Salivary glands

Primary salivary gland neoplasms

Benign

Oncocytoma



Last author update: 1 September 2012
Last staff update: 28 July 2022

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PubMed Search: Oncocytoma[TI] salivary glands

Adriana Handra-Luca, M.D., Ph.D.
Jen-Fan Hang, M.D.
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Cite this page: Handra-Luca A, Hang JF. Oncocytoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/salivaryglandsoncocytoma.html. Accessed August 17th, 2022.
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
Case reports
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
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
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