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Pulmonary Epithelial-Myoepithelial Carcinoma. JOURNAL OF ONCOLOGY 2022; 2022:4559550. [PMID: 36268279 PMCID: PMC9578788 DOI: 10.1155/2022/4559550] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022]
Abstract
Pulmonary epithelial-myoepithelial carcinoma (P-EMC) is an exceptionally rare subtype of salivary gland lung tumor originating from tracheobronchial glands. P-EMC is a biphasic tumor consisting of an inner layer of epithelial cells and an outer layer of spindle-shaped, clear-cell-like myoepithelial cells. Bronchial obstruction symptom is the main clinical characteristic for P-EMC. Because its clinical and imaging characteristics are highly similar to other types of non-small-cell lung cancer (NSCLC), it is easy to cause missed diagnosis and misdiagnosis. The diagnosis is mainly based on the pathology and immunohistochemistry with an inner layer of epithelial cells immunoreactive for cytokeratin and an outside layer of myoepithelial cells immunoreactive for S100 protein (S-100) and smooth muscle actin (SMA). Therefore, positive for cytokeratin, S-100 and SMA can assist in the diagnosis. Although in general, P-EMC is a low-grade malignant neoplasm, it may occasionally recur and metastasize. The optimal method for P-EMC treatment has not been established, and surgical resection is still the main clinical method. Radiotherapy and chemotherapy have been shown not sensitive for P-EMC treatment, whereas targeted therapy and immunotherapy have not evaluated in clinical practice. This review focuses on the pathological characteristics, molecular characteristics, diagnosis, treatment, and prognosis of P-EMC.
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2
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Mohanty S, Sharma S, Tayal A, Khatri S, Mohapatra S. Primary pulmonary epithelial-myoepithelial carcinoma: Report of a rare and under-diagnosed low-grade malignancy. J Cancer Res Ther 2022; 18:795-800. [DOI: 10.4103/jcrt.jcrt_559_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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3
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Nakashima Y, Morita R, Ui A, Iihara K, Yazawa T. Epithelial-myoepithelial carcinoma of the lung: a case report. Surg Case Rep 2018; 4:74. [PMID: 29987577 PMCID: PMC6037657 DOI: 10.1186/s40792-018-0482-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 07/02/2018] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Pulmonary epithelial-myoepithelial carcinoma (P-EMC) is a rare subset of salivary gland-type tumors of the lung. Because of its rarity and unproven malignant potential, the optimal therapy for P-EMC has not been defined. Here, we report a typical case of P-EMC and a review of the literature to consider appropriate treatment. CASE PRESENTATION A 54-year-old woman presented with an abnormal lung shadow on a routine chest X-ray. A chest computed tomography (CT) scan verified an 18-mm endobronchial nodule on the middle lobe. We performed a bronchoscopic biopsy, and the patient was diagnosed with P-EMC. After confirming the absence of tumors in the salivary glands, she underwent a right middle lobectomy along with hilar and mediastinal lymph node dissections. Currently, the patient is doing well, without any sign of recurrence 3 years after surgery. CONCLUSIONS Although a majority of P-EMC cases, as in our case, behave indolently, several poor progression cases have been reported. For distinguishing the minor malignancy cases from others, histological findings such as myoepithelial anaplasia could be a predictive factor. Complete resection is needed to evaluate the whole tumor, because P-EMCs often show histological heterogeneity. Moreover, incomplete excision may be a poor prognostic factor. Although lobectomies as well as lymph node dissections, sleeve lobectomies, or pneumonectomies are routinely performed for complete resection, further investigation is required to establish the optimal treatment strategy.
