Differential challenges in salivary gland neoplasms

Authors

  • Nikola Živković Department of Pathology, Faculty of Medicine, University of Niš, Niš
  • Miloš Kostić Department of Immunology, Faculty of Medicine, University of Niš, Niš
  • Ana Cvetanović Department of Oncology, Faculty of Medicine, University of Niš, Niš
  • Maja Jovičić Milentijević Department of Pathology, Faculty of Medicine, University of Niš, Niš
  • Milan Spasić Department of Oral Surgery, Faculty of Medicine, University of Niš, Niš
  • Milica Petrović Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Niš, Niš
  • Miloš Trajković Department of Maxillofacial Surgery, Faculty of Medicine, University of Niš, Niš
  • Tijana Denčić Department of Pathology, Faculty of Medicine, University of Niš, Niš
  • Dane Krtinić Department of Pharmacology and Toxicology, Faculty of Medicine, University of Niš, Niš

DOI:

https://doi.org/10.2298/ABS201201002Z

Keywords:

salivary gland, neoplasm, morphometry, immunohistochemistry, Ki67

Abstract

Paper description:

  • Salivary gland tumors are a rare group of neoplasms with a broad and overlapping histological presentation despite their dissimilar biological These tumors are a diagnostic challenge. A correct pathohistological diagnosis is the basis for the further course of treatment.
  • Using values of the Ki67 proliferative index and morphometric analysis, we could divide tumors into benign and malignant with high precision.
  • The obtained cut-off values for the proliferative index and the area and optical density indicate that they can serve as reliable parameters to differentiate between benign and malignant tumors.

Abstract: Salivary gland tumors are neoplasms characterized by a high level of pleomorphism and histological overlap. One tumor may contain several cell types; therefore, it is necessary to include immunohistochemical staining, as well as morphometric analysis of tumor cells as prerequisites for an appropriate diagnosis. Our research included 120 tumors, such as pleomorphic adenoma, Warthin tumor, basal cell adenoma, myoepithelioma, adenoid cystic carcinoma, mucoepidermoid carcinoma, salivary duct carcinoma, polymorphous low-grade carcinoma and myoepithelial carcinoma. The aim of the study was to differentiate benign and malignant tumors based on the characteristics of nuclei. The expression of Ki67 and the morphometric nuclear parameters – area, perimeter, Feret diameter, integrated optical density, circularity, and roundness, were analyzed. It was observed that the Ki67 proliferative index was statistically significantly higher in malignant tumors (P<0.001). Adenoid cystic carcinoma exhibited the highest value, whereas the lowest value was exhibited in basal cell adenoma. Morphometric analysis showed statistically significantly increased values of integrated optical density (P<0.001) and nuclear size parameters (P<0.05) in malignant tumors. The determination of the Ki67 proliferative index and morphometric analysis of the integrated optical density and area can differentiate benign from malignant tumors with high precision. The presented values suggest the obtained results as cut-off values.

Downloads

Download data is not yet available.

References

de Oliveira FA, Duarte EC, Taveira CT, Máximo AA, de Aquino EC, de Cássia Alencar R, Vencio EF. Salivary gland tumor: a review of 599 cases in a Brazilian population. Head Neck Pathol. 2009;3(4):271-5.

Guzzo M, Locati LD, Prott FJ, Gatta G, McGurk M, Licitra L. Major and minor salivary gland tumors. Crit Rev Oncol Hematol. 2010;74(2):134-8.

Ettl T, Schwarz-Furlan S, Gosau M, Reichert TE. Salivary gland carcinomas. Oral Maxillofac Surg. 2012;16:267-83.

Lukšić I, Virag M, Manojlović S, Macan D. Salivary gland tumours: 25 years of experience from a single institution in Croatia. J Craniomaxillofac Sur. 2012;40(3):e75-81.

Fonseca FP, Carvalho Mde V, de Almeida OP, Rangel AL, Takizawa MC, Bueno AG, Vargas PA. Clinicopathologic analysis of 493 cases of salivary gland tumors in a Southern Brazilian population. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(2):230-9.

Vasconcelos AC, Nör F, Meurer L, Salvadori G, Souza LB, Vargas PA, Martins MD. Clinicopathological analysis of salivary gland tumors over a 15-year period. Braz Oral Res. 2016;30:e2.

Evenson JW, Auclair P, Gnepp DR, El-Naggar AK. Tumors of the salivary glands: Introduction. In: Barnes L, Eveson JW, Reichart P, Sidransky D. Pathology and Genetics of Head and Neck Tumours. 3rd ed. Lyon: IARCPress; 2005. p. 210-5.

Mayers EN, Ferris RL. Salivary Gland Disorders. Berlin, Heidelberg: Springer-Verlag; 2007.

Zhan KY, Khaja SF, Flack AB, Day TA. Benign Parotid Tumors. Otolaryngol Clin North Am. 2016;49(2):327-42.

Dardick I, van Nostrand AW. Morphogenesis of salivary gland tumors. A prerequisite to improving classification. Pathol Annu. 1987;22:1-53.

Dardick I, Burford-Mason AP. Current status of the histogenetic and morphogenetic concepts of salivary gland tumorigenesis. Crit Rev Oral Biol Med. 1993;4:639-77.

Zarbo RJ. Salivary gland neoplasia: a review for the practicing pathologist. Mod Pathol. 2002;15:298-323.

Bagulkar BB, Gawande M, Chaudhary M, Gadbail AR, Patil S, Bagulkar S. XIAP and Ki-67: A Correlation Between Antiapoptotic and Proliferative Marker Expression in Benign and Malignant Tumours of Salivary Gland: An Immunohistochemical Study. J Clin Diagn Res. 2015;9(2):EC01-4.

