*Department of Pathology and Cell Biology, Columbia University †Department of Diagnostic Pathology and Laboratory Medicine, Beth Israel Medical Center, St Luke's and Roosevelt Hospitals, New York, NY.
Adv Anat Pathol. 2014 Jan;21(1):1-11. doi: 10.1097/PAP.0000000000000000.
Among the more common types of intraoral minor salivary gland neoplasms are pleomorphic adenoma, basal cell adenoma, polymorphous low-grade adenocarcinoma, and adenoid cystic carcinoma. These minor salivary gland neoplasms share similar morphologic features and to a large extent immunohistochemical findings. Differentiation between these benign and malignant neoplasms is often predicated on the presence or absence of invasion. As such, in the presence of limited tissue sampling that typifies the initial testing modalities, including fine needle aspiration biopsy and/or incisional biopsy, it often is not possible to differentiate a benign from malignant minor salivary gland neoplasm. The diagnostic difficulties arise from the absence in needle or incisional biopsy of the tumor's periphery to determine whether infiltrative growth is or is not present. In this manuscript we discuss limitations and considerations associated with evaluation of incisional biopsies of intraoral minor salivary gland tumors. We offer a diagnostic approach to evaluating these biopsies, and suggest diagnostic terminology for biopsy specimens in which distinction between benignancy and malignancy is not feasible. The pathologist's approach to this distinction is critical, as treatment of benign neoplasms is generally conservative, whereas malignant lesions may warrant more aggressive management.
在口腔内的小唾液腺肿瘤中，较为常见的有：多形性腺瘤、基底细胞腺瘤、多形性低度恶性腺癌和腺样囊性癌。这些小唾液腺肿瘤具有相似的形态学特征，在很大程度上还具有免疫组织化学特征。这些良性和恶性肿瘤的区分通常取决于是否存在浸润。因此，在包括细针抽吸活检和/或切开活检等初始检测方法所特有的有限组织采样的情况下，通常无法区分良性和恶性小唾液腺肿瘤。诊断困难源于在针吸或切开活检中缺乏肿瘤边缘的浸润性生长，以确定是否存在浸润性生长。在本文中，我们讨论了评估口腔内小唾液腺肿瘤的切开活检的局限性和注意事项。我们提出了一种评估这些活检的诊断方法，并建议对无法区分良恶性的活检标本使用诊断术语。病理学家在这方面的处理方法至关重要，因为良性肿瘤的治疗通常较为保守，而恶性病变可能需要更积极的治疗。
