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PubMed2001

Salivary duct cyst: its frequency in a certain Japanese population group (Tohoku districts), with special reference to adenomatous proliferation of the epithelial lining.

It is reported in the European and American literature that salivary duct cysts constitute about 10% of all cysts of the salivary glands, although they appear to be rare in Japan. Between 1975 and 1999, only 3 (0.5%) of 586 salivary gland cysts were diagnosed as salivary duct cysts at the Division of Clinical Pathology, Iwate Medical University Hospital. Histologically, two cases appeared as a unilocular lesion lined by double- and multi-layered epithelium. The other case showed marked, intraluminar and intramural adenomatous proliferation of the epithelial lining, suggesting that the lesion was a benign tumor. A review of the literature yielded only two cases of tumors arising in pre-existing salivary duct cysts.

Adult↗

PubMed2005

Novel estrogen receptor coactivator PELP1/MNAR gene and ERbeta expression in salivary duct adenocarcinoma: potential therapeutic targets.

Salivary duct carcinoma (SDC) is a high-grade neoplasm with marked morphological resemblance to mammary duct carcinoma. The novel estrogen receptor (ER)-interacting protein and the proline-, glutamic acid-, and leucine-rich protein 1 ( PELP1 ), also called the modulator of nongenomic activity of ER ( MNAR ), have been shown to activate steroid hormone receptors in mammary carcinomas by nongenomic and genomic mechanisms. The expression and the relationship of this gene to the ER status in SDCs are unknown. We investigated the differential expression of the PELP1 / MNAR and the ERs alpha and beta proteins in SDCs, using Western blotting and immunohistochemistry. Western blot analysis of 7 paired normal and tumor specimens showed increased expression of PELP1 / MNAR and ER beta in 3 and 4 of the SDCs, respectively. No detectable expression of ER alpha in any normal or SDC specimens was noted. Immunohistochemical staining performed on 70 SDCs revealed strong expression of PELP1 / MNAR in 51 (73%) and ER beta in 52 (74%) tumors. PELP1 / MNAR and ER beta were coexpressed in 35 (50%), individually in 17 (24.2%), and negative in 18 (25.7%) tumors. PELP1 / MNAR staining was predominantly cytoplasmic whereas ER beta staining was nuclear and occasionally cytoplasmic in tumor cells. Our results indicate that PELP1 / MNAR and ER beta are coexpressed in most SDCs and may play a role in the pathobiology of these tumors.

Adenocarcinoma↗

PubMed2000

Expression of androgen receptor and prostatic specific markers in salivary duct carcinoma: an immunohistochemical analysis of 13 cases and review of the literature.

Salivary duct carcinoma (SDC) is an uncommon, pathologically distinct entity characterized by its morphologic resemblance to ductal carcinoma of the breast and highly aggressive behavior. Approximately two thirds of patients die within 4 years of initial diagnosis despite aggressive, combined surgical resection and radiotherapy. Review of the literature indicates that androgen receptor (AR), a marker frequently detected in prostatic carcinoma, is expressed in over 90% of SDCs, whereas two common breast carcinoma markers, estrogen and progesterone receptors (ER and PR), are expressed in only 1.3% and 6% of the tumors, respectively, by immunohistochemistry. This hormonal profile suggests that SDC, in contrast to its histiologic similarity to ductal carcinoma of the breast, is immunophenotypically more related to prostatic carcinoma. To substantiate this hypothesis, we performed immunohistochemical staining of 13 cases of SDC for the presence of AR and two prostatic markers, prostate specific antigen (PSA) and prostatic acid phosphatase (PAP). Our results showed multifocal, scattered, moderate immunostaining for PAP and diffuse, moderate immunostaining for PSA in seven (58.3%) and two (16.7%) cases, respectively. These results create a potential diagnostic challenge to surgical pathologists who are dealing with a metastatic adenocarcinoma of AR+/PSA+/-/PAP+/- phenotype, particularly in male patients of unknown primary. Metastatic salivary duct carcinoma should be given serious thought if clinical investigation fails to reveal a prostatic primary. The immunophenotypic homology that exists between SDC and prostatic carcinoma also suggests that antiandrogen therapy as used in the treatment of prostatic carcinoma might be beneficial in patients with metastatic SDC when all other conventional modalities fail.

Acid Phosphatase↗

PubMed1998

Cytologic characteristics and histomorphologic correlations of 21 salivary duct carcinomas.

