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Histologic Classification and Molecular Signature of Polymorphous Adenocarcinoma (PAC) and Cribriform Adenocarcinoma of Salivary Gland (CASG)
- Source :
- Am J Surg Pathol
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- Polymorphous adenocarcinoma (PAC) shows histologic diversity with streaming and targetoid features whereas cribriform adenocarcinoma of salivary gland (CASG) demonstrates predominantly cribriform and solid patterns with glomeruloid structures and optically clear nuclei. Opinions diverge on whether CASG represents a separate entity or a variant of PAC. We aimed to assess the level of agreement among 25 expert Head and Neck pathologists in classifying these tumors. Digital slides of 48 cases were reviewed and classified as: PAC, CASG, tumors with ≥50% of papillary architecture (PAP), and tumors with indeterminate features (IND). The consensus diagnoses were correlated with a previously reported molecular alteration. The consensus diagnoses were PAC in 18/48, CASG in16/48, PAP in 3/48, and IND in 11/48. There was a fair interobserver agreement in classifying the tumors (κ= 0.370). The full consensus was achieved in 3 (6%) cases, all of which were classified as PAC. A moderate agreement was reached for PAC (κ= 0.504) and PAP (κ= 0.561), and a fair agreement was reached for CASG (κ= 0.390). IND had only slight diagnostic concordance (κ= 0.091). PAC predominantly harbored PRKD1 hotspot mutation, whereas CASG was associated with fusion involving PRKD1, PRKD2, or PRKD3. However, such molecular events were not exclusive as 7% of PAC had fusion and 13% of CASG had mutation. In conclusion, a fair to moderate interobserver agreement can be achieved in classifying PAC and CASG. However, a subset (23%) showed indeterminate features and was difficult to place along the morphologic spectrum of PAC/CASG among expert pathologists. This may explain the controversy in classifying these tumors.
- Subjects :
- Canada
Pathology
medicine.medical_specialty
Biopsy
DNA Mutational Analysis
Diagnostic concordance
Adenocarcinoma
Real-Time Polymerase Chain Reaction
Article
Pathology and Forensic Medicine
Predictive Value of Tests
Biomarkers, Tumor
Humans
Medicine
Genetic Predisposition to Disease
Head and neck
In Situ Hybridization, Fluorescence
Observer Variation
medicine.diagnostic_test
Salivary gland
business.industry
Reproducibility of Results
food and beverages
Salivary Gland Neoplasms
medicine.disease
United States
Europe
medicine.anatomical_structure
Predictive value of tests
Mutation
Cribriform
Surgery
Salivary gland neoplasm
Gene Fusion
Anatomy
business
Subjects
Details
- ISSN :
- 01475185
- Volume :
- 44
- Database :
- OpenAIRE
- Journal :
- American Journal of Surgical Pathology
- Accession number :
- edsair.doi.dedup.....b20637c05ab0fcb50d602231587f1ae8