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Abstract：
OBJECTIVE: This study describes a large, well-documented case series of salivary gland polymorphous adenocarcinomas (PAC) from a single Brazilian center.
METHODS: Demographic data, clinical presentation, histopathological and immunohistochemical features from 26 cases of PAC were analyzed and discussed in detail.
RESULTS: Most patients were females (n = 21), with a ratio of 1:4.2 (male: female) with a mean age of 58.8 years (ranging from 36 to 84 years). The most common clinical presentation was a fibrocollagenous, firm nodular lesion, with a mean size of 2.46 cm (ranging from 0.5 to 3 cm). Most lesions occurred on the palate (n = 16), followed by buccal mucosa (n = 3), upper lip (n = 3), buccal vestibule (n = 2) and alveolar ridge (n = 1). Histologically, various growth patterns were observed, including tubular, solid, cribriform, papillary, and cystic. Additionally, glomeruloid slit-like structures, mucous, and clear cells were noted. Surface papillary epithelial hyperplasia was observed in a few cases. Nine cases exhibited myxoid and collagenous areas, while two cases showed fusiform areas and another case demonstrated squamous differentiation. Clear cell predominance was noted in two cases, and peri- and intraneural invasion was seen in eight cases. Immunohistochemical analysis revealed positivity for S-100, p63 and CK7, and negativity for p40 in all cases. The Ki-67 proliferation index was markedly low in most cases, with a mean of 2.5%.
CONCLUSIONS: We have provided a broad, detailed description of the clinical and microscopic features of PAC in a large, Brazilian cohort. These findings, in a resource-limited area, may be quite useful for establishing a proper diagnosis.
METHODS: Demographic data, clinical presentation, histopathological and immunohistochemical features from 26 cases of PAC were analyzed and discussed in detail.
RESULTS: Most patients were females (n = 21), with a ratio of 1:4.2 (male: female) with a mean age of 58.8 years (ranging from 36 to 84 years). The most common clinical presentation was a fibrocollagenous, firm nodular lesion, with a mean size of 2.46 cm (ranging from 0.5 to 3 cm). Most lesions occurred on the palate (n = 16), followed by buccal mucosa (n = 3), upper lip (n = 3), buccal vestibule (n = 2) and alveolar ridge (n = 1). Histologically, various growth patterns were observed, including tubular, solid, cribriform, papillary, and cystic. Additionally, glomeruloid slit-like structures, mucous, and clear cells were noted. Surface papillary epithelial hyperplasia was observed in a few cases. Nine cases exhibited myxoid and collagenous areas, while two cases showed fusiform areas and another case demonstrated squamous differentiation. Clear cell predominance was noted in two cases, and peri- and intraneural invasion was seen in eight cases. Immunohistochemical analysis revealed positivity for S-100, p63 and CK7, and negativity for p40 in all cases. The Ki-67 proliferation index was markedly low in most cases, with a mean of 2.5%.
CONCLUSIONS: We have provided a broad, detailed description of the clinical and microscopic features of PAC in a large, Brazilian cohort. These findings, in a resource-limited area, may be quite useful for establishing a proper diagnosis.
摘要：
目的：这项研究描述了一个大型的，来自单个巴西中心的唾液腺多形性腺癌（PAC）的有据可查的病例系列。
方法：人口统计数据，临床表现,对26例PAC的组织病理学和免疫组织化学特征进行了详细的分析和讨论。
结果：大多数患者为女性（n=21），比例为1：4.2（男性：女性），平均年龄为58.8岁（36至84岁）。最常见的临床表现是纤维胶原，结节性病变,平均尺寸为2.46厘米（范围从0.5到3厘米）。大多数病变发生在腭（n=16），其次是颊粘膜（n=3），上唇（n=3），颊前庭（n=2）和牙槽（n=1）。组织学上,观察到各种生长模式，包括管状，固体,cribriform,乳头状，和囊性的。此外,肾小球样裂隙状结构，粘液，并注意到透明细胞。在少数情况下观察到表面乳头状上皮增生。9例表现为黏液样和胶原区，两例显示梭形区域，另一例显示鳞状分化。在两种情况下都注意到透明细胞优势，8例出现神经周和神经内侵袭。免疫组织化学分析显示，在所有情况下，S-100，p63和CK7均为阳性，p40均为阴性。Ki-67增殖指数在大多数情况下明显较低，平均值为2.5%。
结论：我们提供了广泛的，PAC的临床和微观特征的详细描述，巴西队列。这些发现,在资源有限的地区，可能对建立正确的诊断非常有用。
方法：人口统计数据，临床表现,对26例PAC的组织病理学和免疫组织化学特征进行了详细的分析和讨论。
结果：大多数患者为女性（n=21），比例为1：4.2（男性：女性），平均年龄为58.8岁（36至84岁）。最常见的临床表现是纤维胶原，结节性病变,平均尺寸为2.46厘米（范围从0.5到3厘米）。大多数病变发生在腭（n=16），其次是颊粘膜（n=3），上唇（n=3），颊前庭（n=2）和牙槽（n=1）。组织学上,观察到各种生长模式，包括管状，固体,cribriform,乳头状，和囊性的。此外,肾小球样裂隙状结构，粘液，并注意到透明细胞。在少数情况下观察到表面乳头状上皮增生。9例表现为黏液样和胶原区，两例显示梭形区域，另一例显示鳞状分化。在两种情况下都注意到透明细胞优势，8例出现神经周和神经内侵袭。免疫组织化学分析显示，在所有情况下，S-100，p63和CK7均为阳性，p40均为阴性。Ki-67增殖指数在大多数情况下明显较低，平均值为2.5%。
结论：我们提供了广泛的，PAC的临床和微观特征的详细描述，巴西队列。这些发现,在资源有限的地区，可能对建立正确的诊断非常有用。
