Relationship of clear cell oncocytoma to mitochondrial-rich (typical) oncocytomas of parotid salivary gland. An ultrastructural study.
Nosologically, the designation clear cell oncocytoma seems illogical and contradictory when the definition of an oncocytoma relies on mitochondrial-rich cells; its relationship to the granular (mitochondrial-rich) oncocytoma needs further clarification. Electron microscopy of six examples of oncocytoma from five patients allowed assessment of cellular features in three clear cell variants, two typical oncocytomas and one with a roughly equal proportion of clear and granular tumor cells. Ultrastructurally, in the clear cell types of oncocytoma, a considerable to extensive portion of the central cytoplasm was occupied by monoparticulate glycogen with margination of mitochondria and other organelles. The degree of extraction of the glycogen during fixation and processing accounts for variation in the extent of the clear cell component as phosphotungstic acid-hematoxylin staining reveals considerable mitochondria in many of the tumor cells in the clear cell variant of oncocytoma. Ultrastructural findings further support an interrelationship between clear and granular cells, as some typical oncocytes are evident in the clear cell variant of oncocytoma, and one oncocytoma in this series had a roughly equal number of glycogen-rich and mitochondrial-rich tumor cells both of which took part in the formation of microlumens. The designation clear cell oncocytoma is appropriate within the oncocytoma subgroup of salivary gland tumors.