唾液腺の腫瘍

T1 ≤ 2 cm intraparanchymal;
T2 ≤ 4 cm, intraparenchymal
T3, > 4 cm and/or extracapsular
T4a, skin/mandible/ear canal/facial nerve
T4b, skull base/pterygoid/carotid artery encasement


pN0    No regional lymph node metastasis
 
pN1    Metastasis in a single ipsilateral lymph node, 3 cm or less in great
est dimension without extranodal extension

pN2a    Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension without extranodal extension
    or single <3 cm with extranodal extension

pN2b    Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension without extranodal extension

pN2c    Metastasis in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension without extranodal extension

pN3a    Metastasis in a lymph node more than 6 cm in greatest dimension without extranodal extension

pN3b > 3 cm with extranodal or multiple, ipsilateral or contralateral or bilateral with extranodal extension

pN と Staging はhypopharynxと同じ

Stage I, T1; Stage II, T2
Stage III, T3N0 or T123N1
Stage IVA, T123N2 or T4aN012
Stage IVB, T4b or N3
Stage IVC, M1

Tumours of salivary glands (Please subscribe to see the links)

  悪性腫瘍主な遺伝子変化
Mucoepidermoid carcinoma 粘表皮癌t(11;19)(q21;p13) or t(11;15)(q21;q26) translocation
CRTC1/3-MAML2 gene fusion
Adenoid cystic carcinoma腺様嚢胞癌 t(6;9)(q22- 23;p23-24) translocation
MYB-NFIB
gene fusion, Strong diffuse nuclear staining of MYB
t(8;9)(q13;p22) translocation
MYBL1-NFIB gene fusion
Acinic cell carcinoma腺房細胞癌t(4;9)(q13;q31)
NR4A3 (9q31.1) nuclear expression

Polymorphous adenocarcinoma多形腺癌activating mutation of PRKD1 E710D (p.Glu710Asp, exon 15)
Clear cell carcinoma明細胞癌EWSR1-ATF1 gene fusion
Basal cell adenocarcinoma基底細胞腺癌CTNNB1, CYLD alterations
Intraductal carcinoma導管内癌
Adenocarcinoma, NOS腺癌,NOS
Salivary duct carcinoma唾液腺導管癌AR copy-number gain and splice variants
ERBB2 gene amplification (25%)
Myoepithelial carcinoma筋上皮癌
Epithelial–myoepithelial carcinoma上皮筋上皮性癌
Carcinoma ex pleomorphic adenoma多形腺腫由来癌PLAG1, HMGA2 + TP53 (50-75%), MDM2 and HMGA2 amplification (50%), ERBB2 amplification (31-38%)
Secretory carcinoma分泌癌 t(12;15)(p13;q25) translocation
ETV6-NTRK3 gene fusion, NTRK3 immunohistochemistry
Sebaceous adenocarcinoma脂腺腺癌
Carcinosarcoma癌肉腫
Poorly differentiated carcinoma低分化癌(未分化癌,大細胞神経内分泌癌,小細胞神経内分泌癌)
Lymphoepithelial carcinomaリンパ上皮癌Associated with EBV infection
Squamous cell carcinoma扁平上皮癌
Oncocytic carcinomaオンコサイト癌
Sialoblastoma唾液腺芽腫


  良性腫瘍


Pleomorphic adenoma多形腺腫PLAG1 fusion, HMGA2 fusion, HRAS
Myoepithelioma筋上皮腫
Basal cell adenoma基底細胞腺腫CTNNB1 alterations (nuclear expression)
Warthin tumorワルチン腫瘍
Oncocytomaオンコサイトーマ
Lymphadenomaリンパ腺腫
Cystadenoma嚢胞腺腫
Sialadenoma papilliferum乳頭状唾液腺腺腫
Ductal papillomas導管乳頭腫
Sebaceous adenoma脂腺腺腫
Canalicular adenoma and other ductal adenomas細管状腺腫と他の導管腺腫
  Non-neoplastic epithelial lesions
Sclerosing polycystic adenosis硬化性多嚢胞性腺症耳下腺
Nodular oncocytic hyperplasia結節性オンコサイト過形成
Lymphoepithelial sialadenitisリンパ上皮性唾液腺炎
Intercalated duct hyperplasia介在部導管過形成

唾液腺病変その他

Mucocele (mucous retention and extravasation cysts):
    下口唇などにできる。

Sjogren syndrome: benign lymphoepithelial lesions (BLL)

Ranula: 舌下腺にできる。

Lymphoepithelial cyst: 耳下腺にできる。

Oncocytosis/diffuse oncocytic hyperplasia: 高齢者にできる。

Necrotizing sialometaplasia: 口腔。

Radiation-induced change: 上記と同様mucoepidermoidca.との鑑別

Acute sialadenitis: mumps, coxsackie ECHO, EBV, CMV.

Kuttner tumor (chronis sclerosing sialadenitis);
    a member of family of IgG4-related sclerosing disease.
    MALT lymphomaが出ることも。

Granulomatous sialadenitis:
    サルコイドーシス、心筋、抗酸菌。猫ひっかきの2-3%