glycogen and Salivary-Gland-Neoplasms

Topics: Adenofibroma; Adenoma, Pleomorphic; Alkaline Phosphatase; Atrophy; Basement Membrane; Breast; Breast Diseases; Breast Neoplasms; Carcinoma; Carcinoma, Adenoid Cystic; Carcinosarcoma; Endocrine Glands; Epithelial Cells; Epithelium; Female; Glycogen; Humans; Hyperplasia; Lipids; Male; Middle Aged; Muscle, Smooth; Myoepithelioma; Myofibrils; Pigments, Biological; Salivary Gland Neoplasms; Sarcoma; Sweat Glands; Water

We describe two cases of primary intraosseous hyalinizing clear cell carcinomas of the jaws. One tumor arose in the mandible, the other in the maxilla. Both patients were adult women. Histologically, both tumors were characterized by a population of clear, glycogen-rich cells arranged in solid nests, trabeculae, and occasional single files, surrounded by a markedly hyalinized fibrous stroma. In close admixture with the clear cells, a second component of smaller cells having eosinophilic cytoplasms was also noted. Focal areas of squamous metaplasia were seen in one of the tumors. Neither nuclear pleomorphism nor mitotic activity were conspicuous features. Mucicarmine stains were negative in both tumors. Immunohistochemically, the tumor cells expressed cytokeratins and epithelial membrane antigen. Stains for S100 protein, smooth muscle specific actin, and carcinoembryonic antigen were all negative. Both patients are alive and well 14 and 17 months respectively after the diagnosis without evidence of metastasis or recurrence. The major importance of recognizing the existence of this rare form of salivary gland-type adenocarcinoma arising as a primary lesion in the mandible or the maxilla lies in avoiding misdiagnosing it as other primary or metastatic clear cell neoplasms, including various odontogenic clear cell tumors, other primary intraosseous salivary gland tumors, and metastatic clear cell adenocarcinomas from other organs, particularly the kidney.

Topics: Adenocarcinoma, Clear Cell; Aged; Diagnosis, Differential; Female; Glycogen; Humans; Hyalin; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Odontogenic Tumors; Salivary Gland Neoplasms

Clear cell adenocarcinoma of salivary glands (CCASG) is a relatively rare tumor, composed entirely of clear cells of putative ductal origin. It bears striking morphologic similarities to renal cell carcinoma (RCC) of clear cell type on hematoxylin and eosin stains. Differentiation between CCASG and metastatic RCC to the salivary glands has been considered problematic or even impossible on morphologic grounds. We examined three cases of CCASG and 12 cases of RCC (6 primary and 6 metastatic) by hematoxylin and eosin staining, immunohistochemistry, and electron microscopy. Two distinctive immunohistochemical and ultrastructural patterns emerged from this analysis. CCASG showed positivity for high molecular weight cytokeratin and carcinoembryonic antigen and ultrastructurally showed prominent squamoid differentiation, glycogen pools, and absence of lipid. In contrast, RCC was characterized by positivity for vimentin and complete absence of staining for high molecular weight cytokeratin and carcinoembryonic antigen. On ultrastructural studies, RCC lacked any squamoid differentiation, and the tumor cells contained abundant cytoplasmic lipid in addition to glycogen. Thus, based on the consistent differences on the immunohistochemical staining patterns and their characteristic subcellular morphology, CCASG and RCC can be distinguished on pathologic evaluation. The different direction of differentiation of the cells in CCASG and RCC (i.e., ductal in the former and renal tubular and mesodermal in the latter) results in their distinctive immunophenotypical and ultrastructural features.

Topics: Adenocarcinoma, Clear Cell; Adult; Aged; Carcinoembryonic Antigen; Carcinoma, Renal Cell; Diagnosis, Differential; Female; Glycogen; Humans; Immunoenzyme Techniques; Keratins; Kidney Neoplasms; Lipids; Male; Middle Aged; Salivary Gland Neoplasms; Vimentin

Topics: Carcinoma; Diagnosis, Differential; Female; Glycogen; Humans; Immunohistochemistry; Keratins; Mandibular Neoplasms; Middle Aged; Salivary Gland Neoplasms; Salivary Glands, Minor

Glycogen-rich clear cell carcinoma arising from minor salivary glands of the uvula in a 35-year-old woman is reported. This tumor was composed of nests and cords of clear cells containing cytoplasmic glycogen but no mucin. The epithelial nature of this lesion was obvious because of positive immunoreactivity for cytokeratin and epithelial membrane antigen, and the presence of immature lumina and intercellular spaces lined by many microvilli, associated with desmosomal junctions and basal lamina, as revealed by ultrastructural study. However, no myoepithelial cells could be detected. From these findings, it may be concluded that this tumor corresponds to glycogen-rich clear cell carcinoma (a variant of clear cell tumor), revealing glandular differentiation.

