Fig. 3.26 Adenosquamous carcinoma. A Positive imunohistochemical reaction for CK7 in areas with glandular differentiation. B Mucicarmine positive secretion in the cytoplasm of a single signet ring cell showing a markedly atypical nucleus.

ma, acantholytic SCC, and SCC invading seromucinous glands, and necrotizing sialometaplasia. The most important differential diagnosis is from mucoepider-moid carcinoma as adenosquamous carcinoma has a poorer prognosis (see Table 3.02) {231}.

The presence of mucin in true glandular spaces helps to distinguish adenosqua-mous carcinoma from acantholytic carcinoma. SCC invading or entrapping mucoserous glands can mimic adenosquamous carcinoma, especially in biopsy specimens. In such cases, preservation of lobular gland architecture, and lack of significant atypia can distinguish SCC from adenosquamous carcinoma. Adenosquamous carcinoma is distinguished from necrotizing sialometaplasia, a benign condition that lacks the cytological features of malignancy.

Adenosquamous carcinoma will always have a surface (mucosal) component (dysplasia, in-situ carcinoma), whereas this feature is not seen in mucoepider-moid carcinoma.

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