Abstract
Aims. To evaluate the immunohistochemical expression of bcl-2 and c-kit proteins in the salivary gland tumors, adenoid cystic carcinoma, and polymorphous low-grade adenocarcinoma with a view to tumor differentiation. Methods. Immunohistochemical studies were performed on 29 adenoid cystic carcinoma and 23 polymorphous low-grade adenocarcinoma archival cases with bcl-2 and c-kit antibodies using standard procedures, and the data were statistically analyzed. Results. The difference in bcl-2 expression in adenoid cystic carcinoma and polymorphous low-grade adenocarcinoma was not statistically significant. Whilst the difference in c-kit expression was statistically significant (), the difference proved small so as to be of no practical or diagnostic importance. Moderate to strong immunostaining was noted in adenoid cystic carcinoma with c-kit, the pattern and intensity varying within different histological subtypes, being greater the more aggressive the tumor subtype. Conclusions. Bcl-2 and c-kit are not useful as immunohistochemical markers in differentiating adenoid cystic carcinoma from polymorphous low-grade adenocarcinoma.
Highlights
Adenoid cystic carcinoma (ACC) and polymorphous lowgrade adenocarcinoma (PLGA) are salivary gland malignancies with some overlapping histomorphologic features and immunophenotypic profiles, yet their biologic behavior is significantly different
The distinction between ACC and PLGA is important because ACC is clinically more aggressive and infiltrative, requiring a more radical surgical approach
There remains a need for better-defined immunohistochemical distinction between ACC and PLGA
Summary
Adenoid cystic carcinoma (ACC) and polymorphous lowgrade adenocarcinoma (PLGA) are salivary gland malignancies with some overlapping histomorphologic features and immunophenotypic profiles, yet their biologic behavior is significantly different. Some histopathologic similarity is expected as both tumors are composed of ductal and abluminal myoepithelial differentiated cells. Both tumors have a marked propensity to infiltrate around nerves. The distinction between ACC and PLGA is important because ACC is clinically more aggressive and infiltrative, requiring a more radical surgical approach. These tumors are often readily diagnosed, occasionally differentiation may pose a diagnostic challenge especially when examining tissue from small incision or fragmented biopsies [1]. There remains a need for better-defined immunohistochemical distinction between ACC and PLGA
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