RESUMEN
AIMS: The morphological criteria for identification of intercalated duct lesions (IDLs) of salivary glands have been defined recently. It has been hypothesised that IDL could be a precursor of basal cell adenoma (BCA). BCAs show a variety of histological patterns, and the tubular variant is the one that presents the strongest resemblance with IDLs. The aim of this study was to analyse the morphological and immunohistochemical profiles of IDLs and BCAs classified into tubular and non-tubular subtypes, to determine whether or not IDL and tubular BCA represent distinct entities. METHODS AND RESULTS: Eight IDLs, nine tubular BCAs and 19 non-tubular BCAs were studied. All tubular BCAs contained IDL-like areas, which represented 20-70% of the tumour. In non-tubular BCA, IDL-like areas were occasional and small (<5%). One patient presented IDLs, tubular BCAs and IDL/tubular BCA combined lesions. Luminal ductal cells of IDLs and tubular BCAs exhibited positivity for CK7, lysozyme, S100 and DOG1. In the non-tubular BCA group, few luminal cells exhibited such an immunoprofile; they were mainly CK14-positive. Basal/myoepithelial cells of IDLs, tubular BCAs and non-tubular BCAs were positive for CK14, calponin, α-SMA and p63; they were more numerous in BCA lesions. CONCLUSIONS: IDL, tubular BCA and non-tubular BCA form a continuum of lesions in which IDLs are related closely to tubular BCA. In both, the immunoprofile of luminal and myoepithelial cells recapitulates the normal intercalated duct. The difference between the adenoma-like subset of IDLs and tubular BCA rests mainly on the larger numbers of myoepithelial cells in the latter. Our findings indicate that at least some BCAs can arise via IDLs.
Asunto(s)
Adenoma/patología , Neoplasias de las Glándulas Salivales/patología , Glándulas Salivales/patología , Adenoma/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Neoplasias de las Glándulas Salivales/metabolismo , Glándulas Salivales/metabolismo , Adulto JovenRESUMEN
No presente estudo investigamos a presença da diferenciaçäo mucoepitelial na morfogênese do carcinoma mucoepidermóide (CME) das glândulas salivares menores. Dezessete casos foram investigados, usando-se a técnica imunoistoquímica da estreptavidina-biotina e anticorpos monoclonais anticitoceratina 14 (CK14), antivimentina e antiactina muscular específica (AME). Foram empregados cortes histológicos de 3mm de espessura, de material fixado em formalina 10 por cento e incluído em parafina. Previamente à incubaçäo do anticorpo primário do anticorpo primário anti-CK14, as seçöes teciduais foram submetidas ao tratamento com ácido cítrico 10mM, ph 6, em ambiente de microondas. Nossos achados revelaram que a marcaçäo para CK14 restringiu-se às células intermediárias e epidermóides; nas áreas císticas, em especial, foi identificada nas células basais e parabasais dos revestimentos neoplásicos. Nenhum caso foi positivo para AME, e dois casos mostraram marcaçäo ocasional para vimentina, de fraca intensidade. Estes achados traduzem uma ausência, de fraca intensidade. Estes achados traduzem uma ausência de direnciaçäo mioepitelial nos CMEs de glândulas salivares menores