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Mukoepidermoidkarzinom der Speicheldrüse

Ungewöhnliche Varianten mit Nachweis der Translokation t(11,19)(q21;p13)

Salivary gland mucoepidermoid carcinoma

Unusual variants with detection of the t(11,19)(q21;p13) translocation

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Zusammenfassung

Das Mukoepidermoidkarzinom (MEC), der häufigste maligne Speicheldrüsentumor, besitzt eine vielfältige Morphologie und kann daher eine Reihe anderer primärer Speicheldrüsenkarzinome so imitieren, dass die korrekte Diagnose im Einzelfall stark erschwert bzw. nicht sicher möglich wird. Dies gilt insbesondere bei den monomorphen Erscheinungsformen des MEC, bei denen ein Zelltyp das histologische Bild dominiert und die anderen zur Diagnose beitragenden Zelltypen nur sehr kleinherdig vorkommen oder gar fehlen. Im vorliegenden Beitrag zeigen wir anhand von 4 Eigenbeobachtungen, wie der Nachweis der für das MEC typischen Translokation t(11,19) zur Diagnosesicherung beitragen kann. Die Differenzialdiagnose umfasst Plattenepithelkarzinome, klarzellige Karzinome, onkozytäre Neoplasien und hochmaligne, nicht weiter klassifizierbare Adenokarzinome.

Abstract

Mucoepidermoid carcinoma (MEC) represents the most common malignant salivary gland tumour. Based on the proportion of their constituent cell types, MECs may display a wide morphological spectrum, thereby mimicking diverse types of other primary salivary gland carcinomas. The correct diagnosis relies on demonstration of classical MEC features, assisted by histochemical and immunohistochemical stains in equivocal cases. The current article aims to demonstrate, on the basis of own observations, how the detection of the MEC-typical t(11, 19) translocation may be of great value in difficult-to-classify cases. The differential diagnosis includes squamous cell carcinoma, clear cell carcinoma and oncocytic neoplasms, as well as highly malignant adenocarcinomas which cannot be further classified.

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Abbreviations

CK:

Zytokeratin

FISH:

Fluoreszenz-in-situ-Hybridisierung

HE:

Hämatoxylin-Eosin

MEC:

Mukoepidermoidkarzinom

MECT1:

„Mucoepidermoid carcinoma translocated gene 1“

MAML2:

„Mastermind-like gene 2“

NOS:

„Not otherwise specified“, nicht weiter klassifizierbar

PAS:

Perjodsäure-Schiff/Leukofuchsin

Pn:

Perineuralscheideninfiltration

R:

Residualtumor

TNM:

Tumorausdehnung, Nodalstatus, Fernmetastasierung

UICC:

„Union Internationale Contre le Cancer“

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Authors and Affiliations

  1. Pathologisches Institut, Universitätsklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland

    S. Schwarz & A. Agaimy

  2. Institut für Pathologie, Universität Regensburg, Regensburg, Deutschland

    C. Stiegler

  3. Hals-Nasen-Ohren-Klinik, Universitätsklinikum Erlangen, Erlangen, Deutschland

    J. Zenk & H. Iro

Authors
  1. S. Schwarz
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  2. C. Stiegler
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  3. J. Zenk
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  4. H. Iro
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  5. A. Agaimy
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Correspondence to S. Schwarz.

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Schwarz, S., Stiegler, C., Zenk, J. et al. Mukoepidermoidkarzinom der Speicheldrüse. Pathologe 30, 472–477 (2009). https://doi.org/10.1007/s00292-009-1205-5

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  • DOI: https://doi.org/10.1007/s00292-009-1205-5

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