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Hashmi AA, Khurshid A, Faridi N, Edhi MM, Khan M. A large mediastinal benign myoepithelioma effacing the entire hemithorax: case report with literature review. Diagn Pathol 2015; 10:100. [PMID: 26170201 PMCID: PMC4501044 DOI: 10.1186/s13000-015-0340-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 06/29/2015] [Indexed: 11/23/2022] Open
Abstract
Background Myoepithelial neoplasms, although sometimes encountered in soft tissues are described very rarely in mediastinum and lung. We reported a rare case of such a tumor which was very large in size and not connected to respiratory tree. Case presentation A 24 year old male presented with blunt chest pain and respiratory distress. A CT scan was performed which showed large heterogeneously enhancing soft tissue mass occupying the left hemithorax. It measures 18.5 X 15.8 X 7.6. Thoracotomy with excision of the tumor was done. Operative findings include multilobulated and nodular large glistening white tumor located in anterior mediastinum adherent to parietal pleura and effacing the pulmonary parenchyma. However tumor was not connected or seems to originate from trachea or lung. Microscopic sections show neoplastic lesion composed of nests, cords and trabeculae of small to medium sized cells with round nuclei and clear cytoplasm. Background showed myxoid appearance with areas of cartilaginous differentiation. Immunohistochemical expression of CKAE1/AE3, p63, ASMA, S100 and GFAP favored the diagnosis of benign myoepithelioma. Conclusion Myoepithelial tumors are rare soft tissue tumors thought to arise from stem cells capable of divergent differentiation and occur anywhere in the body. Histopathologic recognition of these tumors is essential as these tumors may behave in a benign fashion despite large sizes.
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Affiliation(s)
- Atif Ali Hashmi
- Department of Histopathology, Liaquat National Hospital and Medical College, Karachi, Pakistan. .,Intern, Liaquat National Hospital and Medical College, Karachi, Pakistan. .,Dhaka Medical College, Dhaka, Bangladesh.
| | - Amna Khurshid
- Department of Histopathology, Liaquat National Hospital and Medical College, Karachi, Pakistan. .,Intern, Liaquat National Hospital and Medical College, Karachi, Pakistan. .,Dhaka Medical College, Dhaka, Bangladesh.
| | - Naveen Faridi
- Department of Histopathology, Liaquat National Hospital and Medical College, Karachi, Pakistan. .,Intern, Liaquat National Hospital and Medical College, Karachi, Pakistan. .,Dhaka Medical College, Dhaka, Bangladesh.
| | - Muhammad Muzzammil Edhi
- Department of Histopathology, Liaquat National Hospital and Medical College, Karachi, Pakistan. .,Intern, Liaquat National Hospital and Medical College, Karachi, Pakistan. .,Dhaka Medical College, Dhaka, Bangladesh.
| | - Mehmood Khan
- Department of Histopathology, Liaquat National Hospital and Medical College, Karachi, Pakistan. .,Intern, Liaquat National Hospital and Medical College, Karachi, Pakistan. .,Dhaka Medical College, Dhaka, Bangladesh.
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Abstract
Rearrangements of the EWSR1 gene are found in an increasing number of human neoplasms, including several tumors that can involve the skin: Ewing sarcoma/primitive neuroectodermal tumor, angiomatoid (malignant) fibrous histiocytoma, myoepithelioma of soft tissue, and clear cell sarcoma. Although these tumors share this common genetic link, they have very different clinical features, morphology, immunophenotype, and sometimes fusion gene partners; these will be the subjects of this review.
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LeBlanc RE, Taube J. Myofibroma, Myopericytoma, Myoepithelioma, and Myofibroblastoma of Skin and Soft Tissue. Surg Pathol Clin 2011; 4:745-759. [PMID: 26837646 DOI: 10.1016/j.path.2011.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The authors address a group of loosely associated, characteristically benign soft tissue neoplasms that exhibit partial myoid differentiation. The entities share similarities in morphology and in nomenclature that have historically created confusion. The authors attempt to clarify the distinct architectural patterns and the corresponding immunophenotypic and ultrastructural features that distinguish myofibroma, myopericytoma, myoepithelioma, and myofibroblastoma.
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Affiliation(s)
- Robert E LeBlanc
- Department of Pathology, The Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | - Janis Taube
- Departments of Dermatology and Pathology, The Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA
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Santos GC, Carvalho KC, Falzoni R, Simoes ACQ, Rocha RM, Lopes A, Vassallo J, Reis LFL, Soares FA, da Cunha IW. Glial fibrillary acidic protein in tumor types with cartilaginous differentiation. Mod Pathol 2009; 22:1321-7. [PMID: 19668151 DOI: 10.1038/modpathol.2009.99] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Glial fibrillary acidic protein (GFAP) is a member of the intermediary filament protein family. It is an important component of astrocytes and a known diagnostic marker of glial differentiation. GFAP is expressed in other neural tumors and pleomorphic adenoma and, less frequently, in cartilage tumors, chordomas, and soft tissue myoepitheliomas. The aim of this study was to evaluate the role of GFAP and its reliability in nonglial tumors as an immunohistochemical marker. We evaluated GFAP gene and protein expression using Q-PCR and immunohistochemistry, respectively, in 81 and 387 cases of soft tissue, bone tumors, and salivary pleomorphic adenomas. Immunohistochemistry staining for GFAP was observed in all osteosarcomas (8 cases), all pleomorphic adenomas (7 cases), in 5 of 6 soft tissue myoepitheliomas, and in 21 of 76 chondrosarcomas. By Q-PCR, GFAP was highly expressed in pleomorphic adenomas and, to a lesser extent, chondrosarcomas, soft tissue myoepitheliomas, and chondroblastic osteosarcomas. The results that we obtained by immunohistochemistry and Q-PCR were well correlated. GFAP is a potential marker for tumors with cartilaginous differentiation, supported by evidence that GFAP is expressed in certain cases of myoepithelial tumors by immunohistochemistry, including soft tissue myoepitheliomas, which are related to cartilaginous differentiation. These findings contribute significantly to the diagnosis of soft tissue myoepitheliomas with cartilaginous differentiation and chondroblastic osteosarcoma in mesenchymal tumors.
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Malignant myoepithelioma of soft tissue: a case report with cytogenetic findings. ACTA ACUST UNITED AC 2008; 183:121-4. [DOI: 10.1016/j.cancergencyto.2008.02.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2008] [Revised: 02/06/2008] [Accepted: 02/20/2008] [Indexed: 11/22/2022]
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