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Modern Pathology : An Official Journal... Nov 2014Pulmonary mucoepidermoid carcinoma is an uncommon but distinctive manifestation of mucoepidermoid carcinoma. Pulmonary mucoepidermoid carcinoma occurs in adults and...
Pulmonary mucoepidermoid carcinoma is an uncommon but distinctive manifestation of mucoepidermoid carcinoma. Pulmonary mucoepidermoid carcinoma occurs in adults and children and can cause diagnostic problems, especially in small biopsies. Few studies have characterized the histologic and immunophenotypic features of pulmonary mucoepidermoid carcinoma. t(11;19)(q21;p13) is considered disease-defining for mucoepidermoid carcinoma; its significance in pulmonary mucoepidermoid carcinoma warrants further study. Forty three pulmonary mucoepidermoid carcinomas were re-reviewed and graded according to the Brandwein grading system for mucoepidermoid carcinoma. Four cases were excluded because of a split opinion between pathology report and re-review. These cases were negative for MAML2 rearrangement by FISH. TTF-1, napsin A, p40 and p63 immunostains were scored: 0 (negative), 1 (1-25% tumor cells), 2 (26-50%), 3 (51-75%) or 4 (>75%). FISH to detect MAML2 rearrangement used a MAML2-11q21 break-apart probe. Thirty nine pulmonary mucoepidermoid carcinoma (4 low, 30 intermediate, 5 high grade) contained mucous, epidermoid and intermediate cells and lacked keratinization and in situ carcinoma of the overlying epithelium. All cases with available gross description (n=22) had a central/endo- or peribronchial location. All 25 cases tested for immunohistochemistry were positive (scores 1-4) for p63; 23 also expressed p40. In six cases, the p63 score was higher than p40. TTF-1 and napsin were uniformly negative in all 25 cases. MAML2 rearrangement was identified by FISH in each of the 24 cases tested (3 low, 19 intermediate, 2 high grade). Clinical history was available in 29 patients (15 men) (median age, 48 years) with follow-up in 24 (median, 8.4 years). Five patients died of unrelated causes; one developed metastatic pulmonary mucoepidermoid carcinoma. In conclusion, features helpful in distinguishing pulmonary mucoepidermoid carcinoma from other lung cancers include its central/endo- or peribronchial location together with the presence of mucous cells, p63 expression, lack of keratinization and MAML2 rearrangement. TTF-1 and napsin are typically not expressed.
Topics: Adolescent; Adult; Aged; Aspartic Acid Endopeptidases; Biomarkers, Tumor; Carcinoma, Mucoepidermoid; Child; DNA-Binding Proteins; Female; Gene Rearrangement; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; Lung Neoplasms; Male; Middle Aged; Neoplasm Grading; Nuclear Proteins; Predictive Value of Tests; Time Factors; Trans-Activators; Transcription Factors; Tumor Suppressor Proteins; Young Adult
PubMed: 24743219
DOI: 10.1038/modpathol.2014.72 -
European Archives of... Mar 2022To describe the clinicopathological characteristics and determinants of survival of patients with mucoepidermoid carcinoma (MEC) of the tongue.
OBJECTIVES
To describe the clinicopathological characteristics and determinants of survival of patients with mucoepidermoid carcinoma (MEC) of the tongue.
METHOD
Retrospective population-based study was conducted using the data of patients diagnosed with MEC of the tongue from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016.
RESULTS
A total of 200 cases of MEC of the tongue were identified. The cohort was composed of 56.5% females. The mean age at diagnosis was 58.8 years. The base of the tongue was the most common primary site (72.5%). Most cases (80.9%) presented with T1 and T2. Lymph node metastases was present in 40.9% of cases, while distant metastases only observed in 2.2% of cases. Overall survival (OS) at 2, 5, and 10 years was 80.2%, 69.8%, and 52.4%, respectively. 77.5 percent of cases (155/200) underwent surgery, and 66 cases received both surgery and radiation therapy. Patients with post-operative radiation had much longer disease-specific survival (DSS). Advanced T stage, distant metastasis contributed independently to shorter OS, while the use of surgery is an independently favorable prognostic factor for OS. In addition, an OS-specific nomogram was established, and the C-index for OS prediction was 0.74 (95% CI 0.67-0.81).
CONCLUSION
This rare malignancy is associated with a generally favorable prognosis, and T stage, distant metastasis as well as surgical therapy are independent predictors of OS.
Topics: Carcinoma, Mucoepidermoid; Female; Humans; Male; Nomograms; Prognosis; Retrospective Studies; SEER Program; Tongue
PubMed: 34152476
DOI: 10.1007/s00405-021-06919-x -
In Vivo (Athens, Greece) 2023To determine the interaction of gemcitabine in chemoradiotherapy with heavy carbon ions in vitro in a mucoepidermoid carcinoma (MEC) cell line.
BACKGROUND/AIM
To determine the interaction of gemcitabine in chemoradiotherapy with heavy carbon ions in vitro in a mucoepidermoid carcinoma (MEC) cell line.
MATERIALS AND METHODS
The human lymphatic MEC metastasis cell line NCI-H292 was used. The cells were treated with photons, carbon ions, and gemcitabine. Survival fractions (SF), apoptosis, and cell cycle progression were analyzed. A paired two-sided t-test was used. Significance was defined as p<0.05.
