Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO 63110, USA.
Hum Pathol. 2013 Nov;44(11):2501-8. doi: 10.1016/j.humpath.2013.06.010. Epub 2013 Sep 10.
Mammary analogue secretory carcinoma (MASC) is a recently described salivary gland tumor that has morphologic features similar to secretory carcinoma of the breast and that also harbors the same ETV6 translocation. Diffuse mammaglobin and S-100 immunoreactivity are used to differentiate MASC from its morphologic mimics, especially acinic cell carcinoma and adenocarcinoma, not otherwise specified. However, the combination of mammaglobin and S-100 immunoreactivity has not been well studied in other types of salivary gland carcinomas that may have focal areas reminiscent of MASC. Here we evaluated mammaglobin and S-100 immunoreactivity in 15 cases each of polymorphous low-grade adenocarcinoma, adenoid cystic carcinoma and mucoepidermoid carcinoma, and also in 2 cases of adenocarcinoma, not otherwise specified, and 1 mucinous adenocarcinoma. Cases with significant co-expression of mammaglobin and S-100 (moderate or strong immunoreactivity in >25% of tumor cells) were further analyzed by fluorescence in situ hybridization using the ETV6 (12p13) break-apart probe. Nine cases (60%) of polymorphous low-grade adenocarcinoma and two (13.3%) of adenoid cystic carcinoma met the criteria for significant co-expression of mammaglobin and S-100. All were negative for the ETV6 translocation by fluorescence in situ hybridization. Although mammaglobin and S-100 positivity was seen in the majority of polymorphous low-grade adenocarcinomas and a minority of adenoid cystic carcinomas, none were positive for the ETV6 translocation characteristic of MASC. This indicates a need for caution in the use of immunohistochemistry for diagnosing MASC, especially in the absence of cytogenetic confirmation.
乳腺样分泌性癌(MASC)是一种新近描述的唾液腺肿瘤,其形态学特征与乳腺分泌性癌相似,并且也具有相同的 ETV6 易位。弥漫性乳腺球蛋白和 S-100 免疫反应用于将 MASC 与其形态学模拟物(尤其是腺泡细胞癌和非特指性腺癌)区分开来。然而,乳腺球蛋白和 S-100 免疫反应在其他可能具有类似于 MASC 的局灶区域的唾液腺癌类型中尚未得到很好的研究。在这里,我们评估了 15 例多形性低度恶性腺癌、腺样囊性癌和黏液表皮样癌,以及 2 例非特指性腺癌和 1 例黏液腺癌中乳腺球蛋白和 S-100 免疫反应。具有显著乳腺球蛋白和 S-100 共表达(肿瘤细胞中≥25%的中度或强免疫反应)的病例进一步通过荧光原位杂交用 ETV6(12p13)断裂探针进行分析。9 例(60%)多形性低度恶性腺癌和 2 例(13.3%)腺样囊性癌符合乳腺球蛋白和 S-100 显著共表达的标准。所有病例均通过荧光原位杂交呈 ETV6 易位阴性。尽管乳腺球蛋白和 S-100 阳性在大多数多形性低度恶性腺癌和少数腺样囊性癌中可见,但没有一个病例呈 MASC 特征性的 ETV6 易位阳性。这表明在诊断 MASC 时需要谨慎使用免疫组织化学,尤其是在没有细胞遗传学证实的情况下。