1
|
Almahari SAI, Chandran N, Maki RJ. Deceptive Triple-Negative Breast Cancer of Intermediate Grade: A Case of Rare Microglandular Adenosis-Associated Carcinoma. Cureus 2023; 15:e39531. [PMID: 37250605 PMCID: PMC10217789 DOI: 10.7759/cureus.39531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 05/31/2023] Open
Abstract
Breast cancer is the most common cancer among women and the leading cause of cancer-related deaths globally. Ductal carcinoma of no special type is the most prevalent, followed by lobular carcinoma. Finding a triple-negative breast cancer of intermediate grade on core biopsies should raise the possibility of dealing with one of the rare subtypes such as microglandular adenosis (MGA)-associated carcinoma. Here, we present a case of a 40-year-old female, who presented with bilateral breast masses, in which one of them was a high-grade carcinoma and the other turned out to be an MGA-associated carcinoma, which was misdiagnosed initially on the core biopsy as a grade II triple-negative ductal carcinoma of no special type. Such diagnosis is challenging to pathologists, especially on small biopsies where the full morphological spectrum is not evident.
Collapse
Affiliation(s)
- Sayed Ali I Almahari
- Department of Pathology: Anatomical Pathology, Salmaniya Medical Complex, Manama, BHR
| | - Nisha Chandran
- Department of Pathology: Anatomical Pathology, Salmaniya Medical Complex, Manama, BHR
| | - Reem J Maki
- Department of Radiology, Salmaniya Medical Complex, Manama, BHR
| |
Collapse
|
2
|
Sugino T, Kakuda Y, Yasui H, Oishi T, Norose T, Kawata T, Tadokoro Y, Nishimura S. A case of extensively spreading acinic cell carcinoma of the breast with microglandular features. Pathol Int 2023; 73:45-51. [PMID: 36579416 DOI: 10.1111/pin.13302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 11/30/2022] [Indexed: 12/30/2022]
Abstract
Acinic cell carcinoma (ACC) is an exceptionally rare type of breast carcinoma with a low-grade morphology and a favorable prognosis. It is postulated to be a type of invasive carcinoma arising in microglandular adenosis (MGA). We report a case of extensively spreading ACC of the breast with MGA-like features. Macroscopically, yellowish nodules were widely distributed throughout the right breast, up to the axilla, without mass formation. Microscopically, the tumor consisted of two distinct carcinoma components: one was multiple nodular lesions showing invasive carcinoma with fused solid nests, and the other was a widely spreading lesion exhibiting MGA-like features with uniform small single glands. Immunohistochemically, both components were negative for ER, PR, and HER2, and expressed EMA, S100 and lysozyme. The distinct morphology and molecular expression indicated ACC. The single glands in the MGA-like area lacked myoepithelial cells but were linearly surrounded by type IV collagen, a basement membrane component. This case supports the hypothesis that ACC and MGA have the same lineage and indicates that ACC is not necessarily a low-grade malignancy and can be aggressive.
Collapse
Affiliation(s)
- Takashi Sugino
- Division of Pathology, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Yuko Kakuda
- Division of Pathology, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Haruna Yasui
- Division of Pathology, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Takuma Oishi
- Division of Pathology, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Tomoko Norose
- Division of Pathology, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Takuya Kawata
- Division of Pathology, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Yukiko Tadokoro
- Division of Breast Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Seiichiro Nishimura
- Division of Breast Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| |
Collapse
|
3
|
Nikitina VI, Khorzhevskii VA, Vershinin IV, Gappoev SV, Alymova EV, Levkovich LG. [ Microglandular adenosis of the breast]. Arkh Patol 2023; 85:40-43. [PMID: 37053352 DOI: 10.17116/patol20238502140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
The presented case describes the difficulties of diagnosis of the breast microglandular adenosis (MGA), taken by clinicians for a malignant process due to the nature of growth and large size. Criteria for histological and immunohistochemical diagnosis and differentiation of MGA with malignant neoplasms, in particular, with tubular breast carcinoma, are presented. Taking into account the rarity of the pathology and the absence of described cases in the Russian-language literature, the observation is of interest to pathologists and clinicians.