Fine-needle samplings (FNS) of 21 salivary duct carcinomas, histologically correlated, including 19 primaries, one local recurrence, and one lymph node metastasis from 19 patients, are reported. Cytologic diagnosis of high-grade adenocarcinoma was established in 15 (71%). Five (24%) cases were misclassified as high-grade mucoepidermoid carcinomas and one (5%) as squamous-cell carcinoma. The histologic evaluation in all cases showed cytomorphologic features resembling mammary duct carcinoma with marked cytonuclear atypia and occasional oncocytic appearance. Our cytohistologic correlations indicate that irregular clusters of high-grade adenocarcinoma cells with necrotic background and oncocytic features suggest a cytologic diagnosis of either primary salivary duct carcinoma or metastatic mammary carcinoma.

Adenocarcinoma↗

PubMed2006

3D MR sialography protocol for postradiotherapy follow-up of the salivary duct system.

PURPOSE: To develop and evaluate an MR sialography protocol that reproducibly images the parotid and submandibular ducts over time, in 3D. Such a protocol is needed in order to investigate the possible radiation-induced changes to the salivary ducts in patients receiving radiotherapy to the head-and-neck. MATERIALS AND METHODS: MR sialography was performed on a 1.5-T MR scanner. Sequence parameters were optimized on 11 healthy volunteers. A 3D water-selective turbo spin echo (TSE) pulse sequence (TR/TE = 6000 msec/190 msec), using a two-element circular surface coil was applied twice in one MR session. In order to assess the reproducibility, the same procedure was repeated four to six months later. The quality of the MR sialograms was measured subjectively by developing a visibility scoring system and objectively by the means of contrast-to-noise ratio (CNR) of the ducts vs. fat (CNR(duct-fat)). RESULTS: High-quality, 3D MR sialographic images were obtained. The quality of the MR sialograms and the subjective visibility score of the salivary ducts were constant over time. The CNR(duct-fat) varied between volunteers (standard deviation, SD 26%) but it was relatively constant per volunteer (SD 5%). CONCLUSION: The MR sialography protocol presented in this study provides good quality 3D imaging of the major salivary ducts, submandibular duct, and the parotid duct and it can be used for the comparison of the salivary duct system of an individual over time.

Head and Neck Neoplasms↗

PubMed1994

Salivary duct carcinoma. Part I. A clinicopathologic evaluation and DNA image analysis of 13 cases with review of the literature.

Salivary duct carcinoma is an uncommon and relatively unknown clinically aggressive adenocarcinoma of salivary origin that histologically demonstrates a remarkable resemblance to invasive carcinoma of the breast. We report the clinicopathologic features of 13 cases that were also examined by image analysis for DNA ploidy. The results were then analyzed collectively with the less than 100 cases of salivary duct carcinoma reported in the English-language literature to define the characteristics of this unusual neoplasm. The 12 men and one woman averaged 68 years of age (range, 49 to 90 years). All tumors arose in the parotid (10 cases) or submandibular glands (three cases). Nine tumors were aneuploid, three diploid, and one was indeterminate because of insufficient tissue. Follow-up (median, 24 months) was available in 12 cases: three patients died of disease, six were alive without disease, and three died of other causes. Combining our cases with those in the literature, a total of 104 cases, confirms that salivary duct carcinoma is a highly malignant neoplasm with distinctive clinical and pathologic features. It arises almost exclusively in the major salivary glands (96% of cases), is three times more common in men, and usually occurs in patients over 50 years of age (range, 22 to 91 years). One-third of patients experience local recurrences, 59% develop positive regional lymph nodes, 46% have systemic metastases (lungs and bones), and 65% die of their disease, usually within 4 years of diagnosis. Determination of tumor ploidy has no prognostic significance. The presence of distant metastasis was the only clinicopathologic feature that was statistically associated with prognosis (p = 0.02); all patients with systemic metastasis died of disease.

Adenocarcinoma↗

PubMedDate not supplied

Ultrastructural and immunohistochemical study of salivary duct carcinoma of the parotid gland.

A case of salivary duct carcinoma of the parotid gland found in an 81-year-old man was studied by light microscopy, immunohistochemistry, and electron microscopy. Histologically, the tumor was composed of elongated cords of cells and ductal structure with desmoplastic stromal reaction. Tumor cell nests sometimes showed central comedonecrosis. Immunohistochemically, the tumor cells were positive for cytokeratin and epithelial membrane antigen, and they were negative for S-100 protein and muscle-specific actin. Electromicroscopically, two cell types were identified. The first cell type showed electron-lucent cytoplasm with scant organelles. The second type cell contained numerous mitochondria. Neither acinar nor myoepithelial cell differentiation was observed. These findings suggest that salivary duct carcinoma originates from the interlobular or excretory ducts.

