Crystalloids in salivary gland pleomorphic adenomas

Two types of crystalloids in salivary gland pleomorphic adenomas were studied by light microscopy and electron microscopy. The first type of crystalloid, the previously described tyrosine-rich crystalloid, was identified in three (1.5%) of 205 cases. The crystalloids by light microscopy assumed a radial configuration, resulting in the characteristic petal-shaped morphology. Transmission electron microscopy revealed them to be electron-dense, lobular projections without internal structure. Scanning electron microscopy demonstrated a range of morphology from rounded and intact doughnutlike structures to aggregates of irregular, loosely cohesive plates. The crystalloids were backscatter positive by backscattered electron imaging, and by x-ray microanalysis exhibited prominent calcium, phosphorus, and magnesium peaks that were not present in the adjacent tumor tissue; these three elements may be important in the formation and structure of tyrosine-rich crystalloids. The second type of crystalloid was intraductal and birefringent and was identified in 26 (12.7%) of 205 cases. In 21 of these 26 cases the crystalloids were lost on 10% formaldehyde fixation and paraffin embedding. Histochemical stains and x-ray microanalysis did not reveal a definite chemical composition, but did suggest a predominantly organic nature.     

Expression and localization of cartilage-specific matrix protein chondromodulin-I mRNA in salivary pleomorphic adenomas

Pleomorphic adenoma is the most common epithelial tumor in the salivary glands. This tumor frequently exhibits mesenchyme-like components, including myxoid or chondroid areas. Recently, using immunohistochemical techniques, we reported that cartilage-specific matrix protein, chondromodulin-I (ChM-I), was deposited on the inter-territorial matrix of the chondroid area in salivary pleomorphic adenomas and that ChM-I, which is also a strong angio-inhibitory factor, plays an important role in the avascular nature of the chondroid area and the chondroid formation in this type of tumor. To elucidate which cells express ChM-I mRNA in pleomorphic adenomas, we examined the expression and localization of ChM-I mRNA in this type of tumor using an in situ hybridization technique. Immunoreactivity for ChM-I was observed in the inter-territorial matrix of the chondroid area, especially around the lacunae, and in the cytoplasm of neoplastic myoepithelial cells of the myxoid element of pleomorphic adenomas. On in situ hybridization analysis, strong signals for ChM-I mRNA were detected in the cytoplasm of the lacuna cells of the chondroid element, and moderate to marked signals were observed in the cytoplasm of the neoplastic myoepithelial cells of the myxoid element. Signals for ChM-I mRNA were also seen in the cytoplasm of the spindle-shaped neoplastic myoepithelial cells in the transitional areas between the myxoid and chondroid elements of this tumor. Signals for ChM-I mRNA were not seen in the inner ductal cells or the fibrous element. These findings indicate that lacuna cells and neoplastic myoepithelial cells express ChM-I mRNA and that mature ChM-I, which lacuna cells and neoplastic myoepithelial cells translate, is deposited in the chondroid matrix of pleomorphic adenomas. In conclusion, lacuna cells and neoplastic myoepithelial cells express ChM-I mRNA ectopically in pleomorphic adenoma, and this plays an important role in chondroid formation and hypovascularity in this type of tumor.     

Immunolocalization of beta-catenin in pleomorphic adenomas and carcinomas ex-pleomorphic adenomas of salivary glands.

Beta-catenin plays a central role in cadherin/catenin cell-cell adhesion complex and is involved in cell signaling pathway. Change in beta-catenin distribution has been associated with several human cancers including salivary gland tumors. We studied the immunolocalization of beta-catenin in a series of pleomorphic adenomas (PA) and carcinomas ex-pleomorphic adenomas (Ca ex-PA). Ten samples of PA and ten of Ca ex-PA were evaluated by immunohistochemistry using streptavidin-biotin-peroxidase technique and a monoclonal antibody against beta-catenin (E-5). Cell membrane/cytoplasmic staining of beta-catenin was observed in normal gland parenchyma, PA, and in well-differentiated Ca ex-PA. Cytoplasmic/nuclear beta-catenin staining was observed in poorly differentiated carcinomas and, interestingly, in one case of PA. Our data showed decreased cell membrane beta-catenin expression in higher-grade tumors suggesting that beta-catenin may play an important role in histologic differentiation and transition to malignant phenotype of Ca ex-PA.     