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Affiliation(s)
- Yasuhiro Nakashima
- Department of Chest Surgery, Tokyo Yamate Medical Center, 3-22-1 Hyakunin-cho, Shinjuku-ku, Tokyo, 169-0073 Japan
- Department of Thoracic Surgery, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519 Japan
| | - Riichiro Morita
- Department of Chest Surgery, Tokyo Yamate Medical Center, 3-22-1 Hyakunin-cho, Shinjuku-ku, Tokyo, 169-0073 Japan
| | - Akiko Ui
- Department of Chest Surgery, Tokyo Yamate Medical Center, 3-22-1 Hyakunin-cho, Shinjuku-ku, Tokyo, 169-0073 Japan
- Department of Thoracic Surgery, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519 Japan
| | - Kuniko Iihara
- Department of Pathology, Tokyo Yamate Medical Center, 3-22-1 Hyakunin-cho, Shinjuku-ku, Tokyo, 169-0073 Japan
| | - Takuya Yazawa
- Department of Pathology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293 Japan
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Takamatsu M, Sato Y, Muto M, Nagano H, Ninomiya H, Sakakibara R, Baba S, Sakata S, Takeuchi K, Okumura S, Ishikawa Y. Hyalinizing clear cell carcinoma of the bronchial glands: presentation of three cases and pathological comparisons with salivary gland counterparts and bronchial mucoepidermoid carcinomas. Mod Pathol 2018; 31:923-933. [PMID: 29434341 DOI: 10.1038/s41379-018-0025-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 12/12/2017] [Accepted: 12/17/2017] [Indexed: 01/27/2023]
Abstract
Hyalinizing clear cell carcinoma of the bronchial glands is a very rare tumor. Since only five reports describing six tumors have been published to date, only a little is known about specific histologic findings and clinical features. Because of its rarity, hyalinizing clear cell carcinoma has not been described in the latest WHO classification of pulmonary tumors yet. Here we present three cases of bronchial hyalinizing clear cell carcinomas, confirmed by both fluorescence in situ hybridization (FISH) and RT-PCR, focusing on histologic and immunohistochemical characteristics in a comparison with three cases of salivary gland origin. In addition, we compared immunohistochemical features with bronchial mucoepidermoid carcinoma, a lesion that needs to be taken into account in differential diagnosis of hyalinizing clear cell carcinoma. All our bronchial hyalinizing clear cell carcinoma cases were surgically resected. Histologically, tumor cells showed clear to eosinophilic cytoplasm with hyalinizing stroma in various proportions, resembling those of salivary gland origin. Immunohistochemically, tumor cells were positive for CK7, CK5/6, p40, p63, and ATF1, while they were negative for TTF1, Napsin A, HMB45, and SOX10. The CK5/6 staining pattern varied in mucoepidermoid carcinomas, while that of hyalinizing clear cell carcinoma was uniformly positive. FISH revealed EWSR1-ATF1 fusion, and RT-PCR with sequencing confirmed specificity of the chimeric gene for hyalinizing clear cell carcinoma. Clinically, bronchial hyalinizing clear cell carcinoma was characterized by occurrence in the fourth to sixth decades, no link with smoking history, and a predilection for the right lung, in line with previous reports. In summary, our study confirmed that the bronchial hyalinizing clear cell carcinoma is a histologically and genetically identical tumor to that of salivary gland origin, and that gene rearrangement analysis can play a critical role in distinction from mucoepidermoid carcinoma.
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Affiliation(s)
- Manabu Takamatsu
- Division of Pathology, The Cancer Institute; Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan
| | - Yukiko Sato
- Division of Pathology, The Cancer Institute; Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan
| | - Mariko Muto
- Division of Pathology, The Cancer Institute; Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan
| | - Hiroko Nagano
- Division of Pathology, The Cancer Institute; Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan
| | - Hironori Ninomiya
- Division of Pathology, The Cancer Institute; Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan
| | - Rie Sakakibara
- Division of Pathology, The Cancer Institute; Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan
| | - Satoko Baba
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan
| | - Seiji Sakata
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan
| | - Kengo Takeuchi
- Division of Pathology, The Cancer Institute; Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan.,Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan
| | - Sakae Okumura
- Department of Thoracic Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan
| | - Yuichi Ishikawa
- Division of Pathology, The Cancer Institute; Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan.
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5
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Korolczuk A, Amarowicz M, Bąk K, Korobowicz E, Koncewicz T. Adenomyoepithelioma of the breast with late pulmonary metastases - case report and review of the literature. J Cardiothorac Surg 2016; 11:121. [PMID: 27487934 PMCID: PMC4973092 DOI: 10.1186/s13019-016-0518-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 07/27/2016] [Indexed: 02/07/2023] Open
Abstract
Background Adenomyoepithelioma (AME) of the breast is a rare tumour of unpredictable clinical behaviour. Most of the tumours are benign with some giving local recurrences or distant metastases. Case Presentation We report a case of late lung metastases in a woman with a history of breast adenomyoepithelioma. Partial lobectomy was performed for lung lesions and initial diagnosis was epithelial-myoepithelial carcinoma. Conclusion Careful slide’s revision of both breast and pulmonary lesions showed identical microscopic appearance with lung tumour performing more malignant features. Tumour cells in both: breast and pulmonary lesions were positive for cytokeratin and EMA (epithelial cells) and also for SMA, S100 and vimentin (myoepithelial cells). Two years and 7 months follow-up showed no recurrent neoplastic disease in our patient.