Topics: Adenocarcinoma; Adult; Female; Glycogen; Histocytochemistry; Humans; Immunohistochemistry; Microscopy, Electron; Palatal Neoplasms; Salivary Gland Neoplasms; Salivary Glands, Minor; Uvula

A case of a glycogen-rich adenocarcinoma arising in the minor salivary glands of the hard palate is described. The clinical, light microscopic, histochemical, and ultrastructural findings supporting this diagnosis are presented.

Topics: Adenocarcinoma; Glycogen; Humans; Male; Middle Aged; Palatal Neoplasms; Salivary Gland Neoplasms; Salivary Glands; Salivary Glands, Minor

A glycogen-rich adenoma occurring in the minor salivary gland of the nasopharynx in a 41-year-old woman was studied ultrastructurally. The cytoplasm of the tumour cells was abundantly filled with glycogen particles. The tumour cells possessed many mitochondria, a great number of microvillous processes and microvilli and were joined to each other by desmosomes. These findings suggest that this adenoma is of salivary duct epithelial origin most probably from storing striated ductal cells, and is a variant of monomorphic oxyphilic adenoma.

Topics: Adenoma; Adult; Cell Nucleus; Cytoplasm; Cytoplasmic Granules; Female; Glycogen; Humans; Microscopy, Electron; Microvilli; Mitochondria; Nasopharynx; Salivary Gland Neoplasms; Salivary Glands, Minor

A detailed electronmicroscopic study on glycogen-rich tumor is presented. The neoplasm originated from the minor salivary glands on the ventral surface of the tongue. The role of myoepithelial cells in the histogenesis of this lesion is not supported. It is proposed that the tumor arises from "undifferentiated" stem cells analogous to cells in the "end bud" stage of salivary gland morphogenesis. The presence of a large amount of glycogen is secondary to defective carbohydrate metabolism within the tumor cells.

Topics: Adenoma; Glycogen; Histocytochemistry; Humans; Male; Microscopy, Electron; Middle Aged; Salivary Gland Neoplasms

A gingival tumor that invaded the anterior maxilla was removed from a 14-year-old boy and studied by light and electron microscopy. The tumor was composed exclusively of myoepithelial cells and appeared to be malignant. By light microscopy, the tumor appeared to be a poorly differentiated epithelial neoplasm of undetermined origin; however, electron microscopical examination showed myoepithelial differentiation, indicative of a salivary gland origin. To our knowledge, the present case represents the only confirmed myoepithelioma that shows features indicative of malignant potential. Myoepitheliomas may be related to mixed tumors of salivary glands.

Topics: Adolescent; Biopsy; Cell Nucleus; Chromatin; Cobalt Radioisotopes; Diagnosis, Differential; Gingiva; Gingival Neoplasms; Glycogen; Humans; Male; Maxilla; Maxillary Neoplasms; Microscopy; Microscopy, Electron; Myoepithelioma; Radiography; Salivary Gland Neoplasms; Staining and Labeling

A malignant glycogen-rich adenocarcinoma of palatal salivary glands is reported. Histopathology revealed nonencapsulated nests and cords of polyhedral cells showing voluminous clear cytoplasms and cellular pleomorphisms, separated by fine vascular septae. Small and large ducts were infrequently seen showing apparent transition of large ducts into clear cells. The tumor cells were PAS- and Best-carmine positive, diastase soluble, and mucicarmine and Alcian-blue negative. Ultrastructurally, the tumor cells were arranged in solid nests and cords of electron-lucent cells surrounding single or multiple lumina, and surrounded by basement lamina. Occasional fusiform electron-dense cell processes were present beneath the basement lamina. The electron-lucent cells were joined by junctional complexes, contained intracytoplasmic canals, and were filled with massive accumulations of beta glycogen particles. The electron-dense processes contained interlacing whorls of fine filaments and exhibited peripheral focal densities. The findings suggest that this glycogen-rich malignant tumor is of epithelial origin most probably of ductal cells.

Topics: Adenocarcinoma; Glycogen; Humans; Male; Microscopy, Electron; Middle Aged; Salivary Gland Neoplasms

Topics: Adult; Age Factors; Aged; Carcinoma; Carcinoma, Adenoid Cystic; Diagnosis, Differential; Endoplasmic Reticulum; Epithelial Cells; Female; Glycogen; Humans; Male; Middle Aged; Myoepithelioma; Parotid Neoplasms; Pinocytosis; Salivary Gland Neoplasms; Sex Factors; Submandibular Gland

Topics: Acid Phosphatase; Alkaline Phosphatase; Biopsy; Carcinoma, Adenoid Cystic; Ear Neoplasms; Ear, External; Esterases; Exocrine Glands; Glycogen; Histocytochemistry; Humans; Lipids; Microscopy, Electron; Salivary Gland Neoplasms; Succinate Dehydrogenase; Tracheal Neoplasms

Topics: Adenoma; Glycogen; Humans; Parotid Neoplasms; Salivary Gland Neoplasms; Salivary Glands