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Pleomorphic Adenoma With Disrupted Biphasic Ductal Structures Attributed to Lymphoid Infiltration: A Case Report.

Maiko Tsuchiya1, Yoshinao Kikuchi1, Toshitaka Nagao2

  • 1Pathology, Teikyo University School of Medicine, Tokyo, JPN.

Cureus
|December 2, 2024
PubMed
Summary

This study details a unique pleomorphic adenoma (PA) case with dense CD8+ T cell infiltration, altering typical tumor structures. This highlights an unusual immune response in benign salivary gland tumors.

Keywords:
hmga2parotid glandpleomorphic adenomasaliary gland tumortalptumor-associated lymphoid proliferation

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Area of Science:

  • Pathology
  • Immunology
  • Oncology

Background:

  • Pleomorphic adenoma (PA) is a common benign salivary gland neoplasm characterized by biphasic ductal and stromal components.
  • Typical PAs exhibit distinct cytomorphological and architectural patterns within a chondromyxoid matrix.

Observation:

  • A unique PA case presented with dense lymphoid infiltration that disrupted the classic biphasic structure.
  • The tumor displayed unusual duct-like slit formations lined by spindle cells with myoepithelial features.

Findings:

  • Immunohistochemistry confirmed myoepithelial markers (pan-cytokeratin, S100, calponin) in the spindle cells.
  • HMGA2 rearrangement was detected via fluorescence in situ hybridization, supporting the PA diagnosis.
  • Severe lymphocytic infiltration, predominantly CD8+ T cells, was observed, differing from typical tumor-associated lymphoid proliferation (TALP).

Implications:

  • This case expands the pathological spectrum of pleomorphic adenoma.
  • It highlights an atypical host immune response within a benign salivary gland tumor.
  • Understanding these variations is crucial for accurate diagnosis and comprehending tumor-host interactions.