scholarly journals Cytopathological Findings of Secretory Carcinoma of the Salivary Gland and the Diagnostic Utility of Giemsa Staining

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2284
Author(s):  
Yuria Egusa ◽  
Midori Filiz Nishimura ◽  
Satoko Baba ◽  
Kengo Takeuchi ◽  
Takuma Makino ◽  
...  

Secretory carcinoma is a salivary gland neoplasm first described as a mammary analogue secretory carcinoma by Skalova et al. in 2010 and redesignated as a secretory carcinoma in the 2017 World Health Organization Classification of Head and Neck Tumors. Secretory carcinoma diagnosis is reliant on specific cytological and histological findings and the detection of an ETV6-NTRK3 fusion gene. Here, we examined the clinical and cytopathological features of four cases of secretory carcinoma occurring in three males and a female, aged between 39 and 74 years. All four tumors involved the parotid gland, and were found to have the ETV6-NTRK3 fusion gene. Fine-needle aspiration-based cytology smears of all tumors displayed papillary and/or dendritic pattern clusters, some of which were associated with blood vessels. The neoplastic cells displayed enlarged nuclei with fine chromatin and small, distinct, single nucleoli. Furthermore, several neoplastic cells with a characteristic vacuolated cytoplasm were identified in each specimen. Giemsa staining revealed cytoplasmic vacuolation, intracytoplasmic metachromatic secretions and/or various sized metachromatic granules, and a background of metachromatic mucin in all four specimens. Given this, we conclude that these cytological findings, especially those of the Giemsa staining, might be helpful in the diagnosis of secretory carcinoma.

Author(s):  
Shashikant Anil Pol ◽  
Surinder K. Singhal ◽  
Nitin Gupta ◽  
Himanshu Bayad

<p>Mammary analogue secretary carcinoma are salivary gland tumors similar to secretary carcinoma of breast histologically. It usually affects adults with mean age group of 45 years. Clinically it is usually slow growing, low grade malignancy with favorable prognosis. We are reporting a case of 47 years old female presented with complaints of swelling behind left ear for last 7 years. It was slow growing, painless and persistent. On examination, 4 x 3 cm swelling was present just below left ear lobule. It was nontender, firm, irregular in shape with smooth surface with slight mobility and overlying skin pinchable. Fine needle aspiration cytology suggested benign tumor with cystic change. On contrast enhanced computed tomography scan, there was a lobulated hypodense lesion measuring 24×35×32 mm with internal septations and enhancement of wall in expected location of superficial as well as deep lobe of left parotid gland. Patient underwent left total conservative parotidectomy and histopathology came out to be secretory analogue mammary carcinoma. Subsequently she received post-operative radiotherapy. Patient is on regular follow up and disease free till date. Usually mammary analogue secretory carcinoma is a low-grade malignancy with good prognosis. Immunohistochemistry is confirmatory which shows positivity for S-100 protein and mammaglobin.</p>


2020 ◽  
pp. 1-9
Author(s):  
Yukiya Hirata ◽  
Kayoko Higuchi ◽  
Koichi Tamashiro ◽  
Keisuke Koja ◽  
Yuiko Yasutomi ◽  
...  

<b><i>Objective:</i></b> The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is a recently published evidence-based categorization system for salivary gland fine-needle aspiration (FNA). We applied MSRSGC to Japanese cases and evaluated its utility. <b><i>Study Design:</i></b> A total of 480 FNA cases were reviewed. We recategorized each case into one of the MSRSGC categories. The risk of neoplasm (RON) and the risk of malignancy (ROM) for each diagnostic category in MSRSGC, and the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) for malignancy and for neoplasms were calculated for cases with histological follow-up. In addition, the overall ROM (O-ROM) was calculated for all FNA cases. <b><i>Results:</i></b> RON, ROM, and O-ROM rates were as follows – non-diagnostic: 51.3, 5.1, and 1.0%; non-neoplastic: 0, 0, and 0%; atypia of undetermined significance: 83.9, 12.9, and 7.3%; neoplasm, benign: 100, 0, and 0%; salivary gland neoplasm of uncertain malignant potential: 100, 32.1, and 23.7%; suspicious for malignancy: 100, 85.7, and 60%; and malignant: 100, 100, 81.8%. The sensitivity, specificity, and accuracy with (without) indeterminate cases for malignancy were 65 (100), 99 (99), 92% (99%) and PPV and NPV were 96 and 100%, respectively, and those for neoplasms were 84 (100), 100 (100), 85% (100%), and PPV and NPV were 100 and 100%, respectively. <b><i>Conclusions:</i></b> The MSRSGC is useful for stratification of ROM and for promoting the performance of salivary gland FNA. The MSRSGC could be easily introduced in Japan and may improve the Japanese salivary gland FNA status.


