Table 2.
Summary of key points in differential diagnosis of salivary Warthin-like MEC, MEC with TALP and mWT.
Tumor genesis | Tumor parenchyma |
Tumor mesenchymal |
Molecular signature |
|||||
---|---|---|---|---|---|---|---|---|
structure | Oncocytic Cell | Epidermoid cell | Mucus cell | Lymphocytes | Mucus extravasation | |||
Warthin-like MEC MEC | excretory ducts | glandular architecture with cystic structures | The diversity of cystic lining epithelial and the transition zone between the disorganized bi-layered oncocytic epithelium and mono-/multi-layered oncocytic epithelium appeared | Epidermoid | Mucus- producing cells | Dense lymphocytic infiltrate with lymphoid follicle | occur | CRTC1/3-MAML2 rearrangement |
MEC with TALP | Solid or cystic structures | Lack the diversity of cystic lining oncocytic epithelium | ||||||
mWT | excretory ducts | Papillary architecture | Typical bi-layered oncocytic cells. | Focal Nonkeratinized squamoid cells | mucoid metaplasia accompanied with necrosis, haemorrhages and fibrosis. | Dense lymphocytic infiltrate with lymphoid follicle | absent | Non-specific |
Note MEC: mucoepidermoid carcinoma, TALP: Tumor-associated lymphoid proliferation (TALP), mWT: Metaplastic Warthin tumor.