pleomorphic adenoma of a salivary gland ICD-10: C07; ICD-O: 8940/0
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Mann, 49 J., derbe Schwellung hinter dem linken Kieferwinkel, besteht
seit mehreren Monaten, wächst langsam
- Praktisch rein seröse Speicheldrüse mit Fettgewebe: Parotis
- Tumorknoten mit schmaler Bindegewebskapsel, gelegentlich kleine Kapseldurchbrüche
- Zelldichte und -arme Areale
- Grundsubstanz des Tumors herdförmig homogen, leicht basophil,
teilweise knorpelähnlich (knorpelige Subst.)
- Eingelagert Zellstränge, teils mit Lumina und homogen eosinophilem
Inhalt
- Aus den Zellkomplexen ausschwärmend schmal auslaufende, spindelige
Zellen
- Regionär sehr unterschiedlicher Bau des Tumors - Pleomorphie.
Epitheliale und scheinbar mesenchymale Gewebsanteile - "Mischtumor"
49-year-old male noticed since several months a slowly-growing, firm mass at the angle of the jaw.
- A well-circumscribed tumor with peripheral normal parotid gland tissue is seen at low-power view. The tumor is surrounded by a thin fibrous capsule which is partly penetrated. The heterogeneous
make-up of the tumor with areas of varying cellularity is characteristic.
- The tumor consists of dark, cuboidal epithelial cells forming strands, sheets, acini and tubules. The latter display a homogenous, eosinophilic content. Small spindle cells emerge from solid
epithelial structures.
- Epithelial elements are blended together with a loose often myxoid connective tissue stroma. Islands of bone and cartilage (knorpelige Subst.) are observed.
- The normal parotid gland tissue consists mostly of serous acini with basophilic cells and ducts lined by brightly eosinophilic cells within a loose stroma containing numerous adipocytes.
The pleomorphic appearance of this tumor with a seeming mixture of epithelial ( Epitheliale) and mesenchymal (mesenchymale)
elements conferred the name mixed tumor of salivary glands. Immunohistochemical evidence points to a
myoepithelial origin of all cellular elements, also those of the stroma.