Živković N, Mihailović D, Kostić M, Cvetanović A, Mijović Ž, Milentijević M, Denčić T. Markers of proliferation and cytokeratins in the differential diagnosis of jaw cysts. Ear Nose Throat J. 2017;96(9):376-83.

Živković N, Mihailović D, Kostić M, Mijović Ž, Jovičić Milentijević M, Cvetanović A, Denčić T, Spasić M. Morphological, Immunohistochemical, and Morphometric Analysis of Myoepithelial Tumors of the Salivary Gland. Anal Quant Cytol Histol 2016;38(6):323-30.

Hammond MEH, Hayes DF, Dowsett M, Allred DC, Hagerty KL, Badve S, Fitzgibbons PL, Francis G, Goldstein NS, Hayes M, Hicks DG, Lester S, Love R, Mangu PB, McShane L, Miller K, Osborne CK, Paik S, Perlmutter J, Rhodes A, Sasano H, Schwartz JN, Sweep FCG, Taube S, Torlakovic EE, Valenstein P, Viale G, Visscher D, Wheeler T, Williams RB, Wittliff JL, Wolff AC. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer (unabridged version). Arch Pathol Lab Med. 2010;134:e48-72.

Norberg-Spaak L, Dardick I, Leidin T. Adenoid cystic carcinoma: use of cell proliferation, BCL-2 expression, histologic grade, and clinical stage as predictors of clinical outcome. Head Neck. 2000;22(5):489-97.

Hellquist HB, Sundelin K, Di Bacco A, Tytor M, Manzotti M, Viale G. Tumour growth fraction and apoptosis in salivary gland acinic cell carcinomas. Prognostic implications of Ki-67 and bcl-2 expression and of in situ end labelling (TUNEL). J Pathol. 1997;181(3):323-9.

Shida H, Tanaka A, Fukuda M, Shigematsu H, Kusama K, Sakashita H. A case of basal cell adenoma in the parotid gland. Jpn J Oral Maxillofac Surg. 2005;51(7):352-5.

Horii A, Yoshida J, Sakai M, Okamoto S, Kubo T. Flow cytometric analysis of DNA content and Ki-67-positive fraction in the diagnosis of salivary gland tumors. Eur Arch Otorhinolaryngol. 1998;255(5):265-8.

Terada T. Hyperplastic intreparotid lymph nodes with incipient Warthin’s tumor presenting as a parotid tumor. Pathol Res Pract. 2008;204(11):863-6.

Saghravanian N, Mohtasham N, Jafarzadeh H. Comparison of immunohistochemical markers between adenoid cystic carcinoma and polymorphous low-grade adenocarcinoma. J Oral Sci. 2009;51(4):509-14.

Suzzi MV, Alessi A, Bertarelli C, Cancellieri A, Procaccio L, Dall'olio D, Laudadio P. Prognostic relevance of cell proliferation in major salivary gland carcinomas. Acta Otorhinolaryngol Ital. 2005;25(3):161-8.

Triantafillidou K, Dimitrakopoulos J, Iordanidis F, KoufogianNiš D. Management of adenoid cystic carcinoma of minor salivary glands. J Oral Maxillofac Sur. 2006;64(7):1114-20.

Nagao T, Sugano I, Ishida Y, Tajima Y, Matsuzaki O, Konno A, Kondo Y, Nagao K. Salivary gland malignant myoepithelioma: a clinicopathologic and immunohistochemical study of ten cases. Cancer. 1998;83(7):1292-9.

de Vicente Rodriguez JC, López Arranz JS, Vega Alvarez JA, Santos Oller JM, Gener González M. Morphometric study of epithelial neoplasms of the parotid gland. Rev ADM. 1990;47(4):215-9.

Gentile R, Zeppa P, Zabatta A, Vetrani A. The role of morphometry in the cytology of pleomorphic adenomas of the salivary glands. Pathologica. 1994;86(2):167-9.

Layfield LJ, Hall TL, Fu YS. Discrimination of benign versus malignant mixed tumors of the salivary gland using digital image analysis. Cytometry. 1989;10:217-21.

Prvulović I, Kardum-Skelin I, Sustercić D, Jakić-Razumović J, Manojlović S. Morphometry of tumor cells in different grades and types of breast cancer. Coll Antropol. 2010;34(1):99-103.

Oz ZS, Bektas S, Battal F, Atmaca H, Ermis B. Nuclear morphometric and morphological analysis of exfoliated buccal and tongue dorsum cells in type-1 diabetic patients. J Cytol. 2014;31(3):139-43.

Obad-Kovačević D, Kardum-Skelin I, Jelić-Puškarić B, Vidjak V, Blašković D. Parotid gland tumors: correlation between routine cytology and cytomorphometry by digital image analysis using conventional and newly introduced cytomorphometric parameters. Diagn Cytopathol. 2013;41(9):776-84.

Kawahara A, Harada H, Akiba J, Kage M. Salivary duct carcinoma cytologically diagnosed distinctly from salivary gland carcinomas with squamous differentiation. Diagn Cytopathol. 2008;36(7):485-93.

Downloads

Published

2021-03-19

How to Cite

1.
Živković N, Kostić M, Cvetanović A, Jovičić Milentijević M, Spasić M, Petrović M, Trajković M, Denčić T, Krtinić D. Differential challenges in salivary gland neoplasms. Arch Biol Sci [Internet]. 2021Mar.19 [cited 2022Aug.7];73(1):65-72. Available from: https://www.serbiosoc.org.rs/arch/index.php/abs/article/view/6051

Issue

Section

Articles