2019 ◽  
Vol 33 (4) ◽  
pp. 541-550 ◽  
Author(s):  
Kiyong Na ◽  
Juan C. Hernandez-Prera ◽  
Jae-Yol Lim ◽  
Ha Young Woo ◽  
Sun Och Yoon

AbstractSecretory carcinoma is a salivary gland tumor with a characteristic chromosomal translocation that results in an ETV6-NTRK3 fusion gene. Secretory carcinoma shows relatively frequent rates of lymph-node metastasis and tumor recurrence and has a characteristic histology. Except for the ETV6 translocation, genomic alterations in secretory carcinoma have not been reported. In the present study, we characterized the novel recurrent genetic mutations of secretory carcinoma. On the basis of histology, immunohistochemistry, and ETV6 gene break-apart fluorescence in situ hybridization assays, 22 tumors were classified as secretory carcinomas (19 ETV6 translocation-positive and 3 ETV6 translocation-negative secretory carcinomas) and their clinicopathologic characteristics were reviewed. Targeted deep sequencing analyses were performed on 20 secretory carcinomas (17 ETV6 translocation-positive and 3 ETV6 translocation-negative secretory carcinomas) to investigate their genetic alterations. The A16V (C→T) mutation in PRSS1, which encodes a cationic trypsinogen and has a mutation associated with hereditary pancreatitis and pancreatic adenocarcinoma, was observed in 40% (8/20) (7/17 of ETV6 translocation-positive and 1/3 of ETV6 translocation-negative secretory carcinomas). Pathogenic variants of MLH1, MUTYH, and STK11 were also identified. Variants of uncertain significance included mutations in KMT5A. These novel characteristic genetic alterations may advance current understandings of secretory carcinoma tumorigenesis and progression, leading to improved diagnoses and treatment strategies.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Takako Inaba ◽  
Yuki Fukumura ◽  
Tsuyoshi Saito ◽  
Junkichi Yokoyama ◽  
Shinichi Ohba ◽  
...  

Mammary analogue secretory carcinoma (MASC) is a recently recognized tumor of salivary glands characterized by the ETV6-NTRK3 fusion gene. This tumor is very rare in children and adolescents. We report a case of MASC in a 15-year-old girl, the fifth youngest case so far reported. The patient complained of a left infra-auricular mass that gradually enlarged for a year. Fine-needle aspiration cytology/imprint cytology showed individual tumor cells that had faintly eosinophilic granular cytoplasm with secretion granules sometimes seen adjacent to the tumor cells. These cytological features overlapped between those of zymogen granule-poor acinic cell carcinoma (AciCC) and MASC. In addition to the case report, we present a review of the related literature with a focus on the cytological features of MASC. The differential diagnostic clues are also discussed.


Author(s):  
Salem Mohammed Hassan Alharthi ◽  
Laila Mohammed Alanazi ◽  
Dalal Jumah Alturaif ◽  
Wesam Yousef Othman Alibrahim ◽  
Waleed Yahya Binammar ◽  
...  

