Salivary glands
Inflammatory
Sclerosing polycystic adenosis


Topic Completed: 1 September 2015

Minor changes: 30 September 2020

Copyright: 2002-2020, PathologyOutlines.com, Inc.

PubMed Search: Sialadenitis[TI] salivary[TI]

Sally Tanakchi, M.D.
F. Zahra Aly, M.D., Ph.D.
Page views in 2020 to date: 176
Cite this page: Tanakchi S, Aly FZ. Sclerosing polycystic adenosis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/salivaryglandssclerosingpolycysticadenosis.html. Accessed October 20th, 2020.
Definition / general
  • General:
    • Rare tumorous condition predominantly affecting the parotid gland (80% of cases)
    • In some cases, may be considered a neoplasm due to monoclonal nature of the lesion
    • May recur after resection (20%) due to multifocal disease / incomplete resection
    • Generally not associated with malignant transformation
  • Gross:
    • Sharply circumscribed, variable encapsulation
  • Micro:
    • Histologically resembles sclerosing adenosis / fibrocystic change of breast.
    • Composed of acini and ductal elements embedded in densely sclerotic stroma
    • Characteristic finding is presence of large acinar cells with abundant eosinophilic cytoplasmic granules
    • May exhibit ductal epithelial proliferation ranging from hyperplasia, atypia to DCIS-like
    • The stroma may show focal adipose tissue, myxoid change, variable radial scar
    • Immunohistochemical studies are of limited value
    • Ductal and acinar components are 1 - 2% positive for Ki67 with consistent but variable expression of ER and PR
    • CEA, p53 and HER2 are negative
  • Differential diagnosis:
    • Highly characteristic histological features exclude all other considerations
    • Cytologically difficult to diagnose due to rarity of condition and presence of variable cell types in a cystic background
Microscopic (histologic) images

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Round to oval, circumscribed borders

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Foamy vacuolated,
apocrine, clear,
oncocyte-like cells

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Highly characteristic

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Variably prominent, dilated ductal

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Dense, sclerotic collagen

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Stromal distortion

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