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Undifferenzierte Karzinome der Speicheldrüsen

  • Schwerpunkt: Orale Pathologie/Pathologien der Speicheldrüsen
  • Published:
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Zusammenfassung

Undifferenzierte Karzinome der Speicheldrüsen lassen sich in klein- und großzellige Typen unterteilen, wobei von den großzelligen Karzinomen im engeren Sinne das undifferenzierte lymphoepitheliale Karzinom abzugrenzen ist. Das lymphoepitheliale Speicheldrüsenkarzinom ist in der Arktis und in Südchina endemisch und in diesen Regionen konstant mit dem Epstein-Barr-Virus (EBV) assoziiert. Jedoch können auch sporadische lymphoepitheliale Speicheldrüsenkarzinome mit diesem Virus assoziiert auftreten. Der Nachweis von EBV-Genprodukten kann in solchen Fällen von diagnostischem Nutzen sein.

Die Differenzialdiagnose aller undifferenzierten Karzinome der Speicheldrüsen umfasst maligne Lymphome und amelanotische Melanome sowie insbesondere auch Merkel-Zellkarzinome und adenoid-zystische Karzinome. Aufgrund ihrer Seltenheit sollten undifferenzierte Karzinome in Speicheldrüsen, insbesondere wenn sie den Schilddrüsen-Transkriptionsfaktor-1 (TTF-1) exprimieren, immer dazu Anlass geben, differenzialdiagnostisch die Metastase eines Primärtumors außerhalb der Speicheldrüsen zu erwägen.

Abstract

Undifferentiated salivary gland carcinomas may be divided into small cell and large cell types. Among large cell undifferentiated carcinomas, lymphoepithelial carcinomas have to be distinguished, the latter of which are endemic in the Arctic regions and southern China where virtually all cases of these tumors are associated with the Epstein-Barr virus (EBV). Association with EBV may also be observed in sporadic cases, and detection of EBV gene products may aid their diagnosis.

Immunohistology may be employed to resolve the differential diagnosis of undifferentiated salivary gland carcinomas, comprising malignant lymphomas, amelanotic melanomas, Merkel cell carcinomas, and adenoid cystic carcinomas, in particular in small biopsy materials. Because of the rarity of undifferentiated salivary gland carcinomas, the differential diagnosis should always include metastases of undifferentiated carcinomas arising at other primary sites, particularly when expressing the thyroid transcription factor-1 (TTF-1).

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Danksagung

Die Arbeiten wurden durch eine Zuwendung der Medizinischen Fakultät Münster (IMF HU120115) gefördert.

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Authors and Affiliations

  1. Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster

    H. Herbst

  2. Institut für Pathologie, Kommunehospitalet, Universität Aarhus, Dänemark

    S. Hamilton-Dutoit

  3. Speicheldrüsenregister, Institut für Oralpathologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg

    K. T. Jäkel

  4. Institut für Pathologie, Friedrich-Alexander-Universität, Erlangen-Nürnberg

    G. Niedobitek

  5. Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster, Domagkstr. 17, 48149, Münster

    H. Herbst

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  1. H. Herbst
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  2. S. Hamilton-Dutoit
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  4. G. Niedobitek
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Correspondence to H. Herbst.

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Herbst, H., Hamilton-Dutoit, S., Jäkel, K.T. et al. Undifferenzierte Karzinome der Speicheldrüsen. Pathologe 25, 56–62 (2004). https://doi.org/10.1007/s00292-003-0674-1

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