Urso Carmelo
Dermatopathology Study Center of Florence, Department of Anatomic Pathology, Fanfani Institute, Florence, Italy;
Rom J Morphol Embryol. 2025 Apr-Jun;66(2):411-415. doi: 10.47162/RJME.66.2.16.
Adenomatoid hyperplasia (AH) is an infrequent intraoral lesion, composed of lobular aggregates of hyperplastic normal-appearing salivary glands (SG). Three cases of adenomatoid hyperplasia of minor salivary glands (AHMSG) are reported: two were located on the hard palate, in a female patient aged 41 and in a male aged 85 years, and one in the lower lip, in a male patient aged 37. Histopathologically, lesions showed enlarged lobules of mucous or mixed acini with dilated salivary ducts and fibrous stroma. Immunohistochemically, acinar cells were positive for CAM 5.2 and cytokeratin 7 (CK7) and negative for epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA); myoepithelial cells were positive for p63 and smooth muscle actin (SMA); luminal cells of intercalated, striated and excretory∕interlobular ducts were positive for CK7, CAM 5.2, EMA and sex-determining region Y (SRY)-box transcription factor 10 (SOX10); basal ductal cells, positive for CK7 and CAM 5.2, also stained with p63; Ki67 labeling index ranged between 1% and 5%. AHMSG is a lesion to be recognized to avoid clinical overdiagnosis, since it can simulate a benign or malignant SG tumor, and to prevent histological underdiagnosis, since hyperplastic SG, showing a normal cyto-architectural structure, may suggest the absence of pathology.
腺样增生（AH）是一种罕见的口腔内病变，由增生的外观正常的唾液腺（SG）小叶聚集体组成。本文报告了3例小唾液腺腺样增生（AHMSG）：2例位于硬腭，分别为一名41岁女性患者和一名85岁男性患者；1例位于下唇，为一名37岁男性患者。组织病理学上，病变表现为黏液性腺泡或混合性腺泡的小叶增大，伴有唾液腺导管扩张和纤维性间质。免疫组织化学检查显示，腺泡细胞CAM 5.2和细胞角蛋白7（CK7）呈阳性，上皮膜抗原（EMA）和癌胚抗原（CEA）呈阴性；肌上皮细胞p63和平滑肌肌动蛋白（SMA）呈阳性；闰管、纹状管和排泄/小叶间导管的管腔细胞CK7、CAM 5.2、EMA和性别决定区Y（SRY）-盒转录因子10（SOX10）呈阳性；基底导管细胞CK7和CAM 5.2呈阳性，p63也呈阳性；Ki67标记指数在1%至5%之间。AHMSG是一种需要识别的病变，以避免临床过度诊断，因为它可能模拟良性或恶性唾液腺肿瘤，同时防止组织学诊断不足，因为增生的唾液腺显示正常的细胞结构，可能提示无病变。
