Mucoepidermoid carcinoma of the lung arising at the primary site of a bronchogenic cyst: clinical, cytogenetic, and molecular findings

Analysis of clinicopathological features of primary diaphragm tumors: A single-center study

Background and Objectives

Primary diaphragm tumors are rare. The aim of this study was to explore the clinicopathological features of primary diaphragm tumor patients who underwent surgical treatment in our center to improve the diagnosis and treatment of this disease.

Methods

Clinical data of patients with primary diaphragm tumor who underwent surgery in our hospital from 2004 to 2019 were reviewed and analyzed.

Results

A total of 18 patients were enrolled. The male:female ratio was 8:10, and the median age was 58 years old (35–74 years old). Most patients included in this study had no typical clinical symptoms. Nine tumor cases were distributed in the left and right diaphragms separately, whereas 11 cases were located at the diaphragm angle. The diaphragm of 12 patients was reconstructed by direct suture. All postoperative pathologies showed that the tumors were benign, and cysts were observed in most of the cases (5/18).

Conclusions

There are no difference in distribution of gender and distribution on both sides of the diaphragm. In addition, primary diaphragm tumor is common in middle‐age patients. Most cases occur in the diaphragm angle and are characterized by cyst lesions. Surgical resection is an effective treatment option for primary diaphragm tumor.

Bronchial Mucoepidermoid Carcinoma With the Classic MAML2 Gene Rearrangement in a 2-year-old Boy

Pulmonary mucoepidermoid carcinoma (PMEC) is rare. To date, primary PMEC has not been reported in a child younger than 3 years of age. We report a case of a 2-year-old boy who presented with 3 episodes of wheezing, cough, and fever over a period of 1 month. Radiologic findings were consistent with foreign body aspiration with consequent bronchial obstruction. Bronchoscopy was performed and attempts to retrieve the foreign body resulted in a biopsy of a fleshy lesion. By histology, the lesion was an epithelial neoplasm comprising cells arranged in a nested pattern. The neoplastic cells were round with round nuclei and amphophilic, vacuolated cytoplasm. Our diagnosis was low-grade salivary gland-type carcinoma of the bronchus. The pneumonectomy specimen showed a well-circumscribed, polypoid intrabronchial mass measuring 2.1 cm in greatest dimension. Histologic examination of the tumor showed an admixture of intermediate cells which were predominant, a small number of mucus cells and rare foci of squamous cells. The final diagnosis rendered was a low-grade mucoepidermoid carcinoma of the bronchus. Accurate diagnosis of PMEC can be challenging on limited biopsy material as seen in the case reported here. The use of molecular studies such as MAML2 gene rearrangement may facilitate diagnosis in difficult cases. Increased awareness of this entity and further molecular studies are needed for a better understanding of the pathogenesis of PMEC. To date, the reported age range for primary bronchial mucoepidermoid carcinoma is between 3 years and 78 years. This case represents the youngest patient reported in the English literature.

Mucoepidermoid Carcinoma of Arising from a Bronchogenic Cyst of the Diaphragm

INTRODUCTION

Bronchogenic cysts may rupture or become infected, and malignant degeneration may occur. Although various types of malignant degeneration have been described, only a few reports of mucoepidermoid carcinoma arising from a bronchogenic cyst have been published. We report such a case.

CASE

A 77-year-old female was referred to our institution for evaluation of left chest pain. A computed tomography scan showed an enhancing 65 × 70 mm mass of the left diaphragm. Based on the intraoperative findings of an intradiaphragmatic tumor involving the lower lobe of the left lung, the resection of the tumor with the wedge resection of left lower lobe and partial resection of the left diaphragm was performed. Histopathologic examination revealed a mucoepidermoid carcinoma arising from a bronchogenic cyst of the diaphragm with the presence of fibrous adhesion to the lower lobe.

CONCLUSION

We believe that complete resection of any bronchogenic cyst is justified.

Childhood and adolescent tracheobronchial mucoepidermoid carcinoma (MEC): a case-series and review of the literature

Tracheobronchial mucoepidermoid carcinomas (MEC) are rare in the pediatric population with literature limited primarily to case reports. Here we present our institutional experience treating MEC in three patients and review the literature of 142 pediatric cases previously published from 1968 to 2013. Although rare, tracheobronchial MEC should be included in the differential diagnosis in a child with recurrent respiratory symptoms. Conservative surgical management is often sufficient to achieve complete resection and good outcomes.

Schwannoma arising in a bronchogenic cyst wall

Bronchogenic cysts are congenital malformations thought to originate from the primitive ventral foregut, and they are the most common type of mediastinal cystic lesion. The clinical presentation of a bronchogenic cyst is variable, from respiratory distress at birth to late appearance of symptoms. Most bronchogenic cysts originate in the mediastinum, and 15% to 20% occur in the lung parenchyma. Various malignant transformations have been reported in the literature. In this report, we describe a case of schwannoma in an intrapulmonary bronchogenic cyst wall in a 38-year-old man, which was found incidentally during a routine examination.

Clinicopathological analysis of pulmonary mucoepidermoid carcinoma

Background

Mucoepidermoid carcinoma (MEC) of the lung is a rare malignant neoplasm. We aimed to investigate clinicopathological features, therapies, and prognoses of eight MEC cases.

Methods

Eight patients underwent surgical treatment for pulmonary MEC between 2005 and 2012 at the Thoracic Surgical Department of West China Hospital, Sichuan, China. The clinical data, radiological manifestation, treatment strategy, pathological findings, and prognoses of all patients were analyzed retrospectively.

Results

Among the eight cases (four males and four females), the age of patients ranged from 35 to 71 years (mean age 50.67 years). Two tumors were located in the upper lobes and three masses were located in the lower lobes. The other three lumps were located in the left main bronchus, middle segmental bronchus of the right lobe, and trachea, respectively. The characteristics of the tumors were consistent with low grade MEC (n = 6) and high grade MEC (n = 2). All of the patients were sent for oncological evaluations, and three patients with N1 or N2 disease received chemotherapy. One of the patients died from brain metastasis at 15 months. Seven of the eight patients were alive at the time of evaluation. The median survival time was 40 (range 8 to 88) months.

Conclusion

Mucoepidermoid tumors have to be treated by radical surgery with lymph node sampling and dissection. Patients with low grade tumors can be expected to be cured following complete resection. Careful histological typing plays a key role in prediction of late results, and further studies are needed.

The alveolar epithelial differentiation of glandular inner lining cells in a mucoepidermoid carcinoma of the lung: a case report

Mucoepidermoid carcinoma is a common malignant epithelial tumor of salivary glands, but relatively rare in lung. The histological features of mucoepidermoid carcinoma of the lung are similar to its counterpart arising from the salivary glands. Here, we reported a special tumor that occurred in the medial segment of the right lower lobe in a 22-year-old man. This tumor exhibited typical features of mucoepidermoid carcinoma with 3 cell types: squamoid cells, mucin-secreting cells and cells of intermediate type. These 3 types of cells organized into cysts, nests, glands and solid patterns. Specially, the inner lining cells of some glandular structures were uniform cuboidal and hobnail-like, similar to the alveolar epithelial cells. Immunohistochemistry staining revealed that the inner lining cells of glandular structures were positive for thyroid transcription factor-1 and surfactant protein-B, used as markers of alveolar epithelial cells, and were negative for p63. These findings for the first time demonstrated a rare alveolar epithelial differentiation of glandular inner lining cells in a mucoepidermoid carcinoma of the lung.

VIRTUAL SLIDES

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