carcinomas, cutaneous adnexal tumors, and metastatic carcinomas showed keratin positivity in a varying number of tumor cells with two keratin antibodies with different specificities. Neoplastic cells of fibrohistiocytic tumors, pigmented nevi, melanomas, hemangiomas, glomus tumors, and lymphomas were positive for vimentin, but not for keratin or desmin. Cutaneous leiomyomas and leiomyosarcomas, on the other hand, were positive for desmin. The results show that the typing of IFs enables the differential diagnosis between carcinomas and sarcomas or melanomas, epidermal appendage tumors, and mesenchymal tumors, and between fibrohistiocytic and leiomyocytic tumors, and therefore are of diagnostic value in histopathologic problems of the skin.

Topics: Adenocarcinoma; Adenoma, Sweat Gland; Antibodies, Monoclonal; Carcinoma, Adenoid Cystic; Carcinoma, Basal Cell; Carcinoma, Renal Cell; Carcinoma, Squamous Cell; Desmin; Diagnosis, Differential; Fluorescent Antibody Technique; Hemangioma; Histiocytoma, Benign Fibrous; Histocytochemistry; Humans; Intermediate Filament Proteins; Keratins; Leiomyoma; Melanoma; Neoplasm Metastasis; Nevus, Pigmented; Skin Neoplasms; Vimentin

Topics: Aged; Carcinoma, Adenoid Cystic; Carcinoma, Small Cell; Female; Histocytochemistry; Humans; Immunoenzyme Techniques; Keratins; Lung Neoplasms; Male; Middle Aged

Normal salivary glands and 55 salivary gland tumors were examined by immunostaining (immunoperoxidase [IMP] and immunofluorescence [IMF]) to identify myoepithelial cells (MCs) and speculate on their role in the histogenesis of the tumors. The classic (C) MCs of normal salivary glands stained by IMP with antibodies to cytokeratin and S100 protein and stained by IMF with the same antibodies and with antibodies to vimentin and actin. Modified (M) MCs of pleomorphic adenomas stained positively by IMP and IMF with all of the preceding antibodies. In many mucoepidermoid carcinomas, adenoid cystic carcinomas, and basal cell adenomas, variable numbers of CMCs and MMCs stained positively by IMP with anti-cytokeratin and anti-S100 protein antibodies. No MCs were detected in adenolymphomas or acinic cell carcinomas. We believe that MCs play a major role in the histogenesis of pleomorphic adenomas and may also be important in many mucoepidermoid carcinomas, adenoid cystic carcinomas, and basal cell adenomas.

Topics: Actins; Adenolymphoma; Adenoma; Adenoma, Pleomorphic; Carcinoma; Carcinoma, Adenoid Cystic; Epithelial Cells; Epithelium; Fluorescent Antibody Technique; Histocytochemistry; Humans; Immunoenzyme Techniques; Keratins; Membrane Proteins; Mucin-1; Muscle, Smooth; S100 Proteins; Salivary Gland Neoplasms; Salivary Glands; Vimentin

The distribution of carcinoembryonic antigen (CEA), secretory component (SC), fat globule membrane antigens ( FGMA ), and keratin was determined immunohistochemically in 22 invasive adenocarcinomas of various types and in 9 adenocarcinomas in situ of the uterine cervix. In the invasive adenocarcinomas 77% were positive for CEA, 47% for SC, 89% for keratin, and 77% for FGMA . In adenocarcinomas in situ 67% were positive for CEA, 11% for SC, and 44% for keratin. The location of the markers was variable in the cells, and the cells in a tumor were irregularly positive. For a given histologic type there were several phenotypes. No correlation was found between histologic types of invasive adenocarcinomas and the various phenotypes. It remains to be shown whether a particular phenotype has a particular biological behavior. The detection in the serum of the markers shown in histologic preparations could be useful in the postsurgical monitoring.

Topics: Adenocarcinoma; Adipose Tissue; Adult; Aged; Antigens, Neoplasm; Antigens, Surface; Carcinoembryonic Antigen; Carcinoma in Situ; Carcinoma, Adenoid Cystic; Female; Histocytochemistry; Humans; Keratins; Middle Aged; Radioimmunoassay; Secretory Component; Uterine Cervical Neoplasms

Six cases of adenoid cystic carcinoma of salivary glands have been examined with antibodies specific for either keratin or vimentin. Tumor cells in all six cases showed coexpression of keratin and vimentin.

Topics: Adult; Carcinoma, Adenoid Cystic; Cytoskeleton; Female; Fluorescent Antibody Technique; Humans; Intermediate Filament Proteins; Keratins; Male; Microscopy, Fluorescence; Middle Aged; Salivary Gland Neoplasms; Vimentin

Surgical specimens of the salivary gland tumor were studied by immunohistochemical techniques using the anti-keratin antibody and the anti-myosin antibody. In the normal tissue, keratin was localized predominantly in the duct epithelial cells and myosin in the myoepithelial cells. According to the immunohistochemical staining patterns, the tumors were able to be divided into two groups: one group consisted of pleomorphic adenoma, adenoid cystic carcinoma, and adenocarcinoma which showed a mixture of keratin- and myosin-positive cells, respectively, mimicking the structures of the intercalated duct; the other comprised monomorphic adenoma and mucoepidermoid tumor which disclosed keratin-positive cells predominantly, resembling the constituent of the excretory duct. These results were mostly consistent with the "bicellular theory" that the salivary tumors generate from the intercalated duct reserve cells and the excretory duct reserve cells.

Topics: Adenocarcinoma; Adenolymphoma; Adenoma, Pleomorphic; Carcinoma; Carcinoma, Adenoid Cystic; Humans; Immunoenzyme Techniques; Keratins; Myosins; Salivary Gland Neoplasms; Salivary Glands

An example of adenoid cystic carcinoma of the cervix was recently encountered in our laboratory and studied by histochemistry, electron microscopy, and immunofluorescence in order to compare the neoplasm with adenoid cystic tumors at other sites and to establish criteria for diagnosis. Histochemically, cervical adenoid cystic carcinoma showed the two types of mucin, epithelial and stromal, as expected in adenoid cystic carcinomas of other organs. Ultrastructurally, this tumor was characterized by redundant basal lamina forming pseudocysts, intercellular spaces, and occasional true lumens with microvilli. Immunofluorescence studies showed that the cells contain at least two antigenically different types of filaments, actin and keratin, and that the cells produce true basement membrane (collagen IV). The presence of actin suggests myoepithelial differentiation even though the tumor probably originated from the cervical reserve cells, and myoepithelium is not a known component of normal cervix. This study shows that cervical adenoid cystic carcinoma is a distinct entity which can be identified and separated from other types of cervical adenocarcinomas.

Topics: Actins; Aged; Carcinoma, Adenoid Cystic; Collagen; Female; Fluorescent Antibody Technique; Histocytochemistry; Humans; Keratins; Microscopy, Electron; Neoplasm Proteins; Uterine Cervical Neoplasms