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Intraductal Carcinoma of Salivary Gland (So-Called Low-Grade Cribriform Cystadenocarcinoma) Arising in an Intraparotid Lymph Node

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Since the first description of an entirely intraductal epithelial proliferation of salivary gland by Chen in 1983 as an “intraductal carcinoma”, there have been several dozen reported cases with the same and various additional names including “low-grade salivary duct carcinoma”, “low-grade cribriform cystadenocarcinoma” and “carcinoma in situ” of salivary gland. These refer to a combination of nests and cysts of varying size formed by a cellular proliferation resembling atypical ductal hyperplasia or ductal carcinoma in situ of the breast. The lesions are generally entirely intraductal with low, intermediate or high-grade dysplasia. Occasional benign tumors of salivary gland, particularly Warthin tumor and rare salivary carcinomas may arise within an intraparotid lymph node. In addition, intraparotid lymph nodes are a routine location for metastatic disease. A case of a 59-year-old female with a parotid mass is described, which grossly had the appearance of a Warthin tumor. Microscopically, it was an entirely intranodal proliferation of cells with diffuse AE1/AE3 and S100 positivity. The nests and cysts were completely surrounded by a rim of non-neoplastic myoepithelial cells, which were positive for CK14, p63, SMA, MSA and calponin. The tumor cells were negative for these markers. The cells were only focally positive for AR and BRST-2. They showed negligible MIB-1 staining. This report describes, for the first time, an entirely intranodal location for a low-grade intraductal carcinoma (so-called low-grade cribriform cystadenocarcinoma).

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  1. Chen KT. Intraductal carcinoma of the minor salivary gland. J Laryngol Otol. 1983;97(2):189–91.

    Article  PubMed  CAS  Google Scholar 

  2. Delgado R, Klimstra D, Albores-Saavedra J. Low grade salivary duct carcinoma. A distinctive variant with a low grade histology and a predominant intraductal growth pattern. Cancer. 1996;78(5):958–67.

    Article  PubMed  CAS  Google Scholar 

  3. Brandwein-Gensler M, Hille J, Wang BY, Urken M, Gordon R, Wang LJ, Simpson Jr, Simpson RH, Gnepp. Low-grade salivary duct carcinoma: description of 16 cases. Am J Surg Pathol. 2004;28(8):1040–4.

    Article  PubMed  Google Scholar 

  4. Simpson RH, Desai S, Di Palma S. Salivary duct carcinoma in situ of the parotid gland. Histopathology. 2008;53(4):416–25.

    Article  PubMed  CAS  Google Scholar 

  5. Brandwein-Gensler MS, Gnepp DR. Low Grade Cribriform Cystadenocarcinoma. In: World Health Organization classification of tumours. Pathology and genetics of head and neck tumours. Barnes EL, Eveson JW, Reichart P, Sidransky D (Eds.), IARC Press; Lyon. 2005. p. 223.

  6. Arai A, Taki M, Mimaki S, Ueda M, Hori S. Low-grade cribriform cystadenocarcinoma of the parotid gland: a case report. Auris Nasus Larynx. 2009;36(6):725–8.

    Article  PubMed  Google Scholar 

  7. Wayne S, Barnes EL, Seethala RR. Low grade intraductal carcinoma: a relative of cystadenocarcinoma, precursor to salivary duct carcinoma, or both?. March: Presented in abstract form at the United States and Canadian Academy of Pathology’s annual conference; 2008.

    Google Scholar 

  8. Weinreb I, Tabanda-Lichauco R, Van der Kwast T, Perez-Ordonez B. Low-grade intraductal carcinoma of salivary gland: report of 3 cases with marked apocrine differentiation. Am J Surg Pathol. 2006;30(8):1014–21.

    Article  PubMed  Google Scholar 

  9. Ellis G, Simpson RH. Acinic cell carcinoma. In: World Health Organization classification of tumours. Pathology and genetics of head and neck tumours. Barnes EL, Eveson JW, Reichart P, Sidransky D (Eds.), IARC Press, Lyon. 2005. p. 216–218.

  10. Thompson LD, Wenig BM, Ellis GL. Oncocytomas of the submandibular gland. A series of 22 cases and a review of the literature. Cancer. 1996;78(11):2281–7.

    Article  PubMed  CAS  Google Scholar 

  11. Skalova A, Vanecek T, Sima R, Laco J, Weinreb I, Perez-Ordonez B, Starek I, Geierova M, Simpson RH, Passador-Santos F, Ryska A, Leivo I, Kinkor Z, Michal M. Mammary analogue secretory carcinoma of salivary glands, containing the ETV6-NTRK3 fusion gene: a hitherto undescribed salivary gland tumor entity. Am J Surg Pathol. 2010;34(5):599–608.

    PubMed  Google Scholar 

  12. Celik A, Kutun S, Pak I, Seki A, Cetin A. Secretory breast carcinoma with extensive intraductal component: case report. Ultrastruct Pathol. 2004;28(5–6):361–3.

    Article  PubMed  Google Scholar 

  13. Cheuk W, Chan JK. Advances in salivary gland pathology. Histopathology. 2007;51(1):1–20.

    Article  PubMed  CAS  Google Scholar 

  14. de Araujo VC, Kowalski LP, Soares F, de Araujo NS, Loducca SV, Sobral AP. Salivary duct carcinoma: cytokeratin 14 as a marker of in situ intraductal growth. Histopathology. 2002;41(3):244–9.

    Article  PubMed  Google Scholar 

  15. Kusafuka K, Itoh H, Sugiyama C, Nakajima T. Low-grade salivary duct carcinoma of the parotid gland: report of a case with immunohistochemical analysis. Med Mol Morphol. 2010;43(3):178–84.

    Article  PubMed  Google Scholar 

  16. Skálová A, Gnepp DR, Simpson RH, Lewis JE, Janssen D, Sima R, Vanecek T, Di Palma S, Michal M. Clonal nature of sclerosing polycystic adenosis of salivary glands demonstrated by using the polymorphism of the human androgen receptor (HUMARA) locus as a marker. Am J Surg Pathol. 2006;30(8):939–44.

    Article  PubMed  Google Scholar 

  17. Fulciniti F, Losito NS, Ionna F, Longo F, Aversa C, Botti G, Foschini MP. Sclerosing polycystic adenosis of the parotid gland: report of one case diagnosed by fine-needle cytology with in situ malignant transformation. Diagn Cytopathol. 2010;38(5):368–73.

    PubMed  Google Scholar 

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Correspondence to Ilan Weinreb.

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Weinreb, I. Intraductal Carcinoma of Salivary Gland (So-Called Low-Grade Cribriform Cystadenocarcinoma) Arising in an Intraparotid Lymph Node. Head and Neck Pathol 5, 321–325 (2011).

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