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High-grade transformation/dedifferentiation in salivary gland carcinomas: occurrence across subtypes and clinical significance

2021-05Review Restricted access
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dc.contributor.authorSkalova, Alena
dc.contributor.authorLeivo, Ilmo
dc.contributor.authorHellquist, Henrik
dc.contributor.authorAgaimy, Abbas
dc.contributor.authorSimpson, Roderick H. W.
dc.contributor.authorStenman, Goran
dc.contributor.authorVander Poorten, Vincent
dc.contributor.authorBishop, Justin A.
dc.contributor.authorFranchi, Alessandro
dc.contributor.authorHernandez-Prera, Juan C.
dc.contributor.authorSlouka, David
dc.contributor.authorWillems, Stefan M.
dc.contributor.authorOlsen, Kerry D.
dc.contributor.authorFerlito, Alfio
dc.date.accessioned2021-09-08T10:57:55Z
dc.date.available2021-09-08T10:57:55Z
dc.date.issued2021-05
dc.description.abstractHigh-grade transformation (HGT) or dedifferentiation has been described in a variety of salivary gland carcinomas, including acinic cell carcinoma, secretory carcinoma, adenoid cystic carcinoma, epithelial-myoepithelial carcinoma, polymorphous adenocarcinoma, low-grade mucoepidermoid carcinoma, and hyalinizing clear cell carcinoma. High-grade (HG) transformed tumors are composed of a conventional low-grade component characterized by specific microscopic and immunohistochemical features for the given entity, intermingled with or juxtaposed to areas of HG morphology. This is usually either poorly differentiated adenocarcinoma, carcinoma not otherwise specified, or undifferentiated carcinoma, in which the original line of differentiation is lost. The HG component is composed of solid nests of anaplastic cells with large vesicular pleomorphic nuclei, prominent nucleoli, and abundant cytoplasm. Frequent mitoses and extensive necrosis may be present. The Ki-67 labeling index is consistently higher in the HG component. The molecular genetic mechanisms responsible for HGT of salivary gland carcinomas are largely unknown, though p53 inactivation and human epidermal growth factor receptor 2 overexpression and/or gene amplification have been demonstrated in the HG component in a few examples, the frequency varies for each histologic type. Salivary gland carcinomas with HGT are more aggressive than conventional carcinomas, with a higher local recurrence rate and a poorer prognosis. They have a high propensity for cervical lymph node metastasis suggesting a need for a wider resection and neck dissection. HGT of salivary gland carcinoma can occur either at initial presentation or less commonly at the time of recurrence, sometimes following postoperative radiotherapy. The potential for HGT in almost any type of salivary gland carcinoma warrants a thorough sampling of all salivary gland malignancies to prevent oversight of a HG component.
dc.description.versioninfo:eu-repo/semantics/publishedVersion
dc.identifier.doi10.1097/PAP.0000000000000298
dc.identifier.issn1072-4109
dc.identifier.urihttp://hdl.handle.net/10400.1/16976
dc.language.isoeng
dc.peerreviewedyes
dc.publisherLIPPINCOTT WILLIAMS & WILKINS
dc.subjectSalivary gland carcinoma
dc.subjectHigh-grade transformation
dc.subjectDedifferentiation
dc.subjectp53
dc.subjectHER2
dc.subjectNeu
dc.subject.otherPathology
dc.titleHigh-grade transformation/dedifferentiation in salivary gland carcinomas: occurrence across subtypes and clinical significance
dc.typereview
dspace.entity.typePublication
oaire.citation.endPage118
oaire.citation.issue3
oaire.citation.startPage107
oaire.citation.titleAdvances in Anatomic Pathology
oaire.citation.volume28
person.familyNameHellquist
person.givenNameHenrik
person.identifier.ciencia-id9C11-221B-93BF
person.identifier.orcid0000-0003-3044-6065
rcaap.rightsrestrictedAccess
rcaap.typereview
relation.isAuthorOfPublicatione632b82a-cf09-4f9a-b445-9d9a9de47438
relation.isAuthorOfPublication.latestForDiscoverye632b82a-cf09-4f9a-b445-9d9a9de47438

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