Differential Diagnosis of Salivary Gland Tumors: The utility of immunohistochemical markers in routine practice

Ilayaraja, V (2009) Differential Diagnosis of Salivary Gland Tumors: The utility of immunohistochemical markers in routine practice. Masters thesis, Tamilnadu Government Dental College and Hospital, Chennai.


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OBJECTIVES : The purpose of this study is to determine whether selective immunohistochemical markers may aid in the differential diagnosis of morphologically difficult salivary gland tumors. STUDY DESIGN : The records and archival paraffin blocks of the Department of Oral Pathology and Microbiology, Tamil Nadu Government Dental College and Hospital, Chennai, South India, served as a source of material for this study. About 20 salivary gland tumors [PA (7), PLGAs (3), ACC (4), BAC (1), SDC (1), Clear cell salivary gland tumors (2) and unusual adenocarcinomas (2)] were selected from the record for the study. Formalin-fixed and paraffin embedded tissue sections of the tumors were immunohistochemically analyzed for the presence of SMA, CK, GFAP, c-kit, vimentin and S-100 protein (only in few cases). A standard streptovidin peroxidase procedure was used after antigen retrieval. To assure proper staining, salivary gland fragments, blood vessels and connective tissue fibers present in the sections adjacent to the tumor and within the tumor were used as internal positive controls. RESULTS : PAs exhibited positivity to CK in 100% of cases, vimentin in 71% of cases, SMA in 57% of cases and c-kit in 71% of cases. PLGAs were positive to CK, vimentin and c-kit in 100% of cases and to SMA in 50% of cases. ACCs showed positivity to CK in 50% of cases, vimentin in 25% of cases, SMA in 75% of cases and c-kit in 100% of cases. GFAP staining was negative in all ACCs, PLGAs and 70% of PAs. BAC exhibited reactivity to all markers except GFAP, whereas SDC was negative to all markers (CK, c-Kit, GFAP, SMA & Vimentin). CCC demonstrated positivity in 100% of cases to CK and SMA (stroma only) and in 50% of cases to vimentin, while c-kit and S-100 were negative. Unusual adenocarcinomas were positive to CK and negative to GFAP in 100% of cases, whereas 50% of cases were positive in vimentin, c-kit and SMA. Out of the two unusual adenocarcinomas S-100 was used in only one case, where it was positive. CONCLUSION : This study suggests that the use of IHC as a supplemental diagnostic tool in border line or difficult salivary gland tumors may well augment the routine microscopic differential, especially when the pattern of reaction is taken into consideration.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Immunohistochemistry ; IHC ; Salivary gland tumors ; Pleomorphic adenoma ; Adenoid cystic carcinoma ; Polymorphous low-grade adenocarcinoma ; Basal cell adenocarcinoma ; Salivary duct carcinoma ; Clear cell carcinoma ; Canalicular adenoma ; Basal cell adenoma ; SMA ; vimentin ; S-100 ; GFAP ; CK ; c-kit.; Tamil Nadu Government Dental College ; Chennai.
Subjects: DENTAL > Oral Pathology and Microbiology
Depositing User: Subramani R
Date Deposited: 05 Sep 2017 02:04
Last Modified: 12 Nov 2017 13:05
URI: http://repository-tnmgrmu.ac.in/id/eprint/2916

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