Collapse
Affiliation(s)
- V I Nikitina
- Krasnoyarsk State Regional Bureau of Pathology, Krasnoyarsk, Russia
| | - V A Khorzhevskii
- Krasnoyarsk State Regional Bureau of Pathology, Krasnoyarsk, Russia
- Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia
| | - I V Vershinin
- Krasnoyarsk State Regional Bureau of Pathology, Krasnoyarsk, Russia
| | - S V Gappoev
- Krasnoyarsk State Regional Bureau of Pathology, Krasnoyarsk, Russia
- Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia
| | - E V Alymova
- Krasnoyarsk State Regional Bureau of Pathology, Krasnoyarsk, Russia
| | - L G Levkovich
- Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia
| |
Collapse
|
4
|
Yu F, Niu L, Wang B, Fan W, Xu J, Chen Q. Two cases of mammary acinic cell carcinomas with microglandular structures mimicking microglandular adenosis. Pathol Int 2022; 72:343-348. [PMID: 35512568 DOI: 10.1111/pin.13227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/30/2022] [Indexed: 12/22/2022]
Abstract
Acinic cell carcinoma (AcCC) of breast is a rare subtype of triple-negative breast carcinoma demonstrating a wide morphologic spectrum. In this study, we perform a detailed morphologic and immunohistochemical description of two cases of the rare entity and review the published relative literature. Histologically, the two cases both showed predominantly microglandular and solid structures overlapping with the histological features of microglandular adenosis (MGA), and one case presented spindle cell metaplastic carcinoma with chondromyxoid matrix as a minor morphologic pattern. In two cases, most of the cancer cells were positive for lysozyme and antitrypsin strongly and extensively, but negative for estrogen receptor (ER), progesterone receptor (PR), androgen receptors (AR) and human epidermal growth factor receptor 2 (HER2). The true relationship between breast AcCC and MGA or carcinoma arising in MGA(CAMGA) may remain unclear; re-excision is advised when the MGA-like content extends to the surgical margins in the setting of breast AcCC. More cases and further molecular investigations are required to elucidate the true histogenesis and give the patients appropriate treatment.
Collapse
Affiliation(s)
- Fang Yu
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.,Wuhan University Center for Pathology and Molecular Diagnostics, Wuhan, Hubei, China
| | - Li Niu
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.,Wuhan University Center for Pathology and Molecular Diagnostics, Wuhan, Hubei, China
| | - Bicheng Wang
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.,Wuhan University Center for Pathology and Molecular Diagnostics, Wuhan, Hubei, China
| | - Wei Fan
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.,Wuhan University Center for Pathology and Molecular Diagnostics, Wuhan, Hubei, China
| | - Jian Xu
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.,Wuhan University Center for Pathology and Molecular Diagnostics, Wuhan, Hubei, China
| | - Qiongrong Chen
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.,Wuhan University Center for Pathology and Molecular Diagnostics, Wuhan, Hubei, China
| |
Collapse
|
5
|
Grabenstetter A, D’Alfonso TM, Wen HY, Murray M, Brogi E, Tan LK. Morphologic and immunohistochemical features of carcinoma involving microglandular adenosis of the breast following neoadjuvant chemotherapy. Mod Pathol 2021; 34:1310-1319. [PMID: 33649459 PMCID: PMC8222073 DOI: 10.1038/s41379-021-00781-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 11/09/2022]
Abstract
Microglandular adenosis (MGA)-related lesions, including atypical MGA (AMGA) and carcinoma involving MGA (C-MGA), are characterized by epithelial atypia, negative hormone receptors, and HER2 status, and can mimic invasive triple negative breast cancer (TNBC) in core needle biopsies (CNB) resulting in selection for treatment with neoadjuvant chemotherapy (NAC). We identified 12 cases of AMGA and/or C-MGA in post-NAC excision specimens (EXC) and analyzed their morphologic and immunohistochemical (IHC) features. All CNBs were initially diagnosed as containing TNBC. Upon re-review, TNBC was confirmed in nine cases. In three CNBs AMGA and/or C-MGA had been interpreted as TNBC. AMGA was initially recognized in only one case but AMGA and/or C-MGA were present in an additional nine CNBs. At EXC, no residual TNBC was present in 5 of 9 EXCs and all 12 cases showed residual AMGA and/or C-MGA. Similar to conventional MGA, AMGA, and C-MGA were positive for S-100, laminin and collagen IV and negative for calponin and p63. Following NAC, these lesions retained their typical staining pattern despite acquiring treatment-related morphologic alterations, most notably of which were areas of single cell growth pattern seen in eight EXCs. This study is the first to report the effects of NAC on AMGA and C-MGA. Our data showed no response of the AMGA and/or C-MGA following NAC in contrast to the high response rate of conventional TNBC. In particular, the infiltrative single cell pattern of post-NAC MGA-related lesions closely mimicked residual TNBC. The persistence of AMGA and C-MGA following NAC supports the notion that these lesions are distinct from conventional TNBC. Our findings also highlight the challenges in recognizing AMGA and C-MGA in CNBs which may lead to unwarranted treatment with NAC in the absence of conventional TNBC.
