Difference between revisions of "Salivary duct carcinoma"
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = | | Image = Salivary duct carcinoma - low mag.jpg | ||
| Width = | | Width = | ||
| Caption = | | Caption = Salivary duct carcinoma. [[H&E stain]]. | ||
| Micro = | | Micro = varied arch. (sheets, nests, cords, cribriform, micropapillary), neoplastic cells line-up around cystic spaces "Roman bridges", nuclear atypia, apocrine snouts, decapitation secretions | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = | | LMDDx = [[ductal carcinoma of the breast]] | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = | ||
| Line 14: | Line 14: | ||
| Gross = | | Gross = | ||
| Grossing = | | Grossing = | ||
| Site = | | Site = [[salivary gland]] | ||
| Assdx = | | Assdx = | ||
| Syndromes = | | Syndromes = | ||
| Line 24: | Line 24: | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = | | Prognosis = poor | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = other [[salivary gland]] tumours | ||
}} | }} | ||
'''Salivary duct carcinoma''', abbreviated '''SDC''', is a rare [[salivary gland]] tumour that typically has an aggressive course. | '''Salivary duct carcinoma''', abbreviated '''SDC''', is a rare [[salivary gland]] tumour that typically has an aggressive course. | ||
Revision as of 09:30, 29 July 2013
| Salivary duct carcinoma | |
|---|---|
| Diagnosis in short | |
 Salivary duct carcinoma. H&E stain. | |
|
| |
| LM | varied arch. (sheets, nests, cords, cribriform, micropapillary), neoplastic cells line-up around cystic spaces "Roman bridges", nuclear atypia, apocrine snouts, decapitation secretions |
| LM DDx | ductal carcinoma of the breast |
| Site | salivary gland |
|
| |
| Prognosis | poor |
| Clin. DDx | other salivary gland tumours |
Salivary duct carcinoma, abbreviated SDC, is a rare salivary gland tumour that typically has an aggressive course.
General
- Malignant counterpart of salivary duct adenoma.
- Male:female ~= 4:1.
- Dismal prognosis.[1]
- Typically >50 years old.
- Mostly in the parotid.
Microscopic
Features - resembles ductal breast carcinoma:[1]
- Architecture: sheets, nests, cords, cribriform, micropapillary.
- Neoplastic cells line-up around cystic spaces "Roman bridges".
- Nuclear atypia (variation in size, shape, staining).
- Apocrine snouts - pseudopod-like/lollipop-like undulations of the cell membrane.
- Decapitation secretions - apocrine snouts (membrane bound blobs of cytoplasm) that have separated from its mother cell.
Notes:
- Similar to ductal breast carcinoma - key to remember.
DDx:
- Carcinoma ex pleomorphic adenoma with SDC component.
Images
SDC - very low mag. (WC/Nephron)
SDC - low mag. (WC/Nephron)
SDC - intermed. mag. (WC/Nephron)
SDC - high mag. (WC/Nephron)
SDC - very high mag. (WC/Nephron)
SDC - low mag. (WC/Nephron)
SDC - intermed. mag. (WC/Nephron)
www:
Subtypes
- Conventional.
- Mucinous - worse prognosis; opposite of what would one expect from the outcomes in breast cancer.
- Micropapillary - assoc. with a poor prognosis.
- Sarcomatoid/spindle cell.
IHC
- LMWK, EMA, CK7, CK19 +ve.
- p63 -ve.
- Androgen receptor +ve.
- BRST2 (GCDFP-15) +ve.
- HER2 +ve ~21%; use of trastuzumab (Herceptin) not systematically studied.
Curiosity:
- PSA +/-.
- PSAP +/-.
- ER-beta +ve.[2]
- ER-alpha -ve (the common ER stain).
See also
References
- ↑ 1.0 1.1 Rajesh, NG.; Prayaga, AK.; Sundaram, C.. "Salivary duct carcinoma: correlation of morphologic features by fine needle aspiration cytology and histopathology.". Indian J Pathol Microbiol 54 (1): 37-41. doi:10.4103/0377-4929.77321. PMID 21393874. http://www.ijpmonline.org/text.asp?2011/54/1/37/77321.
- ↑ URL: http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/MajorSalGlands_11protocol.pdf. Accessed on: 3 April 2012.