|
 Figure 1.1.1 Acinic cell carcinoma with a solid proliferation of serous acinar cells that contain numerous blue-purple granules in their cytoplasm. |
 Figure 1.1.2 Acinic cell carcinomas may show a combination of cell types including serous acinar cells, vacuolated cells, clear cells, and nonspecific glandular cells. |
 Figure 1.1.3 Acinic cell carcinoma demonstrating a mixture of solid, microcystic, and follicular growth patterns. |
 Figure 1.1.4 Acinic cell demonstrating a papillary-cystic growth pattern. |
 Figure 1.1.5 Acinic cell is consistently positive for DOG-1 in a membranous, canalicular-type distribution. |
 Figure 1.1.6 Mammary analogue secretory carcinoma exhibiting microcystic growth. This is the most common growth pattern of mammary analogue secretory carcinoma. |
 Figure 1.1.7 Mammary analogue secretory carcinoma with a follicular growth pattern. With the colloid-like eosinophilic secretions, the tumor mimics thyroid tissue. |
 Figure 1.1.8 Mammary analogue secretory carcinoma with papillary cystic growth. |
 Figure 1.1.9 Mammary analogue secretory carcinoma is comprised of a uniform population of cells with an abundant, eosinophilic cytoplasm. The nucleus is large and round to oval and has a visible nucleolus. |
 Figure 1.1.10 Mammary analogue secretory carcinoma is consistently positive for S100. |
 Figure 1.1.11 Mammary analogue secretory carcinoma is consistently positive for mammaglobin. |
 Figure 1.1.12 Mammary analogue secretory carcinoma harbors translocations for ETv6. In this break apart FISH assay, one copy of the ETv6 gene is intact (red and green signals together) and one is rearranged (red and green signals apart). |
|
 Figure 1.2.1 Adenoid cystic carcinoma with an infiltrative collection of tubules and cribriform structures. |
 Figure 1.2.2 Adenoid cystic carcinoma with cribriform growth. There is a true duct (center) with eosinophilic cytoplasm, numerous pseudoducts, and a predominance of myoepithelial cells with dark, angulated nuclei. |
 Figure 1.2.3 Adenoid cystic carcinomas are comprised of true ductal cells and myoepithelial cells. In this tumor, the eosinophilic ductal cells are surrounded by a zone of clear myoepithelial cells in a way that resembles epithelial-myoepithelial carcinoma. The basophilic stromal matrix is characteristic of adenoid cystic carcinoma. |
 Figure 1.2.4 Epithelial-myoepithelial carcinoma with numerous eosinophilic ducts that are tightly coupled with a surrounding layer of myoepithelial cells with abundant clear cytoplasm. |
 Figure 1.2.5 Epithelial-myoepithelial carcinoma with myoepithelial cells demonstrating large nuclei with open chromatin and prominent nucleoli. |
 Figure 1.2.6 Epithelial-myoepithelial carcinoma with a predominance of myoepithelial cells. |
 Figure 1.2.7 Epithelial-myoepithelial carcinoma demonstrating irregular infiltration intro surrounding fat. |
|
 Figure 1.3.1 Adenoid cystic carcinoma growing as cribriform and solid nests of basaloid cells. |
 Figure 1.3.2 Adenoid cystic carcinoma consisting predominantly of myoepithelial cells characterized by hyperchromatic and angulated nuclei. They form rounded cylindromatous (pseudoglandular) spaces. A few true ducts lined by cells with eosinophilic cytoplasm are also present. |
 Figure 1.3.3 Adenoid cystic carcinomas are positive for p63 in a patchy pattern that spares the ductal cells. |
 Figure 1.3.4 Adenoid cystic carcinomas are usually positive for one or more myoepithelial cell markers such as S100. |
 Figure 1.3.5 Basaloid variant of squamous cell carcinoma growing as rounded nests of cells separated by thin lines of hyalinized stroma, creating a jigsaw puzzle-like pattern. |
 Figure 1.3.6 Basaloid variant of squamous cell carcinoma with central comedo necrosis and pseudoglandular spaces created by the deposition of hyaline basement membrane-like material. Evidence of squamous differentiation is seen as an adjacent focus of keratinizing squamous cell carcinoma and as abrupt keratinization with a basaloid nest (inset). |