Collapse
Affiliation(s)
- Anne Grabenstetter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | | | | | | | | | | |
Collapse
|
6
|
Weaver KD, Isom J, Esnakula A, Daily K, Asirvatham JR. Acinic Cell Carcinoma of the Breast: Report of a Case With Immunohistochemical and Next-Generation Sequencing Studies. Int J Surg Pathol 2021; 29:882-886. [PMID: 33827325 DOI: 10.1177/10668969211008508] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Acinic cell carcinoma of the breast is a rare subtype of triple-negative breast cancer that recapitulates the appearance of tumors seen in salivary glands. We present the case of a 42-year-old woman with an irregular, nontender mass above the left nipple during routine obstetric appointment at 24 weeks gestation. She was subsequently diagnosed with triple-negative invasive ductal carcinoma of the left breast, Nottingham grade 3, via core needle biopsy. She was treated with neoadjuvant therapy (doxorubucin and cyclophosphamide) antenatally and paclitaxel in the postpartum period followed by left mastectomy with sentinel node biopsy. The carcinoma in the mastectomy specimen showed a spectrum of morphologic patterns with immunohistochemistry revealing strong positivity for alpha-1-antichymotrypsin, epithelial membrane antigen (EMA), lysozyme, and S100. The histomorphology paired with the immunoprofile led us to the diagnosis of acinic cell carcinoma. We retrospectively performed immunostains in the core biopsy specimen, which demonstrated GATA-3 and DOG-1 positivity. Next-generation sequencing of the postneoadjuvant specimen using a 70-gene panel revealed 2 single-nucleotide variant (SNV) mutations: tumor protein 53 (TP53) (c.747G>T) SNV mutation and rearranged during transfection (RET) (c.2899G>A) SNV mutation.
Collapse
Affiliation(s)
- Kaitlin D Weaver
- Department of Pathology, Immunology, and Laboratory Medicine, 3463University of Florida, Gainesville, FL, USA
| | - James Isom
- Department of Pathology, Immunology, and Laboratory Medicine, 3463University of Florida, Gainesville, FL, USA
| | - Ashwini Esnakula
- Department of Pathology, Immunology, and Laboratory Medicine, 3463University of Florida, Gainesville, FL, USA
| | - Karen Daily
- Department of Medical Oncology, 12233University of Florida, Gainesville, FL, USA
| | - Jaya R Asirvatham
- Department of Pathology, Immunology, and Laboratory Medicine, 3463University of Florida, Gainesville, FL, USA
| |
Collapse
|
7
|
Damron AT, Korhonen K, Zuckerman S, Tchou J, Dumoff KL, Bleiweiss IJ, Nayak A. Microglandular Adenosis: A Possible Non-Obligate Precursor to Breast Carcinoma With Potential to Either Luminal-Type or Basal-Type Differentiation. Int J Surg Pathol 2019; 27:781-787. [PMID: 31046496 DOI: 10.1177/1066896919845493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Microglandular adenosis (MGA) of the breast is exceedingly rare, with only a few case reports and series published to date. Previous studies have elegantly demonstrated the progression of benign MGA to atypical MGA to MGA-in situ carcinoma to invasive carcinoma and therefore suggest MGA as a possible non-obligate precursor lesion to a subset of breast carcinomas. Immunohistochemically, MGA is negative for estrogen receptor (ER), progesterone receptor (PR), and HER2-neu oncoprotein expression, and carcinomas arising in the setting of MGA are often reported to be triple negative. In this article, we present a unique case of an ER+/PR+/HER2- invasive carcinoma associated with MGA and atypical MGA. Our case highlights the diagnostic pitfall of MGA and suggests that MGA is a heterogeneous group of lesions with potential for either luminal-type or basal-type differentiation during progression to breast carcinoma.