No rearrangement of c-mos in salivary gland pleomorphic adenomas with 8q12 aberrations

The frequent occurrence of salivary gland pleomorphic adenomas characterized by clonal structural chromosome abnormalities involving 8q12 raises the question as to how the cytogenetic rearrangements correspond to molecular mechanisms of tumor development. Since the proto-oncogene c-mos maps to this breakpoint region, DNA from eight adenomas with these aberrations was isolated and checked for rearrangements of c-mos after digestion by BamHI, EcoRI and HindIII. In none of the tumors was a rearranged allele besides the germ-line fragments found.     

Expression of bone matrix proteins, osteonectin and osteopontin, in salivary pleomorphic adenomas

Osteonectin (OSN) is a glycoprotein involved in the early steps of the mineralization of skeletal tissue, while osteopontin (OPN) is a protein involved in normal and pathological calcifications. OSN and OPN are non-collageneous bone matrix proteins expressed by some epithelial tumor cells in exceptional cases. We immunohistochemically investigated the presence and the distribution of OSN and OPN in 43 pleomorphic adenomas to elucidate the production of their molecules by modified myoepithelial cells. In normal salivary glands, OSN was immunolocalized in the striated ducts, while OPN was not expressed. In pleomorphic adenomas, the inner layer of tubulo-glandular structures and modified myoepithelial cells in the myxoid areas showed moderate positivity for OSN (83.7%). OSN was expressed in all of the lacuna cells in the chondroid areas. OPN was strongly expressed in the stroma of the myxoid and hyaline areas of the pleomorphic adenomas (65.1%), but there was no expression of OPN in the chondroid area. All cases of pleomorphic adenomas expressed type IV collagen. These findings suggested that OSN was related to the production of the type IV collagen by modified myoepithelial cells, whereas OPN was involved in the stromal formation of myxoid or hyaline tissues in pleomorphic adenomas. In summary, pleomorphic adenomas expressed the bone matrix proteins OSN and OPN.     

The specific distribution of dendritic interstitial cells at the tumor border of major salivary gland pleomorphic adenomas.

To investigate the role of stromal cells at the tumor border of major salivary gland pleomorphic adenomas, we performed immunohistochemical analysis for detecting CD34-positive stromal cells (dendritic interstitial cells) and alpha smooth muscle actin (ASMA) -positive stromal cells (myofibroblasts) at the periphery of the tumor. We examined 21 pleomorphic adenomas of major salivary glands. All of the 21 pleomorphic adenomas examined had both dendritic interstitial cells and myofibroblasts at the tumor border. The ratio between the two cell types varied, and they exhibited a bilayered capsular structure; myofibroblasts were located in the inner layer of the tumor capsule, whereas dendritic interstitial cells derived from nearby vascular structures and nerves were located in the outer layer of the capsule. On the basis of the specific distribution of the dendritic interstitial cells in the present study, there is a possibility that dendritic interstitial cells are associated with the tumor growth regulation of major salivary gland pleomorphic adenomas.     

Metastasizing pleomorphic adenoma of the salivary gland

Metastasizing pleomorphic adenoma of salivary glands is a group of rare tumors that are histologically identical to benign mixed tumors and that inexplicably metastasize. A review of the literature revealed that it usually occurs after multiple local recurrences, and the interval between diagnosis of primary pleomorphic adenoma and metastases ranges between 3 and 52 years. The most common site for metastasis is bone, followed by the head and neck and lung. No histologic or molecular parameters exist at the present time that could predict the development of metastasis in these neoplasms. Metastasectomy confers significant survival advantage over nonoperative treatment for localized and accessible metastases, but there is no definite treatment protocol available in cases of widespread metastases.     

Histogenesis of pleomorphic adenomas of the salivary glands]

Histogenesis of pleomorphic adenomas was investigated by histological and electron microscopical methods. Histochemically alkaline phosphatase activity was revealed in transformed cells. Positive immunohistochemical reaction was shown in cells of pleomorphic adenomas with polyclonal antibodies against the smooth muscle myosin, human carbonic anhydrase III and monoclonal antibodies to cytokeratins N8, N17, N18, vimentin (clone NT-30) and to membrane epithelial antigen. It is concluded that these tumours are of the epithelial nature.     

