Adenoid Cystic Carcinoma

 Only a few cases have metastasized, usually to lymph nodes and lungs


• Usually a few centimeters, can be up to 8 cm


• Composed of infiltrative lobules, islands, and cords of basaloid cells
image Numerous cystic and ductular spaces with prominent cribriform pattern

• Cells are typically small, relatively monomorphic appearing, and cuboidal shaped

Ancillary Tests

• Epithelial cells stain positive with EMA, CEA-m, and cytokeratins (low and high molecular weight keratins)

• S100, p63, GFAP, SMA, MSA, and calponin often stain peripheral cells, consistent with myoepithelial differentiation

Top Differential Diagnoses

• Basal cell carcinoma (BCC)

• Metastatic adenoid cystic carcinoma

• Other primary cutaneous adnexal tumors

Adenoid Cystic Carcinoma
Adenoid cystic carcinoma (ACC) at low magnification shows a dermal-based basaloid neoplasm with numerous cribriform spaces image containing basophilic mucin and showing a prominent Swiss cheese-like pattern.

Adenoid Cystic Carcinoma With Prominent Mucin
Higher magnification of ACC shows relatively bland basaloid cells surrounding the ductal lumina containing prominent collections of blue mucinous material.

Adenoid Cystic Carcinoma With Perineural Invasion
ACC frequently shows perineural invasion, which accounts for its high local recurrence rate. Here, a large central nerve image is surrounded by multiple tumor cords and ducts.

SMA Immunohistochemistry in ACC
ACC typically demonstrates expression of myoepithelial markers including SMA (shown here), MSA, calponin, cytokeratins, S100, and GFAP.



• Adenoid cystic carcinoma (ACC)


• Primary cutaneous adenoid cystic carcinoma


• Rare adnexal tumor showing prominent cribriform pattern and perineural invasion



• May be related to chronic sun damage in some cases

Apr 24, 2017 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Adenoid Cystic Carcinoma

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