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Abstracts from USCAP 2021: Head and Neck Pathology (635-663)

2021; Elsevier BV; Volume: 34; Linguagem: Inglês

10.1038/s41379-021-00762-5

1530-0285

Jason Chair, Rhonda K. Yantiss, Kristin Jensen Chair, Cme Subcommittee, Laura Collins, Raja R. Seethala, Ilan Weinreb, Benjamin Adam, Rouba Ali‐Fehmi, Daniela Allende, Ghassan Allo, Isabel Alvarado‐Cabrero, Catalina Amador, Tatjana Antic, Roberto Barrios, Rohit Bhargava, Luiz Blanco, Jennifer M. Boland, Alain Borczuk, Elena F. Brachtel, Marilyn M. Bui, Eric Burks, Shelley Caltharp, Wendy Cao, Barbara A. Centeno, Joanna Chan, Jennifer R. Chapman, Yunn‐Yi Chen, Hui Chen, Wei Chen, Sarah Chiang, Nicole A. Cipriani, Beth Z. Clark, Alejandro Contreras, Claudiu Cotta, Jennifer Cotter, David Kaminsky, Zubair Baloch, Daniel J. Brat, Sarah Dry, William C. Faquin, Yuri Fedoriw, Karen Fritchie, Jennifer Gordetsky, Melinda Lerwill, Anna Marie Mulligan, Liron Pantanowitz, David Papke, Carlos Parra‐Herran, Rajiv M. Patel, Deepa T. Patil, Charles M. Quick, Lynette M. Sholl, Olga K. Weinberg, Maria Westerhoff, Michael Cho, Pathologist-In-Training Emad, Bryan B. Hair, Brian B. Burkey, Shlomo A. Koyfman, Mobeen Rahman, Deborah J. Chute, Christopher C. Griffith, Bayan Alzumaili, Bin Xu, Maelle Saliba, Anjanie Khimraj, Ronald Ghossein, Nora Katabi,

Tumors and Oncological Cases

Background: Polymorphous adenocarcinoma (PAC) is a rare salivary gland malignancy characterized by diverse histologic patterns.This study aims to analyze pathologic and clinical findings to refine diagnostic and prognostic findings of significance.Design: All cases with a diagnosis of PAC, cribriform adenocarcinoma of minor salivary gland or polymorphous low-grade adenocarcinoma from 2000-2019 are included.Clinical and pathologic features were reviewed.Results: 55 cases are reviewed.The clinical and pathologic features are presented in table 1. 29 cases had cribriform pattern representing >30% of tumor architecture.One tumor demonstrated 21 mitotic figures per 10 HPF, focal necrosis, and pleomorphism combined.Immunohistochemistry was available for review on a subset and showed nearly all tumors to be diffusely positive for p63, S100, SOX10, and negative for P40.Specific myoepithelial markers were variable but commonly demonstrated focal to patchy reactivity (see table 1).Clinical and follow-up data is available on 28 cases (median 203 weeks, range 1.6-1170).8 cases presented with advanced local disease (pT4) and 6 cases with lymph node metastasis.Patients were treated with surgery alone (n=20) or with postop radiation (n=7).One patient received chemoradiation without surgery.Distant metastases are not present.Margins were positive in 7 cases and close ( 30%) in only 2 cases.3 recurrent cases had increased mitotic activity (4-6 mitosis/10 HPF) and 1 had nuclear pleomorphism.Clinical features M:F ratio 4:1 Mean age in years (range) 63.7 (put range here) Location, n (%) Palate Cribriform 10 (18%) Tubular 5 (9%) Papillary 4 (7%) No predominant pattern 18 (33%) Apocrine change, n (%) 14 (25%) Oncocytic change, n (%) 2 (4%) Significant pleomorphism 2 (4%) Necrosis 2 (4%) >3 Mitoses/10 HPF, n (%) 11 (20%) Perineural Invasion, n (%) 23 (42%) Lymphovascular invasion, n (%) 11 (20%) Immunohistochemistry, n (%) P63 38/39 (97%) S100 36/37 (97%) SOX10 23/23 (100%) P40 0/18 (0%) SMA 13/35 (37%) SMMS 27/30 (90%) AR 4 (29%)Conclusions: Polymorphous adenocarcinoma is generally a low-grade neoplasm with diverse histologic patterns.The immune profile consistently shows diffuse positivity for P63, S100, and SOX10.Focal myoepithelial marker expression is common.Apocrine/oncocytic change can be seen in some cases.Histologic and cytologic findings are not strong predictors of local recurrence, but half of the patients presenting with advanced pT4 disease or lymph node metastases at presentation experienced subsequent recurrence.