Adenocarcinoma↗

PubMed2002

Balloon dilatation of salivary duct strictures: report on 36 treated glands.

PURPOSE: This paper describes the technique for balloon dilatation of salivary duct strictures and evaluates the clinical and radiographic findings in a consecutive series of 36 affected glands. METHODS: Thirty-four patients (36 glands) had balloon dilatation of their salivary duct strictures performed under fluoroscopic control. They were evaluated immediately afterwards and at review by sialography. RESULTS: In 36 cases attempted, 33 (92%) strictures were dilated. The immediate post-treatment sialogram was available in 28 cases, of which 23 (82%) demonstrated complete and four (14%) partial elimination of stricture. In one case the appearance was unchanged (4%). Review data (mean 6.8 months) were available on 25 glands: 12 were asymptomatic (48%), 12 (48%) had reduced symptoms and one (4%) failed to improve. Sialographic data were available on 21 glands: in 10 (48%) the duct remained patent, in one (5%) the stricture was partially eliminated, in seven (33%) the strictures had returned and in the remaining three (14%) cases there was complete obstruction. CONCLUSIONS: Balloon dilatation is an effective treatment of salivary duct stenosis. In half the cases the stricture recurred but symptomatic improvement was achieved and maintained in the majority of cases.

Catheterization↗

PubMed1999

Cytomorphological features of salivary duct carcinoma ex pleomorphic adenoma: diagnosis by fine-needle aspiration biopsy with histologic correlation.

We report a case of salivary duct carcinoma arising from a pleomorphic adenoma (ex pleomorphic adenoma) in a parotid salivary gland of a 70-yr-old man. Fine-needle aspiration biopsy showed two distinct subsets of cells. There was the typical biphasic pattern of pleomorphic adenoma consisting of bland epithelial cells admixed with uniform spindle-shaped cells and chondromyxoid stroma. In addition, there were features of salivary duct carcinoma best demonstrated by necrosis and the presence of large polygonal cells arranged either singly or in rosettes, clusters or sheets reminiscent of ductal carcinoma of the breast. This case illustrates that the presence of background large polygonal cells and necrosis in an otherwise typical pleomorphic adenoma may suggest the diagnosis of a high-grade carcinoma, namely salivary duct carcinoma, which portends poor prognosis and requires aggressive treatment. Differential diagnosis from other carcinomas known to arise in pleomorphic adenoma is discussed.

Adenoma, Pleomorphic↗

PubMed2003

Dopamine and serotonin receptors mediating contractions of the snail, Helix pomatia, salivary duct.

The combination of high performance liquid chromatography, bioassay and immunocytochemistry was applied to study the regulation of the salivary duct muscle of the snail, Helix pomatia. The major function of the duct appears to be to propel the saliva toward the buccal cavity during feeding. It has been established that serotonin and dopamine applied exogenously mimic the effect on the duct exerted by the stimulation of the salivary nerve. Immunohistochemistry revealed the presence of serotonin, but not dopaminergic nerve elements in the nerve and along the duct surface. However, both serotonin (14.9-15.5 pmol/mg) and dopamine (0.38-0.58 pmol/mg), as well as the synthesizing enzymes (tyrozine hydroxylase 0.28 pmol/mg tissue/h and DOPA 0.32 nmol synthesized DA/mg tissue/h) could regularly be assayed in the salivary duct by high performance liquid chromatography. When released following the stimulation of the salivary nerve, both monoamines were shown to interact with distinct membrane receptors. Dopamine elicited a sustained increase of the muscle tone in concentration-dependent manner (K(d)=1.5 microM). Mammalian D(1) receptor antagonist flupenthixol and fluphenazine attenuated, whereas the D(1) receptor agonist SKF-38393 mimicked the effect elicited by exogenous dopamine. Serotonin had a double effect on the salivary duct: a relaxing and a contracting one with different K(d) values 76 nM and 2.4 microM, respectively. 5-HT(2) receptor antagonist ritanserin and ketanserin attenuated the serotonin-induced relaxation. In contrast 5-HT(3) antagonist metoclopramide and MDL2222 decreased and 5-HT(3) receptor agonist 1-(m-chlorophenyl)-biguanide mimicked the serotonin-induced contraction, suggesting that serotonin exerted its action on two different receptor subtypes. The release of radiolabeled serotonin and dopamine upon nerve stimulation was found to be Ca-dependent. Furthermore, the increase in serotonin concentration induced a decrease of the potency of dopamine to elicit sustained contraction. These results provide evidence for the transmitter role of serotonin and dopamine in salivary duct. It is concluded that receptors reveal a pharmacological profile related to vertebrate D(1), 5-HT(2) and 5-HT(3) receptor subtypes. Moreover, it was found that the process of conveying the saliva is modulated by an interaction of dopamine and serotonin.

