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. 2015 Mar;9(1):79-84.
doi: 10.1007/s12105-014-0554-4. Epub 2014 Jun 27.

Polymorphous low grade adenocarcinoma has a consistent p63+/p40- immunophenotype that helps distinguish it from adenoid cystic carcinoma and cellular pleomorphic adenoma

Lisa Rooper  1 , Rajni Sharma, Justin A Bishop
Affiliations

Polymorphous low grade adenocarcinoma has a consistent p63+/p40- immunophenotype that helps distinguish it from adenoid cystic carcinoma and cellular pleomorphic adenoma

Lisa Rooper et al. Head Neck Pathol. 2015 Mar.

Abstract

Polymorphous low grade adenocarcinoma (PLGA) is a tumor of minor salivary glands that exhibits considerable morphologic overlap with adenoid cystic carcinoma and cellular pleomorphic adenoma, especially in small biopsy specimens. Unlike these other tumor types. PLGAs do not harbor a myoepithelial component, yet their frequent positivity for p63 diminishes the usefulness of this particular myoepithelial marker as a discriminating immunostain. p40 is an antibody that recognizes ΔNp63, a p63 isoform that is more specific for true myoepithelial differentiation. As such, p40 immunostaining could help distinguish PLGAs from adenoid cystic carcinomas and pleomorphic adenomas. In this study, p63 and p40 immunohistochemistry was performed on paraffin embedded, formalin fixed tissue from 11 PLGAs, 101 adenoid cystic carcinomas, and 31 pleomorphic adenomas. All 11 PLGAs (100 %) were positive for p63 but completely negative for p40. Among adenoid cystic carcinomas, 91 of 101 (90 %) were positive for p63 and 90/101 (89 %) were positive for p40. The single discordant p63+/p40- adenoid cystic carcinoma exhibited solid architecture and high grade features not typically seen in PLGA. Among pleomorphic adenomas, 21/31 (68 %) were positive for p63 and 13/31 (42 %) were positive for p40. For the pleomorphic adenomas, the discordant p63+/p40- staining pattern was seen only in the overtly mesenchymal chondromyxoid stroma. The cellular epithelial component of the pleomorphic adenomas demonstrated concordant p63+/p40+ or p63-/p40- immunophenotypes. PLGA consistently exhibits a p63+/p40- immunophenotype that can help distinguish it from adenoid cystic carcinoma and cellular pleomorphic adenoma, tumors that characteristically demonstrate concordant p63 and p40 immunostaining patterns. A p63/p40 immunohistochemical panel can provide a valuable tool for making the distinction between these morphologically similar but clinically divergent entities.

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Figures

Fig. 1
Fig. 1
All polymorphous low grade adenocarcinomas (H&E, a) showed diffuse, strong, positivity for p63 (b) but complete negativity for p40 (c). In contrast, most of the adenoid cystic carcinomas (H&E, d) and pleomorphic adenomas (H&E, g) demonstrated positivity for both p63 (e, h) and p40 (f, i) in a peripheral (myoepithelial cell) pattern
Fig. 2
Fig. 2
The few adenoid cystic carcinomas and pleomorphic adenomas that demonstrated a discordant p63+/p40− immunophenotype did not show significant morphologic overlap with polymorphous low grade adenocarcinoma. One adenoid cystic carcinoma with high-grade cytology and solid architecture (a) showed focal positivity for p63 (b) but complete negativity for p40 (c). In the overt chondromyxoid stroma of eight pleomorphic adenomas (d), diffuse positivity for p63 (e) and complete negativity for p40 (f) was seen
See this image and copyright information in PMC

References

    1. Luna MA, Wenig BM. Polymorphous low-grade adenocarcinoma. In: Barnes L, Eveson JW, Reichart P, Sidransky D, editors. Pathology and genetics of head and neck tumours. Lyon: IARC Press; 2005. pp. 223–224.
    1. Ellis GL, Auclair PL. Polymorphous low-grade adenocarcinoma. AFIP atlas of tumor pathology: tumors of the salivary glands. Washington, DC: ARP Press; 2008. p. 246–259.
    1. Frierson HF, Jr, Mills SE, Garland TA. Terminal duct carcinoma of minor salivary glands. A nonpapillary subtype of polymorphous low-grade adenocarcinoma. Am J Clin Pathol. 1985;84:8–14. - PubMed
    1. Aberle AM, Abrams AM, Bowe R, et al. Lobular (polymorphous low-grade) carcinoma of minor salivary glands. A clinicopathologic study of twenty cases. Oral Surg Oral Med Oral Pathol. 1985;60:387–395. doi: 10.1016/0030-4220(85)90261-0. - DOI - PubMed
    1. Venkata V, Irulandy P. The frequency and distribution pattern of minor salivary gland tumors in a government dental teaching hospital, Chennai, India. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111:e32–e39. doi: 10.1016/j.tripleo.2010.08.019. - DOI - PubMed

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