Distinctive pattern of glial fibrillary acidic protein immunoreactivity useful in distinguishing fragmented pleomorphic adenoma, canalicular adenoma and polymorphous low grade adenocarcinoma of minor salivary glands

被引：24

作者：

Curran A.E. ^{[1
]}

Allen C.M. ^{[2
]}

Beck F.M. ^{[3
]}

Damm D.D. ^{[4
]}

Murrah V.A. ^{[1
]}

机构：

[1] Department of Diagnostic Sciences, CB 7450, Division of Oral and Maxillofacial Pathology, University of North Carolina School of Dentistry, Chapel Hill

[2] Oral and Maxillofacial Pathology, Ohio State University College of Dentistry, Columbus, OH

[3] Department of Oral Biology, Ohio State University College of Dentistry, Columbus, OH

[4] Section of Oral Pathology, University of Kentucky College of Dentistry, Lexington, KY

来源：

Head and Neck Pathology | 2007年 / 1卷 / 1期

关键词：

Canalicular adenoma; Glial fibrillary acidic protein; Immunohistochemistry; Pleomorphic adenoma; Polymorphous low-grade adenocarcinoma; Salivary gland neoplasms;

D O I：

10.1007/s12105-007-0003-8

中图分类号：

学科分类号：

摘要：

Objectives Immunohistochemistry (IHC) can be helpful in the diagnosis of minor salivary gland neoplasms including those that have been incisionally biopsied or fragmented during surgery that do not contain key diagnostic features on hematoxylin and eosin sections. IHC has been used as an adjunct to distinguish among many salivary gland neoplasms using both qualitative and quantitative methods. The objective of this study was to determine whether a distinctive immunoreactivity staining pattern to GFAP can be consistently observed among three selected minor salivary gland neoplasms and thus serve as a diagnostic adjunctive procedure. Study Design Glial fibrillary acidic protein (GFAP) reactivity was examined among 78 minor salivary gland neoplasms: 27 canalicular adenomas (CAA), 21 pleomorphic adenomas (PA) and 30 polymorphous low grade adenocarcinomas (PLGA). Each case was evaluated by two oral and maxillofacial pathologists (OMP) blinded to the diagnosis. Consensus was reached on the pattern of GFAP reactivity among the neoplastic cells and on the similarities and differences among the cases. Results Ninety-six percent (96%) of CAAs demonstrated a distinctive linear immunoreactive pattern among cells in proximity to connective tissue interface. All (100%) PAs demonstrated diffuse immunopositivity within tumor cells. All (100%) PLGAs showed little or no intralesional reactivity and no peripheral linear immunoreactivity. Additional challenge cases were examined by outside OMPs to demonstrate the utility of these findings. Conclusions This study demonstrates that the pattern of GFAP immunoreactivity may be an adjunct to diagnosis among PA, CAA and PLGA. The pattern of distinctly linear GFAP immunoreactivity at the tumor/ connective tissue interface in CAA has not been reported previously. This distinctive feature may permit the pathologist to differentiate among CAA, PA and PLGA when an incisional biopsy and/or fragmentation cause key diagnostic features to be absent. Because each of these neoplasms requires a different treatment approach, this can be of major significance. © Humana Press Inc. 2007.

引用

页码：27 / 32

页数：5

共 12 条

[1]

Gnepp D.R., el-Mofty S., Polymorphous low grade adenocarcinoma: Glial fibrillary acidic protein staining in the differential diagnosis with cellular mixed tumors, Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 83, pp. 691-695, (1997)

[2]

Castle J.T., Thompson L.D., Frommett R.A., Wenig B.M., Kessler H.P., Polymorphous low-grade adenocarcinoma: A clinicopathologic study of 164 cases, Cancer, 86, pp. 207-219, (1999)

[3]

Curran A.E., White D.K., Damm D.D., Murrah V.A., Polymorphous low-grade adenocarcinoma versus pleomorphic adenoma of minor salivary glands: Resolution of a diagnostic dilemma by immunohistochemical analysis with glial fibrillary acidic protein, Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 91, pp. 194-199, (2001)

[4]

Gould V.E., Koukoulis G.K., Jansson D.S., Franke W.W., Moll R., Coexpression patterns of vimentin and glial fibrillary acidic protein in normal, hyperplastic and neoplastic breast, Am J Surg Pathol, 137, pp. 1143-1155, (1990)

[5]

Liuder T.M., Kros J.M., Sillevis Smitt P.A., van den Bent M.J., Vecht C.J., Glial fibrillary acidic protein and its fragments discriminate astrocytoma from oligodenroglioma, Electrophoresis, 20, pp. 1087-1091, (1999)

[6]

Murphy K.G., Hatton J.D., Role of glial fibrillary acidic protein expression in the biology of human glioblastoma U-373MG cells, J Neurosurg, 89, pp. 997-1006, (1998)

[7]

Zarbo R.J., Prasad A.R., Regezi J.A., Gown A.M., Savera A.T., Salivary gland basal cell and canalicular adenomas: Immunohistochemical demonstration of myoepithelial cell participation and morphogenetic considerations, Arch Pathol Lab Med, 124, pp. 401-405, (2000)

[8]

Sharkey T.E., Systematic evaluation of WHO classification of salivary gland tumors: A clinicopathologic study of 366 cases, Am J Clin Pathol, 67, pp. 272-278, (1977)

[9]

Ellis G.L., Auclair P.L., Tumors of the salivary glands, (1996)

[10]

Nishimura T., Furukawa M., Kawahara E., Miwa A., Differential diagnosis of pleomorphic adenoma by immunohistochemical means, J Layngol Otol, 105, pp. 1057-1060, (1991)

← 1 2 →