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Beautiful example of a secretory carcinoma of the salivary gland. Secretory carcinoma (aka mammary analogue secretory carcinoma) is a ~recently described malignant tumor of the salivary gland, most commonly the parotid as in this case. Classically presents as a painless mass 1/5 ImageImageImageImage
in a middle-aged adult. Histologic appearance can vary significantly from well-circumscribed, lobulated growth with fibrous septa to infiltrative; papillary, solid, follicular and cystic architectures are common. Watch out for excessive solid growth, necrosis, mitotic 2/5
activity and/or significant cytologic atypia in cases of SC with high-grade transformation. Because of the variable histologic findings, IHC can be essential (esp. when presenting outside of the salivary gland): classically S100+ mammaglobin+ GCDFP-15+ SOX-10+ TTF1- AR-. 3/5
Read 6 tweets
H&E: Sorry @DrAhmedKalebi No pseudoepitheliomatous hyperplasia. @OkelloAliker

Any differential? Any IHC/molecular you would like to have?

I should also mention that the patient is immune compromised.
This turns out to be EBV-associated smooth muscle tumor (HE/SMA/EBER). Kudo to @lizawati38

3 spindle cell tumors in immune compromised:
- KS
- microbacterial spindle cell pseudotumor

Without clinical history: ddx broader including all cellular spindle cell lesions.
Read 3 tweets
A to Z alphabet in #ENTpath #oralpath #endopath

A: angioinvasive fungal sinusitis, adenoid cystic carcinoma, ameloblastic fibroima and anaplastic thyroid carcinoma

@smlungpathguy @aakasharmand @VijayPatho @TheKarenPinto @histolover @Histopatolomon @luishcruzc @kriyer68
Basal cell adenoma
Biphenotypic sinonasal sarcoma
branchial cleft cyst
Clear cell carcinoma
Clear cell odontogenic carcinoma
Read 29 tweets

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