Animals↗

PubMed1999

Hybrid carcinoma of the salivary gland: salivary duct adenocarcinoma adenoid cystic carcinoma.

AIMS: Hybrid tumours of the salivary gland are rare neoplasms that have been described only in the parotid and palate. Their recognition is important particularly when the component tumours have different biological behaviours. The occurrence of a submandibular hybrid tumour has not been reported. METHODS AND RESULTS: We describe a case of a 36-year-old woman with a hybrid carcinoma composed of salivary duct adenocarcinoma and adenoid cystic carcinoma of the right submandibular gland. There was no evidence of a pre-existing or concurrent pleomorphic adenoma. The presence of the two components was verified by differential immunohistochemical staining using a panel of cytokeratin, vimentin, smooth muscle actin and S100. The patient subsequently developed metastases to the pelvis, lumbar, vertebra and wrist. The clinical course in this patient was consistent with the behaviour of the salivary duct adenocarcinoma component. CONCLUSIONS: The histogenesis of hybrid tumours is largely unknown, but in this case it may represent diverging differentiation of luminal tumour cells. Because some histological features of different salivary gland tumours overlap, immunohistochemistry is a valuable tool especially when used to delineate the components of a hybrid tumour.

Actins↗

PubMed1995

Na+, K+, and H+/HCO3- transport in submandibular salivary ducts. Membrane localization of transporters.

The mechanisms mediating transepithelial ion transport in salivary ducts were characterized and localized by studying the regulation of [Na+]i, [K+]i, and pHi in isolated intralobular ducts and perfused main ducts of the submandibular salivary gland. A new procedure was developed for the rapid preparation of intralobular ducts. Measurements of pHi revealed the presence of Na+/H+ and Cl-/HCO3- exchange activities in intralobular duct cells. We could not obtain evidence for a coupled K+/H+ exchange activity which was postulated to exist in the luminal membrane of duct cells. Rather, a Kout+-dependent pathway which mediates the transport of H+/HCO3- and Na+ was found. This pathway was absent from acinar cells of the same gland and was active in unstimulated duct cells incubated in 5mM Kout+. Accordingly, inhibition of the Na+ pump with ouabain resulted in rapid and large Na+ influx in duct but not acinar cells. Perfusion experiments with the experimentally accessible main duct and measurements of pHi were used to provide the first direct localization of ion transporters in salivary ducts. The luminal and basolateral membranes of the duct express separate Na+/N+ and Cl-/HCO3- exchangers. Na+/H+ exchange activity in both membranes was similar, whereas the luminal Cl-/HCO3- exchange activity was higher than that in the basolateral membrane. The perfused main dust was also used to localize the newly discovered Kout(+)-dependent H+/HCO3- and Na+ transport pathway to the luminal membrane, which suggests that this pathway may play an important role in Na+ reabsorption of K+ and HCO3- secretion by the salivary ductal system.

Animals↗

PubMed1997

Salivary duct carcinoma: clinical characteristics and treatment strategies.

BACKGROUND: Salivary duct carcinoma (SDC) is a highly malignant tumor of the salivary gland. METHODS: Twenty-six cases observed during the period 1975 to 1994 were selected from the pathology archives of the Instituto Nazionale Tumori of Milan. A review of all the similar cases published in the literature and comparison with the present series was performed. RESULTS: SDC was mainly a parotid gland tumor diagnosed at an advanced stage. Lymphatic involvement seems to be related to T stage. Distant spread was evidently related to the presence of lymph node metastasis. Surgery with radiotherapy was the standard treatment. The only demonstrable negative prognostic factor was the presence of node metastases (p = 0.01). CONCLUSIONS: Most patients died of disseminated disease in spite of an aggressive and often successful local-regional treatment. The role of a prophylactic ipsilateral neck dissection and adjunctive systemic treatment should be investigated.

Adult↗

PubMed2002

[Amplification and overexpression of HER-2/neu in parotid gland salivary duct carcinoma. Immunohistochemical study and fluorescence in situ hybridization].