As reported on 23rd May 2021, there are a total of 167,313,629 confirmed cases of Covid-19 all across the world with a mortality of about 3,473,851 whereas in Saudi Arabia 439,847 were registered cases of covid-19 and 7,237 deaths. According to the World Health Organization (WHO) a total of 12,244,264 people were vaccinated with Covid-19 vaccination. Covid-19 is a respiratory infectious disease. More recent researches on SARS-COV-2 suggests the entry of the virus into the host cell using the host entry factors like TMPRSS-2, TMPRSS-4 and ACE-2 in the oral tissues. The spike proteins of the SARS COV-2 attaches to the ACE-2 and TMPRSS2 of the salivary gland. Saliva provides the lubrication of the oral cavity, initiation of digestion and provides immunity in host. A complete research of all the articles was done using databases like: SCOPUS, PUBMED, EMBASE and WEB OF SCIENCE. In case of SARS CoV-2, the salivary glands act as reservoir for the virus. Intake of these viruses present in infectious saliva droplets found in the air would lead to the transmission of infection to an individual. Saliva is more efficient when compared to the blood as it doesn't clot. A reduced secretion of saliva is observed in patients post the covid 19 disease.


Author(s):  
Stephanie Minnies ◽  
Byron W.P. Reeve ◽  
Loren Rockman ◽  
Georgina Nyawo ◽  
Charissa C. Naidoo ◽  
...  

Background: Tuberculosis lymphadenitis (TBL) is the most common extrapulmonary TB (EPTB) manifestation. Xpert MTB/RIF Ultra (Ultra) is a World Health Organization-endorsed diagnostic test, but performance data for TBL, including on non-invasive specimens, are limited. Methods: Fine needle aspiration biopsies (FNABs) from outpatients (≥18 years) with presumptive TBL (n=135) underwent: 1) routine Xpert (later Ultra once programmatically available), 2) a MGIT 960 culture (if Xpert- or Ultra-negative, or rifampicin-resistant), and 3) study Ultra. Concentrated paired urine underwent Ultra. Primary analyses used a microbiological reference standard (MRS). Results: In a head-to-head comparison (n=92) of FNAB study Ultra and Xpert, Ultra had increased sensitivity [91% (95% confidence interval 79, 98) vs. 72% (57, 84); p=0.016] and decreased specificity [76% (61, 87) vs. 93% (82, 99); p=0.020], and detected patients not on treatment. HIV nor alternative reference standards affected sensitivity and specificity. In patients with both routine and study Ultras, the latter detected more cases [+20% (0, 42); p=0.034] and, further indicative of potential laboratory-based room-for-improvement (e.g., specimen processing optimisation), false-negative study Ultras were more inhibited than true-positives. Study Ultra false-positives had less mycobacterial DNA than true-positives [trace-positive proportions 59% (13/22) vs. 12% (5/51); p<0.001]. “Trace” exclusion or recategorization removed potential benefits offered over Xpert. Urine Ultra had low sensitivity [18% (7, 35)]. Conclusions: Ultra on FNABs is highly sensitive and detects more TBL than Xpert. Patients with FNAB Ultra-positive “trace” results, most of whom will be culture-negative, may require additional clinical investigation. Urine Ultra could reduce the number of patients needing invasive sampling.


2020 ◽  
pp. 106689692093778
Author(s):  
Ludovica De Vincentiis ◽  
Maria Paola Mariani ◽  
Anna Maria Cesinaro ◽  
Anna Maria Dalena ◽  
Gerardo Ferrara

Introduction. Previously considered an exceedingly rare entity, sebaceous carcinoma of the breast is now regarded in the World Health Organization 2019 classification as a “special histopathological pattern” of invasive breast carcinoma of no special type. Case Description. In this article, we report the case of a fine needle aspiration cytology and the histopathological features of a breast carcinoma with clear-cut morphological features suggesting sebaceous differentiation, but showing no positive staining with the anti-adipophilin antibody. Conclusions. A morphologically clear-cut sebaceous differentiation is not invariably associated with adipophilin positivity; moreover, in breast carcinoma, adipophilin positivity does not automatically imply sebaceous differentiation. At present, immunomorphological evidence for the recognition of sebaceous carcinoma as a “special type” breast carcinoma subtype is too weak.


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