Sialadenopapillary Ductal Tumors: Unifying the Spectrum of Sialadenoma Papilliferum-like Tumors With Low Malignant Potential.

IF 4.5 1区 医学 Q1 PATHOLOGY
American Journal of Surgical Pathology Pub Date : 2025-01-01 Epub Date: 2024-10-30 DOI:10.1097/PAS.0000000000002325
Elan Hahn, Ilan Weinreb, Raja R Seethala, Esther O'Regan, Daniel Baumhoer, Elizabeth Ann Bilodeau, Jeffrey Gagan, Peter J B Sabatini, Yen Chen Kevin Ko, Nada Binmadi, R John McComb, Iona T Leong, Justin A Bishop
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引用次数: 0

Abstract

Sialadenoma papilliferum is a tumor characterized by surface papillary projections and glandular/microcystic proliferation at the lesion base. Cases in which surface involvement is absent have been termed "sialadenoma papilliferum-like intraductal papillary tumor." Similar tumors that are present in the mandible have been termed "tubulopapillary hidradenoma-like tumor of the mandible." While previously considered benign, these tumors demonstrate variable clinical behavior and likely exist on a spectrum, rather than as discrete entities. In this study, we present a detailed clinicopathologic and molecular analysis of these lesions and propose a unifying diagnostic term: sialadenopapillary ductal tumor (SDT). Twenty-two cases with similar histologic features were reviewed, with special attention being paid to the clinicopathologic features. Immunohistochemistry for BRAF V600E and molecular testing were performed where material was available. The cases had varying diagnoses, ranging from benign to malignant. Six cases involved bone, 1 of which metastasized to a local lymph node. Of the 20 cases tested for BRAF V600E by immunohistochemistry, 18 were positive. Molecular testing was performed in 5 cases, where BRAF, PTPN11, and PIK3CA mutations were identified, predominantly members of the RAS-RAF-MEK-ERK pathway. In addition, 1 case was reclassified as an intraductal carcinoma after the identification of an NCOA4::RET gene fusion. Tumors on the SDT spectrum all share morphologic and molecular commonalities with unreliable distinguishing features. These tumors demonstrate the potential for aggressive local growth and regional metastasis. We propose a unifying diagnostic term for these lesions to reflect their common morphologic and molecular features and, most importantly, low malignant potential.

Sialadenopapillary 导管肿瘤:统一恶性可能性低的乳头状窦状腺瘤样肿瘤的范围
乳头状唾液腺瘤是一种以表面乳头状突起和病变基底部腺体/微囊增生为特征的肿瘤。表面不受累的病例被称为 "乳头状唾液腺瘤样导管内乳头状肿瘤"。出现在下颌骨的类似肿瘤被称为 "下颌骨管状乳头状乳头状瘤样肿瘤"。虽然这些肿瘤以前被认为是良性的,但它们的临床表现各不相同,很可能存在于一个谱系中,而不是作为独立的实体存在。在本研究中,我们对这些病变进行了详细的临床病理和分子分析,并提出了一个统一的诊断术语:下颌腺乳头状导管瘤(SDT)。我们对 22 例组织学特征相似的病例进行了回顾,并特别关注了临床病理学特征。在有材料的情况下,还进行了 BRAF V600E 免疫组化和分子检测。这些病例的诊断各不相同,从良性到恶性不等。其中 6 例累及骨骼,1 例转移至局部淋巴结。在通过免疫组化检测 BRAF V600E 的 20 个病例中,有 18 例呈阳性。对 5 例病例进行了分子检测,发现了 BRAF、PTPN11 和 PIK3CA 突变,主要是 RAS-RAF-MEK-ERK 通路的成员。此外,1 个病例在发现 NCOA4::RET 基因融合后被重新归类为导管内癌。SDT谱系上的肿瘤在形态和分子上都有共同之处,但鉴别特征并不可靠。这些肿瘤具有侵袭性局部生长和区域转移的潜能。我们为这些病变提出了一个统一的诊断术语,以反映它们共同的形态和分子特征,最重要的是,它们的恶性可能性较低。
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来源期刊
CiteScore
10.30
自引率
5.40%
发文量
295
审稿时长
1 months
期刊介绍: The American Journal of Surgical Pathology has achieved worldwide recognition for its outstanding coverage of the state of the art in human surgical pathology. In each monthly issue, experts present original articles, review articles, detailed case reports, and special features, enhanced by superb illustrations. Coverage encompasses technical methods, diagnostic aids, and frozen-section diagnosis, in addition to detailed pathologic studies of a wide range of disease entities. Official Journal of The Arthur Purdy Stout Society of Surgical Pathologists and The Gastrointestinal Pathology Society.
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