A case of salivary gland secretory carcinoma in the right upper lip

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  • 右上唇部に発生した唾液腺分泌癌の 1 例

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<p>Background : Salivary gland secretory carcinoma (SSC) is defined by its morphological similarity to mammary secretory carcinoma and the presence of the ETV6-NTRK3 fusion gene, and is, in general, a low-grade salivary gland carcinoma. SSC was newly added to the WHO classification of Head and NeckTumors in 2017.</p><p>Case : A female patient in her 80 s was detected 2 years before her visit as having a small mass about 2 cm in size in the mucosa of her right upper lip. Imprint cytology revealed solitary to sheet-like, stacked cell clusters of tumor cells against a background of mucus-like material. The N/C ratio was low and the cytoplasm was foamy to granular, with some cells containing vacuolated and acidophilic cytoplasm. The nuclei were round with slightly fine granular chromatin and distinct nucleoli. May-Giemsa staining showed cells with heterochromatic secretions in the cytoplasm. Histological examination revealed that the tumor was almost completely circumscribed, with slight muscular invasion. The tumor showed a lobulated growth pattern and was composed of cell nests with microcystic structures containing a weakly acidic secretory-like substance. We made the diagnosis of SSC based on the above features and positive immunohistochemical staining of the tumor cells for S-100 protein, mammaglobin and SOX10. Fluorescence in situ hybridization (FISH) showed breaking of the ETV6 gene, but not of the NTRK3 gene.</p><p>Conclusion : SSCs show diverse cytological features, and it is important to distinguish these tumors from various other tumors.</p>

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