Salivary glands
Primary salivary gland neoplasms
Benign
Ductal papilloma
Editorial Board Member: Lisa Rooper, M.D.
Last author update: 1 September 2012
Last staff update: 26 April 2023
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PubMed Search: Ductal papilloma
Table of Contents
Definition / general | Epidemiology | Sites | Pathophysiology | Clinical features | Case reports | Treatment | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Positive stains | Negative stains | Electron microscopy images | Differential diagnosisCite this page: Handra-Luca A. Ductal papilloma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ductalpapilloma.html. Accessed September 22nd, 2023.
Definition / general
- Category includes both Intraductal papillomas and inverted ductal papillomas
- Benign papillary neoplasms that generally occur in minor salivary glands
- Rare, benign papillary proliferations of bland cuboidal / columnar epithelial cells with fibrovascular cores, inflammation
Epidemiology
- Usually adults, no gender preference (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:68)
Sites
- Usually in minor salivary glands, rare in parotid or sublingual glands
Pathophysiology
- Derives from proximal salivary gland excretory duct (Cancer 1982;49:519)
Clinical features
- Painless submucosal lesions, most frequently in the oral cavity
- Patients present with mass, discomfort with chewing (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:68)
- Probably of luminal ductal origin
Case reports
- 41 year old man with parotid mass (Acta Otolaryngol 2002;122:314)
- 47 year old man with minor salivary gland tumor (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:e34)
- 49 year old man with inverted ductal papilloma in buccal mucosa of mandible (Pathol Int 2006;56:457)
- 70 and 72 year old men with benign sublingual tumor and parotid papilloma with microinvasion and intraparotid lymph node metastases (Arch Pathol Lab Med 2000;124:291)
Treatment
- Surgery; does not recur
Microscopic (histologic) description
- Intraductal papilloma
- Centered in excretory ducts of minor salivary gland
- Unicystic lesion lined by apillary proliferation composed of bland cuboidal to columnar epithelial cells with fibrovascular cores
- Rarely has intermixed mucinous cells
- No cytologic atypia and only rare mitotic figures
- Inverted ductal papilloma
- Generally has central opening that communicates with surface mucosa
- Unencapsulated lesion composed of complex endophytic proliferation of non-keratinizing squamous epithelium which resembles inverted papilloma of nasal cavity
- Can have intermixed goblet cells and columnar cells
- No cytologic atypia and only rare mitotic figures
Microscopic (histologic) images
Images hosted on other servers:
Upper lip tumor has papillary
proliferation of epithelial
cells with branching fronds
in cystically dilated duct lumen
Cytology description
- Compact clusters of papillary monomorphic columnar cells with abundant finely vacuolar cytoplasm; oval nuclei basally located, indistinct nucleol; no squamous cells (Acta Cytol 1999;43:457)
Positive stains
Negative stains
Electron microscopy images
Images hosted on other servers:
A: secretary granules, rough endoplasmic reticulum, golgi apparatus
and mitochondria; B: microvilli on luminal surface of epithelial cells
appear to be secretory; C: annulate lamellae composed of parallel
arrays of cisternae have small annuli or fenestrae
Differential diagnosis
- Acinic cell carcinoma - papillary cystic variant
- Metastatic papillary thyroid carcinoma
- Papillary cystadenocarcinoma
- Papillary cystadenoma
- Polymorphous low grade adenocarcinoma
- Salivary duct carcinoma
- Sialadenoma papilliferum
