Utility of p63 and p40 in Distinguishing Polymorphous Adenocarcinoma and Adenoid Cystic Carcinoma

Document Type: Research Articles

Authors

Department of Pathology, Shaukat Khanum Cancer Hospital, Johar Town, Lahore, Pakistan.

Abstract

Objective: Adenoid cystic carcinoma and polymorphous adenocarcinoma are primarily the tumor of minor salivary
glands. Both show certain morphological similarities, which limit their proper diagnosis in settings where there are
obscuring factors and limited biopsy material. However, there is a considerable difference in treatment and prognosis,
which raises the need to distinguish these two entities. In this study, we discuss the utility of two immunohistochemical
stains, p63 and p40, in different combinations for distinguishing polymorphous adenocarcinoma from adenoid cystic
carcinoma. Materials and Methods: Two immunohistochemical stains, p63 and p40, were performed on 47 cases of
adenoid cystic carcinoma and 23 cases of polymorphous adenocarcinoma. Results: 36 out of 47 cases of adenoid cystic
carcinoma showed p63+ve/p40+ve immunoprofile, followed by p63-ve/p40-ve immunoprofile, which is seen in10
cases of adenoid cystic carcinoma. However, 22 out of 23 cases of polymorphous adenocarcinoma displayed p63+ve/
p40-ve immunoprofile. p63-ve/p40+ve is the least frequent observed immunoprofile, which is seen in only one case
of adenoid cystic carcinoma. Conclusion: On combining all possible immunoprofile combinations, p63+ve/p40-ve
immunoprofile appears to be the most sensitive profile for distinguishing polymorphous adenocarcinoma from adenoid
cystic carcinoma.

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