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Affiliation(s)
- Agnieszka Korolczuk
- Department of Clinical Pathomorphology, Medical University, Jaczewskiego 8, 20-059, Lublin, Poland.
| | - Magdalena Amarowicz
- Department of Clinical Pathomorphology, Medical University, Jaczewskiego 8, 20-059, Lublin, Poland
| | - Kamila Bąk
- Department of Clinical Pathomorphology, Medical University, Jaczewskiego 8, 20-059, Lublin, Poland
| | - Elżbieta Korobowicz
- Department of Clinical Pathomorphology, Medical University, Jaczewskiego 8, 20-059, Lublin, Poland
| | - Tomasz Koncewicz
- Chair and Department of Thoracic Surgery, Medical University, Lublin, Poland
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6
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Cho SH, Park SD, Ko TY, Lee HY, Kim JI. Primary epithelial myoepithelial lung carcinoma. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2014; 47:59-62. [PMID: 24570870 PMCID: PMC3928267 DOI: 10.5090/kjtcs.2014.47.1.59] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 09/21/2013] [Accepted: 09/23/2013] [Indexed: 11/16/2022]
Abstract
Primary epithelial-myoepithelial carcinoma (EMC) of the lung is an extremely rare neoplasm that originates from submucosal bronchial glands and has been found in the salivary glands, breast tissue, and sweat glands. However, only a few cases in the respiratory tract have been identified. In the literature, most pulmonary EMCs have been reported to have developed endobronchially although a few EMC cases have been presented as intraparenchymatous tumors. We have identified a case of primary EMC that developed in the peripheral lung parenchyma.
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Affiliation(s)
- Seong Ho Cho
- Department of Thoracic and Cardiovascular Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Korea
| | - Sung Dal Park
- Department of Thoracic and Cardiovascular Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Korea
| | - Taek Yong Ko
- Department of Thoracic and Cardiovascular Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Korea
| | - Hae Young Lee
- Department of Thoracic and Cardiovascular Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Korea
| | - Jong In Kim
- Department of Thoracic and Cardiovascular Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Korea
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7
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Primary epithelial myoepithelial carcinoma of lung, reporting of a rare entity, its molecular histogenesis and review of the literature. Case Rep Pathol 2012; 2012:319434. [PMID: 22934215 PMCID: PMC3423864 DOI: 10.1155/2012/319434] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Accepted: 05/20/2012] [Indexed: 12/03/2022] Open
Abstract
Primary epithelial myoepithelial carcinoma of lung is a rare entity and is thought to arise from the submucosal bronchial glands distributed throughout the lower respiratory tract. Because of the rarity of this tumor, we describe one case of epithelial myoepithelial carcinoma arising in the bronchus intermedius and presenting as an endobronchial mass. A 57-year-old male patient presented with an incidental finding of an endobronchial mass located in the lumen of the right lower lobe bronchus and caused near total luminal occlusion of the bronchus. An endobronchial carcinoid tumor was entertained clinically. Subsequently the patient underwent an uneventful videothoracoscopic lobectomy of lower and middle lobes of the right lung. Morphologically and immunohistochemically the tumor was characterized by two cell populations with epithelial and myoepithelial cells forming duct-like structure. The final diagnosis of epithelial myoepithelial carcinoma of lung was rendered.
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8
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9
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Muñoz G, Felipo F, Marquina I, Del Agua C. Epithelial-myoepithelial tumour of the lung: a case report referring to its molecular histogenesis. Diagn Pathol 2011; 6:71. [PMID: 21798017 PMCID: PMC3159095 DOI: 10.1186/1746-1596-6-71] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Accepted: 07/28/2011] [Indexed: 11/24/2022] Open
Abstract
Tracheobronchial submucous glands can be considered the pulmonary equivalent of minor salivary glands and therefore they can develop most of the tumours originated in these. Nevertheless, in spite of the wide distribution of this kind of glands along the tracheobronchial tree, pulmonary salivary gland-like neoplasms are not very frequent. Among them, the most frequent are mucoepidermoid and adenoid cystic carcinomas. On the contrary, pulmonary neoplasms showing a mixture of epithelial and myoepithelial elements are extraordinary infrequent, with only 11 cases collected from literature. We present the case of a 76 year-old woman with no interesting pathological history, to whom a pulmonary nodule is detected during a study of unknown origin neutropenia. An upper right lobectomy is performed. After macro and microscopic study, the diagnosis of pulmonary epithelial-myoepithelial tumour is made. It is a low malignant potential tumour with capacity to locally recur and less frequently to metastasize. Our case has the peculiarity of not being connected neither to visceral pleura nor to bronchial tree; we have not found this characteristic in any literature reviewed case. These tumours have been named in a lot of different ways, including adenomyoepithelioma, epithelial-myoepithelial tumour, epithelial-myoepithelial carcinoma or epithelial-myoepithelial tumour of uncertain malignant potential. The p27/kip-1 protein plays a fundamental role in the development of these neoplasms. As we have verified in our case, its aberrant cytoplasmic location, besides its proved oncogenic function, would favour the proliferation of stem cells, which would explain both dual phenotype with presence of myoepithelial cells without connection with the bronchial tree, and TTF-1 immunostaining in epithelial cells.
