MYB expression: Potential role in separating adenoid cystic carcinoma (ACC) from pleomorphic adenoma (PA)

Diagn Cytopathol. 2016 Oct;44(10):799-804. doi: 10.1002/dc.23551. Epub 2016 Aug 5.

Abstract

Background: Basaloid tumors of the salivary gland both benign and malignant comprise ACC, cellular PA, basal cell adenoma (BCA), and basal cell adenocarcinoma. Rendering a diagnosis given a limited biopsy or fine needle aspiration (FNA) sample proves challenging. Activation of MYB by gene fusion has been found in salivary gland ACCs; therefore we investigated the utility of MYB immunohistochemistry (IHC) as a tool for distinguishing ACCs from other basaloid neoplasms.

Methods: We selected 48 cases of ACC (11 FNA blocks [CB]), 37 histologic resections [HR]), 74 PA (36 CB, 38 HR), and 18 BCA (7 CB, 11 HR). FNA CB showed 82% of ACCs (N = 9 of 11) as positive for MYB nuclear staining whereas 68% of ACCs (N = 25 of 37) were positive in HR.

Results: All PA were negative for MYB nuclear staining in both CB (N = 0 of 36) and HR (N = 0 of 38). CB showed 29% of BCA (N = 2 of 7) as positive for MYB nuclear staining and 55% (N = 6 of 11) positive in HR. Both ACC and BCA showed significantly higher mean staining intensity than PA in both CB and HR (P < 0.0001). When comparing ACC and BCA, significantly higher mean staining intensity was observed in CB (P = 0.02382) but not in HR (P = 0.42952).

Conclusion: MYB nuclear staining may prove useful in separating ACC from PA and BCA, especially in limited cellular samples. Diagn. Cytopathol. 2016;44:799-804. © 2016 Wiley Periodicals, Inc.

Keywords: MYB; adenoid cystic carcinoma; fine needle aspiration; pleomorphic adenoma.

Publication types

  • Evaluation Study

MeSH terms

  • Adenoma, Pleomorphic / classification
  • Adenoma, Pleomorphic / metabolism
  • Adenoma, Pleomorphic / pathology*
  • Biomarkers, Tumor / metabolism*
  • Biopsy, Fine-Needle
  • Carcinoma, Adenoid Cystic / classification
  • Carcinoma, Adenoid Cystic / metabolism
  • Carcinoma, Adenoid Cystic / pathology*
  • Diagnosis, Differential
  • Humans
  • Oncogene Proteins v-myb / metabolism*
  • Sensitivity and Specificity

Substances

  • Biomarkers, Tumor
  • Oncogene Proteins v-myb