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sclerozing polycystic adenosis
Wednesday 1 June 2016
sclerosing polycystic adenosis of salivary glands; salivary sclerozing polycystic adenosis
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Definition: Sclerosing polycystic adenosis (SPA) is a rare entity of the salivary gland that presents as a slow growing mass.
According to a review by Petersson, eighty percent of SPA affect parotid gland and is mostly unifocal though involvement of minor salivary glands, as well as multifocality may rarely be encountered.
This condition affects male and female equally with a wider age spectrum of 9 to 84 years old; the size of the reported SPA ranges from 0.7 cm to 12 cm; recurrence may occurred in up to 19% of the cases.
Although SPA often presented as an isolated finding, it may be associated with other entities including pleomorphic adenoma, oncocytoma, Warthin’s tumor.
Images
Sclerosing polycystic adenosis / pink granules
- http://www.webpathology.com/image.asp?n=1&Case;=967
- https://twitter.com/headandneckpath/status/843899598909259777
Microscopy
It is a histologically complex entity that consists of enlarged and distorted lobules, crowded acini with apocrine metaplasia, prominent stromal fibrosis and is reminiscent of fibrocystic disease of the breast.
Chronic inflammation, myxoid stroma and various degrees of intraductal proliferations may present.
Immunoprofiles reveal positivity for AE1/AE3 and Cam5.2 in both ductal and acinar cells while GCDFP-15 is strongly expressed in the acinar component; Consistent but variable expression of ER and PR is detected in ductal and acinar cells while Her-2/neu is negative.
The etiology of SPA is still unclear and the nature of this lesion was initially believed to be pseudoneoplastic inflammatory sclerosing process. However, monoclonality has been detected by human androgen receptor assay in SPA cases with epithelial atypia.
Further, a single case of invasive carcinoma arising from SPA has been recently reported.
Cytology
http://www.papsociety.org/cotm16/cotmmar16.html
See also
chronic sialadenitis
salivary gland tumors
adenosis
Open references