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Affiliation(s)
- Guillermo Muñoz
- Department of Pathology, Hospital Universitario Miguel Servet Zaragoza, Spain.
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10
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A case of epithelial–myoepithelial carcinoma of the bronchus – A review of reported cases and a comparison with other salivary gland-type carcinomas of the bronchus. Pathol Res Pract 2010; 206:121-9. [DOI: 10.1016/j.prp.2009.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Revised: 03/10/2009] [Accepted: 03/11/2009] [Indexed: 11/23/2022]
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11
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Nguyen CV, Suster S, Moran CA. Pulmonary epithelial-myoepithelial carcinoma: a clinicopathologic and immunohistochemical study of 5 cases. Hum Pathol 2009; 40:366-73. [DOI: 10.1016/j.humpath.2008.08.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2008] [Revised: 08/11/2008] [Accepted: 08/14/2008] [Indexed: 10/21/2022]
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12
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Doganay L, Bilgi S, Ozdil A, Yoruk Y, Altaner S, Kutlu K. Epithelial-myoepithelial carcinoma of the lung. A case report and review of the literature. Arch Pathol Lab Med 2003; 127:e177-80. [PMID: 12683896 DOI: 10.5858/2003-127-e177-ecotl] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Primary lung tumors mimicking the salivary gland-type neoplasms are extremely rare. These types of tumors originate from submucosal bronchial glands. Epithelial-myoepithelial carcinoma is an uncommon tumor in this group, and only 7 cases have been reported. It is considered to be a low-grade malignant neoplasm. We report a case of epithelial-myoepithelial carcinoma of bronchial gland origin in a 73-year-old man who presented with coughing and dyspnea. The bronchus of the left lower lobe contained a tumor mass that had a polypoid growth pattern. The tumor also extended into the pulmonary parenchyma, forming a well-circumscribed mass with a pushing margin. The tumor consisted of epithelial and myoepithelial cells. The epithelial cells were positive for cytokeratins and epithelial membrane antigen, while the myoepithelial cells were positive for S100 protein and muscle-specific actin. According to these findings, we diagnosed epithelial-myoepithelial carcinoma. After undergoing pneumonectomy, the patient has been disease free for 34 months.
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Affiliation(s)
- Latife Doganay
- Department of Pathology, Trakya University Medical Faculty, Edirne, Turkey.
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13
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Litzky L. Epithelial and soft tissue tumors of the tracheobronchial tree. CHEST SURGERY CLINICS OF NORTH AMERICA 2003; 13:1-40. [PMID: 12698636 DOI: 10.1016/s1052-3359(02)00045-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This article provides a broad overview of tumors that can involve the tracheobronchial tree. For the most part, the clinical, radiographic, and endoscopic presentation of these rare tumors does not differ significantly from the more common tumors of the lung. Appropriate classification of many tracheobronchial tumors ultimately requires complete sampling and a thorough microscopic evaluation. The introduction of ancillary diagnostic techniques such as immunohistochemistry and molecular analysis will continue to refine tumor classification.
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Affiliation(s)
- Leslie Litzky
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, 6 Founders Pavilion, 3400 Spruce Street, Philadelphia, PA 19104-4283, USA.
