pleomorphic adenoma clinical features – painless – slow growing – mobile – discreet masses...
TRANSCRIPT
Pleomorphic adenoma
• Clinical features– Painless– Slow growing– Mobile– Discreet masses– Carcinoma arising in a pleomorphic adenoma
is called Carcinoma ex pleomorphic adenoma or malignant mixed tumour
Pleomorphic adenoma
• Clinical features– Incidence of Malignant transformation increases
with duration of tumour• 2% for tumours less than 5 years• 10% for tumours more than 15 years duration• Usually adenocarcinoma or undifferentiated
carcinoma• Tumours are very aggressive • For a diagnosis of Carcinoma ex Pleomorphic
adenoma, recognizable traces of pleomorphic adenoma must be present
Warthin Tumour
• Papillary Cystadenoma Lymphomatosum
Warthin Tumour
• Benign neoplasm• Second most common salivary gland
tumour• Arises only within the Parotid• Occurs more commonly in males• Fifth to seventh decades• 10% multifocal; 10% bilateral• Smokers have 8 times the risk of non
smokers
Warthin Tumour
• Morphology - Gross– Round to oval– Encapsulated masses– 2 to 5 cms– Superficial parotid gland– Cut surface pale gray puctuated by narrow
cystic spaces filled with mucin or serous secretion
Warthin Tumour
• Morphology - Microscopy– Cystic spaces lined by double layer of
neoplastic epithelial cells– Neoplastic cells rest on a dense lymphoid
stroma sometimes with germinal centers– Spaces narrowed by presence of polypoidal
lymphoepithelial projections
Warthin Tumour
• Morphology - Microscopy
– Double layer of epithelial lining cells
• Surface palisade of columnar cells having abundant, finely granular, eosinophilic cytoplasm - oncocytic appearance
• These cells rest on a layer of cuboidal cells
• Oncocytes are epithelial cells stuffed with mitochondria
• Occasionally foci of squamous metaplasia
Topics covered
• Premalignant lesions of oral cavity– Leukoplakia– Erythroplakia
• Squamous cell carcinoma of oral cavity• Tumours of salivary gland