Epithelial–mesenchymal transdifferentiation and extracellular matrix gene expression in pleomorphic adenomas of the parotid salivary gland

Mesenchymal and epithelial cell differentiation are assumed to be dichotomic primary events in embryonic development. In this study, pleomorphic adenomas of the parotid gland were analysed as a model which shows morphological features of both epithelial and mesenchymal tissue types. Using matrix gene expression profiles as a supplementary criterion for the identification of cellular phenotypes, areas with unequivocal epithelial and mesenchymal differentiation could be demonstrated. Many areas displayed a transitional phenotype with cells showing both epithelial and mesenchymal features. The data provide evidence that epithelial–mesenchymal transitions represent the basic principle of the tisuse heterogeneity in pleomorphic adenomas. Thus, pleomorphic adenomas demonstrate the potential of adult (neoplastic) epithelial cells to transdifferentiate into mesenchymal cells in vivo. Copyright © 1998 John Wiley & Sons, Ltd.     

Immunohistochemical localization of αl-antitrypsin and αl-antichymotrypsin in salivary pleomorphic adenomas

Summary Immunohistochemical identification of l-antitrypsin (l-AT) and l-antichymotrypsin (l-ACh) in pleomorphic adenomas of salivary glands is reported in order to compare their distribution profiles with those of lysozyme and lactoferrin, already described elsewhere.Normal salivary glands indicated positive l-AT staining in ductal segments and had no l-ACh in any glandular cell. Pleomorphic adenomas displayed moderate positivity to l-AT staining in duct-like, tubular and glandular epithelia which was particularly intense in luminal cells. The limited number of tumour cells which showed duct-like structures with a single cellular layer arrangement, displayed the highest staining to l-ACh. Strongly l-AT positive tumour cells located on the inner side of luminal cavities were also markedly positive to l-ACh. Spindle shaped tumour cells existed outside tubular and ductal structures and were negative to l-AT and l-ACh.Distribution of l-AT in salivary glands was similar to that of lysozyme as is usual in ductal segments or their transformed cells, and occurrence of l-ACh localization rather resembled that of lactoferrin, with occurrence in acinar compartments and changed epithelia within acini.The biological role of a specific immunohistochemical distribution of l-AT and l-ACh in pleomorphic adenomas may be associated with a self regulating mechanism which inhibits degradation by tissue proteinases.     

Her-2/neu oncogene amplification in clinically localised prostate cancer

AIM: To examine the incidence of Her-2/neu oncogene amplification in clinically localised prostate cancer using in situ hybridisation. METHODS: One hundred and seventeen patients, who had undergone radical prostatectomy, were identified and in situ hybridisation was performed on formalin fixed, paraffin wax embedded tissue using the Quantum Appligene probe for Her-2/neu. The enzyme peroxidase was used to detect the probe because this enabled a permanent record to be kept. Tumours in which there were five or more signals in each nucleus in > 20% of the tumour cells were considered to have a significantly increased copy number. A serial section from these tumours was then hybridised with the chromosome 17 alpha satellite probe. The ratio of the percentage of cells showing an increase in Her-2/neu copy number to the number showing polysomy for chromosome 17 was calculated. A ratio above 2 was considered amplified. RESULTS: Biochemical recurrence occurred in 50 (43%) patients and 24 (21%) had clinical recurrence. In situ hybridisation for Her-2/neu was accessible in 114 (97%) patients. A significant increase in copy number was present in two patients (1.75 %), but chromosome 17 hybridisation showed that the increase was the result of polysomy rather than true amplification. Both these patients had a Gleason score of 7 and stage T3; they also had recurrent clinical disease with distal metastasis within two and 19 months. CONCLUSIONS: Increased Her-2/neu oncogene copy number appears to be rare in clinically localised prostatic adenocarcinoma and is related to chromosome 17 polysomy rather than true amplification. As a result, it would not be a useful biomarker for identifying those patients who will have recurrences after radical prostatectomy.     