Collapse
Affiliation(s)
| | - Katrina Korhonen
- 1 Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Julia Tchou
- 1 Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Ira J Bleiweiss
- 1 Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Anupma Nayak
- 1 Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
8
|
Tsang JY, Tse GM. Microglandular adenosis: a prime suspect in triple-negative breast cancer development. J Pathol 2017; 239:129-32. [PMID: 27061094 DOI: 10.1002/path.4726] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 03/29/2016] [Accepted: 04/04/2016] [Indexed: 02/01/2023]
Abstract
Microglandular adenosis (MGA) and atypical MGA (AMGA) are unusual lesions of the breast. They were once regarded as benign proliferative lesions and innocent bystanders. Several lines of evidence suggested that they could be neoplastic, clonal lesions and a non-obligate precursor for triple-negative breast cancers (TNBC). Recent work published in The Journal of Pathology by Guerini-Rocco and colleagues provided further evidence regarding the precursor-product relationship between MGA/AMGA and TNBC. Using a massively parallel sequencing approach, they demonstrated that MGA/AMGA, particularly those associated with TNBC, could be clonal neoplastic lesions showing clonal non-synonymous mutations, but none in pure MGA. Importantly, those alterations were observed in the associated TNBC. They were also able to identify recurrent alterations in TP53 in those MGA/AMGA cases as well as their associated TNBC. The findings, in conjunction with others, underscore the significance for MGA in clinical diagnosis. The potential of a benign lesion to progress into an aggressive malignant tumour implies that modification of the current management approach may be necessary. Copyright © 2016 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Julia Ys Tsang
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, Shatin, NT, Hong Kong
| | - Gary Mk Tse
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, Shatin, NT, Hong Kong
| |
Collapse
|
9
|
Liu LY, Sheng SH, Zhang ZY, Xu JH. A case of matrix-producing carcinoma of the breast with micoglandular adenosis and review of literature. Int J Clin Exp Pathol 2015; 8:8568-8572. [PMID: 26339435 PMCID: PMC4555763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 06/26/2015] [Indexed: 06/05/2023]
Abstract
Matrix-producing carcinoma (MPC) of the breast is an extremely rare variant of metaplastic breast carcinoma that contains a mixture of epithelial and mesenchymal elements. As overt carcinoma with direct transition to a cartilaginous and/or osseous stromal matrix cells, MPC is of no spindle cells between those two elements. This is the case of a 43 year-old female patient with MPC which coexisted with microglandular adenosis (MGA), atypical MGA (AMGA) and carcinoma in situ arising in MGA (MGACA in situ). MGA is a rare, infiltrative, benign lesion of the breast with an indolent clinical course. Histological evidence of carcinoma arising from MGA has previously been documented. MPC arising in MGA is an extremely rare subtype of breast carcinoma and has been seldom detailed described in the previous studies. This report highlights one such case with cytomorphological and histopathological correlation, along with a review of pertinent literature and differential diagnosis.
