Top Ten Differentials to Mull Over for Head and Neck Myoepithelial Neoplasms

Area of Science:

• Pathology
• Oncology
• Histology

Background:

• Myoepithelial neoplasms of the salivary gland encompass benign myoepithelioma and malignant myoepithelial carcinoma.
• These tumors are characterized by neoplastic myoepithelial cells and display diverse cytomorphologic and architectural patterns.

Purpose of the Study:

• To review the histologic features of myoepithelial tumors.
• To discuss their differential diagnoses.
• To highlight useful diagnostic tools.

Main Methods:

• Literature review of myoepithelial neoplasms.
• Analysis of cytomorphologic and architectural features.
• Evaluation of immunohistochemical and molecular alterations.

Main Results:

• Myoepithelial cells exhibit varied morphologies (epithelial, plasmacytoid, clear cell, spindle cell, oncocytic) and arrangements (trabeculae, sheets, nests, cords, single cells).
• A stromal component is often present, broadening the differential diagnoses to include other salivary gland neoplasms, plasmacytoma, melanoma, and mesenchymal tumors.
• Characteristic histologic features, immunohistochemical panels, and molecular alterations are summarized.

Conclusions:

• Distinguishing myoepithelial tumors requires a comprehensive understanding of their diverse presentations.
• An algorithmic approach incorporating an immunohistochemical panel with multiple myoepithelial markers is crucial for accurate diagnosis.
• This review provides essential information for pathologists and oncologists managing these rare neoplasms.