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14
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Fulford LG, Kamata Y, Okudera K, Dawson A, Corrin B, Sheppard MN, Ibrahim NB, Nicholson AG. Epithelial-myoepithelial carcinomas of the bronchus. Am J Surg Pathol 2001; 25:1508-14. [PMID: 11717540 DOI: 10.1097/00000478-200112000-00006] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Epithelial-myoepithelial carcinomas are very rare in the lung, and little is known about the relationship of their histologic features to prognosis. We describe five primary pulmonary epithelial-myoepithelial carcinomas with details on clinical presentation, histology, and immunohistochemical profiles. We also reviewed the literature to detail further their prognosis. The patients' ages ranged from 33 to 57 years (average 51 years). The tumors were all endobronchial and the patients presented with symptoms or imaging features of airway obstruction. The tumors were completely resected; none showed nodal involvement. All five patients are alive and free of disease 4 months to 8 years (average 4.2 years) after surgery. Four tumors showed a mixed pattern of glands lined by a dual layer of cells and solid sheets of either spindle cells or clear cells, the glandular and solid components being present in variable proportions. The fifth tumor comprised purely spindle cells. The mitotic rate was <1/20 high power fields in both the glandular and spindle/clear cell components. In one case there was focal nuclear pleomorphism. The inner layer of the glands stained for cytokeratins and epithelial membrane antigen, and the outer layer for S-100 and smooth muscle actin. In one case the spindle cells stained for CD34. A review of published cases shows the majority of tumors behave in an indolent fashion, the rare aggressive tumors being predominantly myoepitheliomatous. Nevertheless, the term epithelial-myoepithelial carcinoma is preferred because of their malignant potential. A high mitotic rate, tumoral necrosis, and nuclear pleomorphism appear to be adverse prognostic factors.
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Affiliation(s)
- L G Fulford
- Department of Histopathology, Royal Brompton Hospital, London, UK
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15
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Pelosi G, Fraggetta F, Maffini F, Solli P, Cavallon A, Viale G. Pulmonary Epithelial-Myoepithelial Tumor of Unproven Malignant Potential: Report of a Case and Review of the Literature. Mod Pathol 2001; 14:521-6. [PMID: 11353064 DOI: 10.1038/modpathol.3880341] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Epithelial-myoepithelial tumors of the lung are rare neoplasms whose biological behavior and clinical course still remain to be defined. A case of epithelial-myoepithelial tumor of the lung arising from bronchial mucosa-submucosa and occurring as a polypoid lesion of the upper left bronchus in a 47-year-old man is reported. The tumor did not infiltrate the cartilaginous wall of the bronchus and showed a biphasic histological appearance with a double layering of epithelial and myoepithelial cells. Myoepithelial spindle cells with eosinophilic cytoplasm were also observed. Mitotic figures were very rare and necrosis absent. Immunohistochemical study for epithelial and muscular markers confirmed the presence of a double-cell component in the tumor, namely epithelial and myoepithelial. The patient is alive and well, with no evidence of recurrent or metastatic disease 6 months after surgery. On the basis of the present case and the six previously reported cases, we suggest using the noncommittal term pulmonary epithelial-myoepithelial tumor of unproven malignant potential (PEMTUMP) for this type of neoplasm. In addition, we first introduce p63 as a novel marker for highlighting the myoepithelial cells of the respiratory tract and speculate on the role of these cells in the development of this unusual tumor.
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Affiliation(s)
- G Pelosi
- Department of Pathology and Laboratory Medicine, European Institute of Oncology and University of Milan School of Medicine, Italy.
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16
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Miura K, Harada H, Aiba S, Tsutsui Y. Myoepithelial carcinoma of the lung arising from bronchial submucosa. Am J Surg Pathol 2000; 24:1300-4. [PMID: 10976707 DOI: 10.1097/00000478-200009000-00016] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Myoepithelial neoplasm mainly occurs in the salivary glands and breasts and is extremely rare in the lung. To our knowledge, this report describes the first documented case of a myoepithelial carcinoma present in the lung. The tumor derived from the right main bronchial submucosa and exhibited a dual epithelial and smooth muscular phenotype by immunohistochemical and ultrastructural studies. It invaded the neighboring pulmonary tissue and the hilar lymph nodes. Despite a right pneumonectomy and chemotherapy, metastasis was found in the left lung 7 months later.
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Affiliation(s)
- K Miura
- Division of Pathology, Hamamatsu University School of Medicine, Japan.
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17
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Kasper HU, Mellin W, Kriegsmann J, Cheremet E, Lippert H, Roessner A. Epithelial-myoepithelial carcinoma of the salivary gland--a low grade malignant neoplasm? Report of two cases and review of the literature. Pathol Res Pract 1999; 195:189-92. [PMID: 10220800 DOI: 10.1016/s0344-0338(99)80033-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Epithelial-myoepithelial carcinomas (EMC) are rare neoplasms of the salivary gland with an incidence of less than 1% arising predominantly in the parotid gland. Although they are thought to be of low grade malignancy, fatal courses are described. We report a case of EMC of the parotid gland in a 58-year-old woman with an unfavorable course of this disease in long term follow-up. The malignant potential of this tumor is discussed. In addition, we include another case of EMC of the submandibular gland.
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Affiliation(s)
- H U Kasper
- Department of Pathology, Otto-von-Guericke University Magdeburg, Germany
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