The frequency and distribution of mast cells in pleomorphic adenomas of salivary glands

AIM: To investigate whether the frequency and distribution of mast cells (MCs) in pleomorphic adenomas (PAs) of major and minor salivary glands justifies the suggestion that there exists an association between MCs and mucoid stromal changes in PAs. METHODS: The material consisted of 22 cases of pleomorphic adenoma (eight arising in major and 14 in minor salivary glands) and a control group represented by five cases of monomorphic adenoma (MA). Representative 3-microm thick, paraffin-embedded sections were stained with H&E and Azur A. Computer-aided image analysis was performed in order to evaluate the relative surface area occupied by epithelial and connective tissue components, as well as the absolute number of MCs. RESULTS: According to our findings, PAs from minor salivary glands contain significantly greater numbers of mast cells compared with tumours from major glands. Additionally, the distribution of MCs within the stromal connective tissue appeared not to be random. CONCLUSION: It is possible that differences in the pattern of connective tissue might influence the actual concentration of MCs and that these differences are responsible for the observed variations between major and minor gland PAs.     

Langerhans' cells in a pleomorphic adenoma of submandibular salivary gland

Large numbers of round and dendritic cells similar to Langerhans' cells of normal epidermis and other epithelia were seen within a pleomorphic adenoma of the submandibular salivary gland. These cells, which were present only in areas of non-cornifying epidermoid metaplasia, exhibited Birbeck granules with isolated terminal vesicles, cytoplasmic microfilaments, microtubules, and a few poorly developed intercellular junctions.     

Immunohistochemical localization of the bone morphogenetic protein-6 in salivary pleomorphic adenomas

Salivary pleomorphic adenomas are often associated with chondroid tissue formation. We have found that bone morphogenetic proteins (BMP), especially BMP-2, may play an important role in ectopic chondrogenesis in this tumor. Bone morphogenetic protein-6 was reported to be related to the osteogenic metastasis of prostatic carcinomas. The relationship between BMP-6 expression and chondroid tissue formation is investigated. Twenty-three pleomorphic adenomas were examined immunohistochemically. The overexpression of BMP-6 was observed in 10 pleomorphic adenomas of the major salivary glands (43. 5%), and no evidence of BMP-6 expression in any of the nine pleomorphic adenomas of the palate. Bone morphogenetic protein-6 was immunolocalized in the lacuna cells of the chondroid tissue, in which type II collagen was localized. Bone morphogenetic protein-6 was expressed in inner ductal cells of the tubulo-glandular structures in the pleomorphic adenomas. This finding indicates that BMP-6 may be associated with the differentiation of inner ductal cells. Bone morphogenetic protein-6 was expressed weakly in neoplastic myoepithelial cells in the myxoid areas, which may be related to the production of extracellular matrices. Bone morphogenetic protein-6 has a role in chondroid formation, and also tubulo-glandular differentiation in pleomorphic adenomas. In conclusion, a large portion of pleomorphic adenomas of the salivary gland origin, but not of palate origin, was shown to overexpress BMP-6 protein.     

Fluorescence in situ hybridization study of HER-2/neu oncogene amplification in prostate cancer.

Prostate cancer is a serious disease affecting men worldwide and treatment compromises the quality of life of prostate cancer patients. We conducted a study of 88 cases of prostate cancer in an attempt to identify prognostic biomarkers that can distinguish aggressive cases that must be treated immediately. HER-2/neu oncogene amplification was initially studied because amplification of this gene has been reported in many other cancers, including those studied in this laboratory. Fluorescence in situ hybridization (FISH) using a HER-2/neu gene probe with a chromosome 17 centromere control probe was performed on formalin-fixed, paraffin-embedded tissues. Of a total of 86 cases successfully analyzed, only 8 (9.3%) were found to be amplified. This frequency was lower than the frequency of amplification found in other cancers studied. Furthermore, no case was found where the level of amplification can be considered high. Only one case was found to have moderate amplification. The rest of the positive cases can all be classified as low amplification. Thus, while we have demonstrated that FISH is a sensitive technique for detecting oncogene amplification, the frequency and level of HER-2/neu amplification detected in prostate cancer seem to be lower than those in most cancers that we studied. In view of the fact that HER-2/neu amplification does not seem to play as significant a role, exploration of other biomarkers in prostate cancer is warranted.