Salivary duct carcinoma (SDC) is highly malignant salivary gland tumour with aggressive clinical behaviour, characterised by its histological resemblance to invasive ductal carcinoma of the breast. Amplification of gene HER-2/neu and overexpression of its gene product have been shown to have both prognostic and treatment implications in breast cancer. The reports concerning the expression of c-erbB2/HER-2/neu in salivary gland tumours are few and controversial. Thus, eleven cases of SDC were evaluated for HER-2/neu status using immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH). To the best of our knowledge, this is the first molecular genetic analysis of SDCs using FISH. HER-2/neu overexpression, identified as strong membrane staining, was observed in all but one case of SDC in majority of neoplastic cells while only four tumours, of nine cases analysed, revealed HER-2/neu gene amplification by means of FISH analysis. SDCs were associated with poor clinical outcome, 6 patients (55%) died of disseminated carcinoma within 4 to 44 months after therapy. There was no difference in outcome of patients with IHC positive-nonamplified and IHC positive-amplified tumours.

Adult↗

PubMed1989

Low-grade and high-grade adenocarcinomas of the salivary duct system.

Adenocarcinomas of salivary glands are encountered less frequently than adenoid cystic or mucoepidermoid carcinomas. They fall into two well-defined clinicopathologic groups: 1) those arising from intercalated ducts and 2) those from the excretory and interlobular ducts. The former, designated terminal duct adenocarcinomas, are low-grade malignancies found preponderantly in the oral cavity, especially the palate. The latter, designated salivary duct carcinomas, are high-grade neoplasms and arise almost exclusively in major salivary glands, especially the parotid gland.

Adenocarcinoma↗

PubMedDate not supplied

Intraoral salivary duct carcinoma: a clinicopathological study of four cases and review of the literature.

Salivary duct carcinoma (SDC) is a distinctive entity of highly malignant salivary gland tumors. We present the clinical features and outcomes of four cases in minor salivary glands and of 69 additional cases previously reported in the literature. The tumor occurs most frequently in the sixth and seventh decades of life with a 3.8:1 male preponderance. The prognosis is dismal. Sixty-one percent of patients were dead within 5 months to 10 years (mean 25 months) and the rate of lymph node metastasis was 60%. Twenty-eight percent of patients were without evidence of the disease for 13 months to 9 years (mean 33 months). The histologic features, differential diagnosis, and origin of SDC are discussed.

Adenocarcinoma↗

PubMed2001

H+ and HCO3- transporters in human salivary ducts. An immunohistochemical study.

The presence and cellular distribution of key H+ and HCO3- transport proteins was studied in human salivary ducts. Immunofluorescence and immunoperoxidase light microscopy was applied, using specific antibodies against the NHE1 and NHE3 isoforms of the Na+/H+ exchanger, against the 31 and 70 kDa subunits of the vacuolar H+-ATPase and against the electrogenic Na+-HCO3- cotransporter. The results show basolateral NHE1 and apical NHE3 in human submandibular, parotid and sublingual duct cells. Vacuolar H+-ATPase was found predominantly in the apical membrane of parotid, submandibular and sublingual duct cells, although it was absent in certain parotid striated duct cells. The Na+-HCO3- cotransporter was predominantly expressed in the apical membrane of parotid and sublingual striated ducts, and intracellularly distributed in the distal parts of the gland tree and in submandibular ducts. The results indicate that HCO3- transport properties of salivary ducts may vary not only between gland and species, but even in different duct segments of the same gland as well.

Adult↗

PubMedDate not supplied

Salivary duct carcinoma of the parotid gland. Report of a case with cytologic and immunocytochemical findings on fine needle aspiration biopsy.

BACKGROUND: Salivary duct carcinoma (SDC) is a rare high grade neoplasm arising from the larger ducts of the major salivary glands, most frequently in the parotid glands in the elderly. It is important to identify some characteristics that allow differentiating SDC from the other salivary gland adenocarcinomas, which have different prognoses. CASE: A 63-year-old, white male presented with an indolent swelling in the left parotid gland, the retromandibular angle. Fine needle aspiration biopsy (FNAB) showed polygonal or cuboidal, medium-sized, moderately pleomorphic cells with round to oval nuclei in cytocentrifuge preparations. Small tissue fragments with a prominent cribriform pattern and an area of comedocarcinoma were observed in the cytocentrifuged material. Tumor cells were diffusely immunoreactive for low- and high-molecular-weight cytokeratins, and strong positivity was observed with 115D8 and Ber-EP4 antibodies. Overexpression of c-ERB B-2 was absent, and < 5% of the nuclei were immunoreactive for p53. CONCLUSION: The cytologic and immunocytochemical appearance of SDC are characteristic, and FNAB results provide the surgeon with useful information for planning surgical therapy.

Biopsy, Needle↗