Collapse
Affiliation(s)
- Li-Yun Liu
- Department of Pathology, Tangshan Gongren HospitalTangshan, China
| | - Shu-Hai Sheng
- Department of Breast Surgery, Tangshan Gongren HospitalTangshan, China
| | - Zhi-Yong Zhang
- Department of Pathology, Tangshan Gongren HospitalTangshan, China
| | - Jin-Heng Xu
- Department of Pathology, Tangshan Gongren HospitalTangshan, China
| |
Collapse
|
10
|
Zhong F, Bi R, Yu B, Cheng Y, Xu X, Shui R, Yang W. Carcinoma arising in microglandular adenosis of the breast: triple negative phenotype with variable morphology. Int J Clin Exp Pathol 2014; 7:6149-6156. [PMID: 25337263 PMCID: PMC4203234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 08/23/2014] [Indexed: 06/04/2023]
Abstract
Carcinoma arising in microglandular adenosis (MGACA) is an extremely rare subtype of breast carcinoma. In this study, clinicopathological analysis of MGACA from 11 Chinese patients was conducted. Microscopically, all cases showed a spectrum of structure and glandular proliferations ranging from microglandular adenosis (MGA) to atypical MGA (AMGA) to MGACA. Carcinoma components were composed of high grade ductal carcinoma in situ (DCIS) in 1 case and invasive carcinoma in 10 cases. Invasive carcinomas were grade 3 in 10 tumors and grade 2 in 1. Invasive components in 5 of 10 cases were composed of invasive carcinoma of no special type (NST), and 1 case showed partially acinic cell differentiation. In 5 cases, invasive components were mixed of NST and matrix-producing carcinoma (MPC). All epitheliums in 11 cases were triple negative (ER-, PR-, HER2-), and diffuse positive for CK and S-100 protein. No myoepithelial cells were demonstrable from MGA to invasive components with immunohistochemical staining for P63 and calponin. PAS or reticulin stain showed the presence of a basement membrane around glands in MGA, AMGA, DCIS, and its absence in invasive components. Follow-up time ranged from 10 to 64 months. One patient developed a lung metastasis 24 months after surgery, 10 patients have been alive without recurrence. Our study revealed that MGACA is a distinct subset of breast carcinoma, with triple negative phenotype, high grade nuclear and variable morphology. Despite histopathologic and immunohistochemical features usually associated with a poor prognosis, MGACA seems to have a relatively favorable outcome.
Collapse
Affiliation(s)
- Fangfang Zhong
- Department of Pathology, Cancer Center, Fudan UniversityShanghai, China
- Department of Oncology, Fudan UniversityShanghai, China
| | - Rui Bi
- Department of Pathology, Cancer Center, Fudan UniversityShanghai, China
- Department of Oncology, Fudan UniversityShanghai, China
| | - Baohua Yu
- Department of Pathology, Cancer Center, Fudan UniversityShanghai, China
- Department of Oncology, Fudan UniversityShanghai, China
| | - Yufan Cheng
- Department of Pathology, Cancer Center, Fudan UniversityShanghai, China
- Department of Oncology, Fudan UniversityShanghai, China
| | - Xiaoli Xu
- Department of Pathology, Cancer Center, Fudan UniversityShanghai, China
- Department of Oncology, Fudan UniversityShanghai, China
| | - Ruohong Shui
- Department of Pathology, Cancer Center, Fudan UniversityShanghai, China
- Department of Oncology, Fudan UniversityShanghai, China
| | - Wentao Yang
- Department of Pathology, Cancer Center, Fudan UniversityShanghai, China
- Department of Oncology, Fudan UniversityShanghai, China
| |
Collapse
|
11
|
Khan RA, Chernock RD, Lewis JS. Seromucinous hamartoma of the nasal cavity: a report of two cases and review of the literature. Head Neck Pathol 2011; 5:241-7. [PMID: 21618016 PMCID: PMC3173540 DOI: 10.1007/s12105-011-0269-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 05/14/2011] [Indexed: 11/25/2022]
Abstract
The sinonasal tract is a complex anatomic site, home to a wide variety of reactive, inflammatory, benign, and malignant lesions. Inflammatory polyps and papillomas are usually easily recognized by pathologists. A poorly understood lesion that has been more clearly defined in recent years is the nasal hamartoma. The epithelial subtypes include seromucinous hamartoma, respiratory epithelial adenomatoid hamartoma, and hybrid lesions. Seromucinous hamartomas have only been recognized and substantially reported over the past few years. They are a diagnostic challenge, needing to be distinguished from low grade adenocarcinomas, and are of interest because most of the basic questions about their pathophysiology remain unanswered. Herein, we present two novel cases of seromucinous hamartoma with features that partly expand the morphologic spectrum of these lesions, discuss the differential diagnosis, and review the literature to compare our findings with previously reported cases with the aim of better understanding this interesting entity.
Collapse
Affiliation(s)
- R. A. Khan
- Division of Anatomic and Molecular Pathology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO USA
| | - R. D. Chernock
- Division of Anatomic and Molecular Pathology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO USA
| | - J. S. Lewis
- Division of Anatomic and Molecular Pathology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO USA
- Department of Otolaryngology Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO USA
| |
Collapse
|