 Figure 1.3.7 Basaloid variant of squamous cell carcinoma with a focus of abrupt keratinization. Evidence of keratinization helps distinguish the basaloid variant of squamous cell carcinoma from the solid variant of adenoid cystic carcinoma. |
 Figure 1.3.8 Basaloid variant of squamous cell carcinoma is typically positive for p63 in a diffuse pattern. |
|
 Figure 1.4.1 Adenosquamous carcinoma with two separate, distinct components: squamous cell carcinoma (top left) and adenocarcinoma (bottom right). |
 Figure 1.4.2 Adenosquamous carcinoma associated with squamous carcinoma in situ of the surface epithelium. The invasive portion of the tumor shows areas of obvious glandular differentiation. |
 Figure 1.4.3 Adenosquamous carcinoma exhibits marked cellular atypia in both the squamous (upper) and glandular (lower) tumor components. |
 Figure 1.4.4 In adenosquamous carcinomas, mucin stains highlight luminal mucin in the glandular component. |
 Figure 1.4.5 High-grade mucoepidermoid carcinoma composed of predominantly intermediate and squamoid cells. Mucinous cells may be difficult to appreciate in routinely stained sections. |
 Figure 1.4.6 High-grade mucoepidermoid carcinoma with a single mucin droplet in a nest of malignant squamoid cells. |
 Figure 1.4.7 In high-grade mucoepidermoid carcinomas, mucin stains (e.g., mucicarmine stain) can be helpful in highlighting the presence of mucinous cells. |
|
 Figure 1.5.1 Basal cell adenocarcinomas infiltrate surrounding tissues as rounded pushing nodules. |
 Figure 1.5.2 Basal cell adenocarcinomas show a nested pattern of growth with some suggestion of palisading at the periphery of the lobules. Cellular atypia and mitotic activity are often minimal. |
 Figure 1.5.3 The tumor cells of basal cell adenocarcinoma have minimal cytoplasm, round to oval nuclei with pale chromatin, and small nucleoli. Squamous nests and ductal formations are often encountered in the center of the basaloid lobules. |
 Figure 1.5.4 Basal cell adenocarcinoma with intra- and intercellular deposition of eosinophilic basal lamina material. |
 Figure 1.5.5 Adenoid cystic carcinomas are highly infiltrative carcinomas and almost always exhibit perineural invasion. |
 Figure 1.5.6 Adenoid cystic carcinoma with a mixture of tubules and cribriform structures. Cylindromatous microcystic spaces filled with basophilic mucoid or hyaline basement membrane-like material are characteristic findings. |
 Figure 1.5.7 With loss of cribriform structures and the presence of more solid growth, adenoid cystic carcinoma can be easily confused with basal cell adenocarcinoma. |
 Figure 1.5.8 Adenoid cystic carcinoma with tumor cells that have clear cytoplasm and hyperchromatic, angulated nuclei with no nucleoli. The cylindromatous spaces are filled with a basophilic mucoid material. |
 Figure 1.5.9 The solid variant of adenoid cystic carcinoma exhibits high cellularity and increased cytologic atypia. |
|
 Figure 1.6.1 Basal cell adenoma with a thin capsule and no invasive growth. |
 Figure 1.6.2 Basal cell adenoma with nests and trabeculae of basaloid cells that often palisade at the periphery and stream within the center of the nests. |
 Figure 1.6.3 Ductal lumina are often observed between the basaloid cells. They are prominent in the tubular form of basal cell adenoma. |
 Figure 1.6.4 The membranous form of basal cell adenoma, abundant hyaline material is deposited in and around the islands of basal cells. |
 Figure 1.6.5 Basal cell adenocarcinoma demonstrating rounded islands of basal cells extending into fat. The presence of invasion is a key feature in distinguishing basal cell carcinoma from basal cell adenoma. |
 Figure 1.6.6 Basal cell adenocarcinoma with perineural invasion. |
 Figure 1.6.7 Basal cell adenocarcinoma exhibiting uniform, elongated cells with mild atypia and an elevated mitotic rate. |
|
 Figure 1.7.1 Basal cell adenoma with a prominence of branching tubular formations (tubulotrabecular form of basal cell adenoma). In contrast to canalicular adenoma, the stroma is more cellular. |
 Figure 1.7.2 In this tubulotrabecular form of basal cell adenoma, some of the trabeculae are solid, and the cells lack the columnar appearance seen in canalicular adenomas. |
