Basal cell adenoma (salivary gland)

Case contributed by Dr Mikkaela McCormack

Presentation

This 59 year-old man presented with a slowly enlarging, painless lump in the parotid gland. A superficial 'lumpectomy' was performed - the specimen was 45mm in greatest dimension and well-circumscribed - macroscopically-visible non-lesional salivary gland tissue was not identified.

Patient Data

Age: 59
Gender: Male
Pathology

The specimen was composed wholly of this fully circumscribed, nodular lesion with a thin fibrous capsule, comprising a central region of fibrosis and a cellular periphery formed by islands, tubules and anastomosing trabeculae of cytologically bland basaloid cells, set within an occasionally blue-tinged, variably cellular and somewhat loose fibrous stroma.  There is no necrosis and mitotic figures are scarce.  Perineural invasion is not present.  There is no evidence of chondromyxoid stroma. Benign salivary gland parenchyma is not seen. 

Case Discussion

Basal cell adenomas are benign tumours that tend to arise within the parotid glands of adults. Just like in this case, tumours are well circumscribed, non-infiltrative and may be encapsulated.  They often are composed of both basaloid epithelial cells, along with myoepithelial cells.

Differential Diagnosis:

  • Pleomorphic adenoma:  They differ from pleomorphic adenomas in that they don't have a chondromyxoid stroma component - this may be somewhat subjective - one pathologist's pleomorphic adenoma may be another's cellular pleomorphic adenoma.
  • Canalicular adenoma:  The same cellular components as in basal cell adenoma, however these differ from BAs in their distinctive architecture - strands and ribbons of cells with a columnar appearance and a loose stroma.
  • Adenoid cystic carcinoma: Invasive front with no capsule, predilection for perineural invasion, cookie-cutter cribriform structures, can have similar matrix material, may have more mitotic activity and cytological atypia.
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Case information

rID: 43989
Case created: 1st Apr 2016
Last edited: 5th Apr 2016
System: Head & Neck
Inclusion in quiz mode: Included

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