Pleomorphic adenoma pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

The exact pathogenesis of [disease name] is not fully understood.

OR

It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].

OR

[Pathogen name] is usually transmitted via the [transmission route] route to the human host.

OR

Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.

OR


[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].

OR

The progression to [disease name] usually involves the [molecular pathway].

OR

The pathophysiology of [disease/malignancy] depends on the histological subtype.

Pathophysiology

Pathogenesis

  • The exact pathogenesis of [disease name] is not completely understood.

OR

  • It is understood that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
  • [Pathogen name] is usually transmitted via the [transmission route] route to the human host.
  • Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
  • [Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
  • The progression to [disease name] usually involves the [molecular pathway].
  • The pathophysiology of [disease/malignancy] depends on the histological subtype.

Genetics

  • PLAG1 and HMGA2 chromosomal rearrangments is specific to Pleomorphic adenoma.[1]
  • Some clonal chromosomal abnormalities involving 8q12 and 12q15 have also been described.[2]

Gross Pathology

  • The gross pathological features of Pleomorphic adenoma are as follows:
    • Firm
    • Mobile
    • Well demarcated
    • Encapsulated(mostly, but the Myxoid and Stroma rich subtype sometimes show focal absences of capsule) [3]
    • Tan-white in appearance
      Pleomorphic adenoma gross appearance,Calicut Medical College [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)

Microscopic Pathology

  • Pleomorphic adenoma has a highly variable appearance on microscopy, hence the name.
  • It is characterized by both polygonal epithelial and spindle-shaped myoepithelial cells in a variable stroma matrix which can be either epithelomucoid, myxoid, cartilaginous,or hyaline.
  • Epithelial elements are usually polygonal,spindle, or stellate shaped cells which may be arranged into duct-like structures, sheets, clumps or interlacing strands.[4]
  • The ducts and tubules exhibiting an outer lining in addition to an inner cuboidal epithelial cell layer are seen.
  • This is outer myoepithelial cell layer which merges into the surrounding stroma which also contains dispersed or clumped myoepithelial element cells.[4]
  • Some areas of squamous metaplasia and epithelial pearls are also seen.
    Librepath [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], from Wikimedia Commons

References

  1. Mendoza, Pia R.; Jakobiec, Frederick A.; Krane, Jeffrey F. (2013). "Immunohistochemical Features of Lacrimal Gland Epithelial Tumors". American Journal of Ophthalmology. 156 (6): 1147–1158.e1. doi:10.1016/j.ajo.2013.06.034. ISSN 0002-9394.
  2. Debnath SC, Adhyapok AK (June 2010). "Pleomorphic adenoma (benign mixed tumour) of the minor salivary glands of the upper lip". J Maxillofac Oral Surg. 9 (2): 205–8. doi:10.1007/s12663-010-0052-5. PMC 3244097. PMID 22190789.
  3. Zhan KY, Khaja SF, Flack AB, Day TA (April 2016). "Benign Parotid Tumors". Otolaryngol. Clin. North Am. 49 (2): 327–42. doi:10.1016/j.otc.2015.10.005. PMID 27040584.
  4. 4.0 4.1 Bokhari MR, Greene J. PMID 28613579. Missing or empty |title= (help)

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