 Figure 1.7.3 Canalicular adenoma with double rows of columnar cells forming anastomosing canaliculi. The stroma is loose and paucicellular. |
 Figure 1.7.4 Canalicular adenoma is composed of a single layer of uniform, columnar cells. |
 Figure 1.7.5 Canalicular adenoma with diffuse immunostaining for S100. |
|
 Figure 1.8.1 Basal cell adenoma comprised of a circumscribed and encapsulated proliferation of basaloid cells. |
 Figure 1.8.2 Basal cell adenoma with nests and trabeculae of basaloid cells that often palisade at the periphery and stream within the center of the nests. |
 Figure 1.8.3 The cellularity of the stroma in basal cell adenomas is variable, but they lack the abundant loose chondromyxoid stroma that characterizes most pleomorphic adenomas. In this example, the stroma is comprised of a cellular proliferation of spindled cells. |
 Figure 1.8.4 Pleomorphic adenomas are circumscribed, often encapsulated neoplasms comprised of epithelial and modified myoepithelial elements in a stroma that is often loose and myxoid. |
 Figure 1.8.5 The epithelial cells of pleomorphic adenomas can take on many forms, but they most commonly form ducts. They are intimately associated with myoepithelial cells that merge with a chondromyxoid stroma. |
 Figure 1.8.6 Stromal poor areas of a pleomorphic adenoma may resemble basal cell adenoma. |
 Figure 1.8.7 Same tumor as shown in Figure 1.8.6. Thorough microscopic evaluation can usually disclose areas where the loose stroma of pleomorphic adenoma is better developed. |
|
 Figure 1.9.1 Invasive carcinoma ex-pleomorphic adenoma (right) infiltrating into periparotid soft tissues. Although most of the pleomorphic adenoma has been overridden by the carcinoma, its chondroid stroma is still focally present (left). |
 Figure 1.9.2 Although the carcinomatous component may be either low or high grade, most are high-grade adenocarcinomas with features of salivary duct carcinoma. |
 Figure 1.9.3 Carcinoma ex-pleomorphic adenoma, noninvasive type, with salivary duct carcinoma contained within the ductal system and entirely surrounded by actin-positive myoepithelial cells (immunohistochemical stain for smooth muscle actin). |
 Figure 1.9.4 Infarcted pleomorphic adenoma with a central zone of coagulative necrosis. |
 Figure 1.9.5 Infarcted pleomorphic adenoma with a central zone of infarction (left) surrounded by a zone of highly proliferative squamous metaplasia (center). The zone of squamous metaplasia may be mistaken for squamous cell carcinoma. |
 Figure 1.9.6 Adjacent to the zone of infarction, the ducts of pleomorphic adenoma are filled with metaplastic squamous cells. |
 Figure 1.9.7 The zones of proliferative squamous metaplasia may exhibit dyskeratosis and cellular atypia. |
 Figure 1.9.8 Thorough inspection will usually disclose areas of conventional pleomorphic adenoma. In this area, the zone of squamous metaplasia shows transition with the nonmetaplastic ductal epithelium. |
|
 Figure 1.10.1 Carcinoma ex-pleomorphic adenoma with a high-grade salivary duct carcinoma (bottom) arising in association with a chondroid stroma-rich pleomorphic adenoma (top). |
 Figure 1.10.2 Carcinoma ex-pleomorphic adenoma, with carcinoma demonstrating not only invasion into fat but also frankly malignant cellular features. |
 Figure 1.10.3 Recurrent pleomorphic adenoma, with multiple nodules of stroma-rich pleomorphic adenoma scattered throughout the fat in a pseudoinvasive manner. |
 Figure 1.10.4 Recurrent pleomorphic adenoma, with a mixture of stromal and epithelial components that exhibit no cellular atypia. The cellularity of the various nodules may be highly variable, but most nodules have an abundant myxoid stroma. |
 Figure 1.10.5 The recurrent nodules of pleomorphic adenoma often arise in a background of changes reflecting prior surgery such as scarring. In this example, the nodule is arising next to a traumatic neuroma characterized by proliferating nerve twiglets. |
|
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
