Salivary glands
Primary salivary gland neoplasms
Benign
Oncocytoma
Last author update: 1 September 2012
Last staff update: 19 May 2023
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PubMed Search: Oncocytoma[TI] salivary glands
Table of Contents
Definition / general | Clinical features | Radiology description | Case reports | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Cytology images | Positive stains | Negative stains | Electron microscopy description | Differential diagnosisCite this page: Handra-Luca A, Hang JF. Oncocytoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/salivaryglandsoncocytoma.html. Accessed May 8th, 2024.
Definition / general
- Benign tumor composed of oncocytes
- Also called oxyphilic adenoma
- 1 - 2% of salivary gland neoplasms; more frequent than oncocytosis and oncocytic carcinoma
Clinical features
- Usually parotid gland mass, also submandibular gland or minor salivary glands
- Mean age 60 years
- 20% associated with radiation therapy or radiation exposure
- Rarely bilateral, multiple
- Rarely synchronous with Warthin tumor or carcinoma ex pleomorphic adenoma
- May occur in trisomy 7 or in BHD syndrome
Radiology description
- Specific MRI features: T1 hypointense, isointense to normal gland on fat saturated T2 and postcontrast T1; CT features: enhancing tumor and nonenhancing cystic component (AJNR Am J Neuroradiol 2011;32:1703, AJNR Am J Neuroradiol 2010;31:1413)
Case reports
- 68 year old man with parotid mass (J Cytol 2012;29:80)
- 79 year old woman with parotid tumor with multinodular oncocytic hyperplasia (Arch Pathol Lab Med 2003;127:e53)
Treatment
- Local excision
- Excellent prognosis but may have late recurrence
Gross description
- Well circumscribed with fibrous capsule, solid, tan-red-brown, lobulated, often small, may have cystic spaces
Microscopic (histologic) description
- Eosinophilic or clear cell (glycogen) with sheets, trabeculae, acini or follicular patterns of monotonous large polygonal cells with well defined cell borders, deeply eosinophilic, granular cytoplasm, small round nuclei
- Vascular stroma, may have clear cell change, background of oncocytic nodular hyperplasia, psammoma bodies, tyrosine rich crystals
- No mitotic figures, no elastosis
Microscopic (histologic) images
Images hosted on other servers:
Various images
Cytology description
- Cellular oncocytic aspirates with very clean background
- Oncocytes show abundant finely granular cytoplasm, centrally placed or eccentric nuclei and occasional distinct nucleoli
- Cellular arrangement can be irregular sheets, small clusters or single cells
Cytology images
Contributed by Jen-Fan Hang, M.D.
Clean background
Bland oncocytes
Positive stains
Negative stains
- Myoepithelial markers (alpha smooth muscle actin, smooth muscle myosin heavy chain, calponin, Arch Pathol Lab Med 1999;123:801), CEA, GFAP
Electron microscopy description
- Packed with mitochondria with partitions
Differential diagnosis
- Metastases: prostate carcinoma is PSA+, renal cell carcinoma is p63+, CD10+, CK20+
- Oncocytic carcinoma: malignant features, invasive, high Ki67, regional nodal or distant metastases
- Oncocytic metaplasia: no mass
- Oncocytoid artifact: electrocautery
- Oncocytosis
- Warthin tumor: FNA has lymphoid component, mucus, necrosis
