Subtitle: Salivary gland histology for pathologists: acini, ducts and myoepithelial cells, how each maps to tumours, and the immunostains that separate the key salivary neoplasms, with virtual slides and 10 MCQs.
Author: PathologyMCQ Editorial Board
Category: Head and Neck Pathology
Last Updated: October 2026
Read Time: 8 minutes
At-a-Glance
- The basic unit is an acinus (serous or mucous) draining into intercalated, striated and excretory ducts.
- Myoepithelial cells wrap acini and intercalated ducts; most salivary tumours recapitulate this luminal plus abluminal (bicellular) organisation.
- Parotid is serous, submandibular mixed (mostly serous), sublingual mixed (mostly mucous); most minor glands are mucous.
- Immunostains split luminal (CK7, CD117, DOG1) from abluminal/myoepithelial (p63, p40, SMA, calponin, S100, SOX10) cells and point to specific tumours.
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The Major Glands
| Gland | Acini | Duct | Histology clues |
|---|---|---|---|
| Parotid | Serous | Stensen duct | Intraglandular lymph nodes, fat increases with age, sebaceous cells |
| Submandibular | Mixed, mostly serous | Wharton duct | Serous demilunes, long striated ducts |
| Sublingual | Mixed, mostly mucous | Several small ducts (Rivinus, Bartholin) | Short ducts, few striated ducts |
| Minor glands | Mostly mucous | Short ducts to mucosa | Lip, palate, buccal mucosa; von Ebner glands are serous |
The Secretory Unit
- Serous acini: pyramidal cells with basal nuclei and apical, PAS-positive zymogen granules; watery, enzyme-rich saliva.
- Mucous acini: pale, foamy cytoplasm with flattened basal nuclei; viscous saliva.
- Serous demilunes: crescents of serous cells capping mucous acini in mixed glands (partly a fixation artifact).
- Myoepithelial cells: contractile, flattened cells between the epithelium and basement membrane of acini and intercalated ducts.
Acini and Ducts at a Glance
Link to tumours: oncocytes resemble striated duct cells; most bicellular tumours recapitulate the intercalated duct with its myoepithelial layer.
Normal Immunoprofile
Immunostains help to identify which cell type a tumour is made of. The table below maps markers to the normal components of the gland.
| Component | Typical positives | Notes |
|---|---|---|
| Serous acinar cells | SOX10, DOG1 (apical), amylase | Mirror acinic cell carcinoma |
| Intercalated duct cells | CK7, CD117, SOX10, S100 | Luminal layer of bicellular tumours |
| Striated and excretory ducts | CK7, AR (focal), GATA3; SOX10 negative | Salivary duct carcinoma and oncocytic lesions resemble them |
| Myoepithelial cells | p63, p40, SMA, calponin, S100, SOX10 | Abluminal layer of bicellular tumours |
| Basal cells (excretory ducts) | p63, p40, CK5/6 | Squamous and basaloid differentiation |
IHC of Key Tumours
| Tumour | Helpful positives | Molecular |
|---|---|---|
| Pleomorphic adenoma | Luminal CK7; myoepithelial p63, SMA, S100, SOX10; PLAG1, HMGA2 | PLAG1 or HMGA2 rearrangement |
| Adenoid cystic carcinoma | Luminal CD117; abluminal p63, SMA; MYB | MYB::NFIB or MYBL1 fusion |
| Mucoepidermoid carcinoma | p63/p40 (epidermoid and intermediate cells), mucicarmine | CRTC1/3::MAML2 |
| Acinic cell carcinoma | SOX10, DOG1, NR4A3 (nuclear); mammaglobin negative | NR4A3 upregulation |
| Secretory carcinoma | S100, mammaglobin, SOX10; DOG1 usually negative | ETV6::NTRK3 (most) |
| Salivary duct carcinoma | AR, GATA3, HER2 (some); SOX10 and S100 negative | HER2 amplification, TP53, PIK3CA |
| Oncocytoma, Warthin tumour | Oncocytes with p63+ basal cells; PTAH highlights mitochondria | — |
For the fusions and mutations in more detail, see genetic alterations in salivary gland tumours.
Virtual Slides
Start with normal salivary gland, then compare two carcinomas that recapitulate different parts of the gland. Tap an annotated region to zoom to it.
What to look for
Drag to pan · pinch or double-tap to zoom · use the + / − buttons
Video lesson
Salivary gland histology, explained
A detailed video on salivary gland structure and immunostains.
Approach-Based Histopathology & Cytology
- Salivary gland tumours, pattern by pattern
- Slide videos from pattern to diagnosis
- Built by practising pathologists for sign-out and exams
Test Yourself: 10 MCQs
Salivary gland histology and IHC: 10 MCQs
Acini, ducts, myoepithelial cells and tumour markers, with instant explanations.
More practice: the salivary tumour genetics →
Exam Pearls
- Parotid serous, sublingual mostly mucous, submandibular mixed.
- Striated ducts: eosinophilic, basal striations, mitochondria; oncocytes mimic them.
- Myoepithelial cells: p63, p40, SMA, calponin, S100, SOX10.
- DOG1 and NR4A3: acinic cell carcinoma. S100 and mammaglobin: secretory carcinoma.
- AR and GATA3: salivary duct carcinoma; check HER2.
- CD117 luminal plus p63 abluminal with MYB: adenoid cystic carcinoma.
More courses
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Related reads: Genetics of salivary gland tumours → · Approach-based course →
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References
- WHO Classification of Tumours Editorial Board. Head and Neck Tumours. 5th ed. IARC; 2022.
- Mills SE, ed. Histology for Pathologists. 5th ed. Wolters Kluwer; 2019.
- Seethala RR, Stenman G. Update from the 4th edition of the WHO classification of head and neck tumours: tumours of the salivary gland. Head Neck Pathol. 2017;11:55–67.
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