Ghost/shadow cell differentiation in salivary gland tumors
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COMMENTARY
Ghost/shadow cell differentiation in salivary gland tumors Fumio Ide 1,2 & Yumi Ito 1
&
Michiko Nishimura 2 & Kentaro Kikuchi 2 & Kaoru Kusama 2
# Springer-Verlag GmbH Germany, part of Springer Nature 2020
To the Editor, We read with keen interest the brief report “Salivary ghost cell carcinoma: case report and proposal of a new entity” by Ihrler et al. [1], which was recently published in your journal. The authors claimed “To the best of our knowledge, this is the first description of such a case in the literature.” In this context, it is worth mentioning a similar tumor reported in the dental journal in 1972, which Eversole et al. [2] referred to as mucoepidermoid carcinoma. Lewis R. Eversole in the USA was a leader in the field of oral and maxillofacial pathology. As acknowledged by the majority of general surgical pathologists specializing in oral cavity lesions, he possessed a deep knowledge and understanding of salivary gland tumors and was very familiar with the ghost cells found in odontogenic tumors. In their clinicopathological study of mucoepidermoid carcinomas arising in minor salivary glands, Eversole et al. [2] briefly commented that “one lesion showed unusual features in that keratinized “ghost cells,” similar to those present in pilomatrixoma or calcifying epithelial odontogenic cyst, were found.” They also provided one photomicrograph with a figure legend: “Lowgrade mucoepidermoid carcinoma. Globular, keratinized “ghost cells” are admixed with epidermoid cells.” Eversole et al. [2] had selectively introduced this case because it was a matter of particular interest to experts.
This article is part of the Topical Collection on Quality in Pathology * Yumi Ito [email protected] 1
Division of Diagnostic Pathology, Tsurumi University Dental Hospital, Yokohama 230-8501, Japan
2
Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama 350-0283, Japan
It has long been recognized that pleomorphic adenomas may on occasion feature skin adnexal-type morphology [3]. In a small series of pleomorphic adenomas showing cutaneous adnexal differentiation, Schmidt et al. [4] reported in 2010 that isolated ghost/shadow cells were found in 33% of palate tumors and 20% of lip tumors. In view of their findings, ghost/ shadow cell differentiation may not be as rare as Ihrler et al. [1] suggest. In fact, it can be hypothesized that such changes are underrecognized and might have been regarded as conventional squamous metaplasia or nondescript keratinization. From a pathogenetic standpoint, it is currently unclear whether accentuated ghost cells are the primary pathologic features in a rare subset of salivary basaloid carcinomas [1, 2]. In conclusion, one can only assume that Ihrler et al. [1] simply missed the above two important references [2, 4]. They are certainly not alone in being unaware of the previous description by Eversole et al. [2], because other authoritative reviews on the subject with detailed coverage of the literature al
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