Zusammenfassung
Hintergrund
Speicheldrüsentumoren sind zwar sehr selten, zeigen aber eine große morphologische Heterogenität mit über 30 verschiedenen Entitäten. In jüngster Zeit ließen sich die verschiedenen Tumoren nicht nur histologisch und immunhistochemisch, sondern auch molekular besser als zuvor charakterisieren, sodass zunehmend sog. Treibermutationen, die eine Rolle bei der Entwicklung neuer, auf eine Zielstruktur gerichteter Therapien spielen, entdeckt wurden.
Ziel
Ziel des Beitrags ist es, grundlegende morphologische und immunhistochemische Parameter zur Differenzierung einzelner Tumorentitäten vorzustellen sowie einen Überblick über die bislang gefundenen genetischen Aberrationen der häufigsten Speicheldrüsentumoren zu geben.
Material und Methoden
Fälle aus dem eigenen Einsendegut mit histochemischen Standard- und immunhistochemischen Sonderfärbungen werden präsentiert. Daneben bildet eine umfassende Literaturrecherche den derzeitigen Kenntnisstand über molekulare Veränderungen in Speicheldrüsentumoren ab.
Ergebnisse und Schlussfolgerung
In der histopathologischen Diagnostik differenzierter Speicheldrüsentumoren ist die immunhistochemische Markierung basaler/myoepithelialer und luminaler/epithelialer Zellen zur Beurteilung von Komposition und Architektur verschiedener Zelltypen neben der Bestimmung der proliferativen Aktivität essenziell. Auf Basis einer korrekten Tumortypisierung können verschiedene molekulare Parameter untersucht werden, um im Falle hoch differenzierter nichtmetastasierter Tumoren die Diagnose weiter zu verifizieren und im Falle gering differenzierter, metastasierter Tumoren mögliche therapeutische Zielstrukturen zu identifizieren. Bei hochaggressiven Karzinomen erscheint nach heutigem Kenntnisstand die Erstellung eines umfassenden genomischen Profils wesentlich.
Abstract
Background
Salivary gland tumors are rare but display great morphological heterogeneity with more than 30 entities. Recently, the different tumors have not only been better characterized using conventional histochemical and immunohistochemical methods, but also by molecular means. Hence, so-called driver mutations which play a role in the development of novel molecularly targeted therapies could be identified.
Objective
The article aims to show morphological criteria and immunohistochemical characteristics of different tumor entities. Additionally, an overview of tumor-specific genetic aberrations of the most common salivary gland tumors is given.
Materials and methods
Samples from daily routine practice are presented with histochemical and immunohistochemical staining. To compile recent molecular findings in salivary gland tumors, a literature review was performed.
Results and conclusion
For histopathological diagnosis of differentiated salivary gland tumors, immunohistochemical staining of basal/myoepithelial and luminal/epithelial cells is essential to assess cellular architecture and attribute proliferative activity. Based on correct tumor typing, various molecular parameters can be investigated in order to verify the diagnosis of highly differentiated nonmetastatic tumors. In the case of less differentiated, metastatic cancers, molecular pathology permits identification of potential therapeutic targets. Comprehensive genome profiling should nowadays be applied to highly aggressive salivary gland cancers.
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Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
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Benedicta Beck-Broichsitter, Berlin
Tobias Ettl, Regensburg
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Schwarz-Furlan, S. Histologie und Molekularpathologie von Speicheldrüsentumoren. MKG-Chirurg 14, 287–295 (2021). https://doi.org/10.1007/s12285-021-00324-3
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DOI: https://doi.org/10.1007/s12285-021-00324-3