RESULTS
Cell proliferation assays showed a significant reduction in SF for combined photon chemoradiation versus photons only. The linear-quadratic fits of combined therapy with carbon ion dose of 0 to 2.5 Gy led to reductions of mean 15% in SF. The LD (lethal radiation dose required to reduce cell survival by 50%) for carbon ions only was 0.7 Gy and for carbon ions with gemcitabine 0.6 Gy. The LD for photons (with gemcitabine) was 2.8 Gy (2.0 Gy) and for carbon ions (with gemcitabine) 0.7 Gy (0.6 Gy), resulting in a relative biological effectiveness at 10% cell survival (RBE10) of 3.0 (2.7). Carbon ions and photons reduced S phase and increased G2/M phase cell distribution. Isolated treatment with gemcitabine as well as combination with photons led to prolonged S phase transit, whereas combined treatment with carbon ions led to early accumulation in G2/M phase. A significant increase in the sub-G1 population as a hint of relevant number of apoptotic cells was not observed.
CONCLUSION
Gemcitabine showed radiosensitizing effects in combination with photons. The combination of gemcitabine and carbon ions had independent additive effects. Carbon ions only had a RBE10 of 3.0, compared to photons only. The combination of gemcitabine, photon, and carbon ions in patients with MEC seems promising and warrants further investigation.
Topics: Humans; Gemcitabine; Deoxycytidine; Carcinoma, Mucoepidermoid; Cell Line, Tumor; Heavy Ion Radiotherapy; Chemoradiotherapy; Photons; Carbon; Ions
PubMed: 37652498
DOI: 10.21873/invivo.13291 -
Journal of the American Society of... 2020Diagnosis of salivary gland tumors on small biopsy can be difficult because of overlapping morphology, limited tissue availability, and technical artifact. Although a... (Review)
Review
Diagnosis of salivary gland tumors on small biopsy can be difficult because of overlapping morphology, limited tissue availability, and technical artifact. Although a specific diagnosis is not feasible in all cases, a cautious and thoughtful approach to the differential diagnosis and a keen awareness of clinical consequences can facilitate the most complete and useful classification possible. In this review, we present a general strategy for the evaluation of small salivary biopsies, including consideration of clinical and radiographic information, systematic assessment of histologic patterns, and judicious use of immunohistochemistry and molecular studies. We then focus on the distinctive differential diagnoses raised by 6 specific histologic patterns: tubular and cribriform architecture, squamous differentiation, mucin and other secretions, high-grade cytology, epithelial and lymphoid elements, and oncocytic features. Throughout this systematic and pattern-based approach, we focus on practical and cost-effective strategies to overcome the most common diagnostic challenges in limited material.
Topics: Artifacts; Biomarkers, Tumor; Biopsy; Carcinoma, Adenoid Cystic; Carcinoma, Mucoepidermoid; Carcinoma, Squamous Cell; Diagnosis, Differential; Humans; Immunohistochemistry; Mucins; Salivary Gland Neoplasms
PubMed: 32660844
DOI: 10.1016/j.jasc.2020.06.004 -
ORL; Journal For Oto-rhino-laryngology... 2020Mucoepidermoid carcinoma (MEC) of the upper aerodigestive tract (UADT) is an uncommon malignancy, with limited literature available on its clinical and pathologic...
INTRODUCTION
Mucoepidermoid carcinoma (MEC) of the upper aerodigestive tract (UADT) is an uncommon malignancy, with limited literature available on its clinical and pathologic characteristics. Here, we describe the behavior of MEC of the UADT including pathologic characteristics and predictors of nodal metastasis.
METHODS
Retrospective cohort study of patients with MEC of the UADT treated at an academic medical center from January 2008 to May 2018. Data was collected about demographics and tumor characteristics including clinical and histological data. The two-tailed Student t test and χ2 analysis were performed to assess for predictors of nodal metastasis.
RESULTS
We identified 44 patients with minor salivary gland MEC of the oral cavity (OC) and oropharynx (OP). All patients were treated with primary site surgery. The primary site was the OC in 25 patients (57%) and OP in 19 (43%). Low-grade histology was seen in 27 specimens (61.4%), intermediate histology in 9 specimens (20.5%), and high-grade histology in 8 specimens (18.2%). Perineural invasion was noted in 10 specimens (22.7%). Neck dissection was performed in 17 patients (39%), with pathologically positive nodes found in 9 (20.5%). Notably, 5 of the 9 positive nodal specimens were found in clinically node-negative necks. Pathologically positive cervical lymph nodes were significantly associated with the OP as the primary site (p = 0.0005), perineural invasion (p = 0.012), lymphovascular invasion (p < 0.001), and high-grade histology (p = 0.004) in the primary specimen.
DISCUSSION
MEC of the UADT is an uncommon malignancy. Our findings suggest elective neck dissection should be considered with perineural and lymphovascular invasion, high-grade tumor, and the OP as the primary site.
Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Carcinoma, Mucoepidermoid; Female; Humans; Laryngeal Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Mouth Neoplasms; Neoplasm Staging; Oropharynx; Pharyngeal Neoplasms; Prognosis; Retrospective Studies; Salivary Gland Neoplasms; Salivary Glands, Minor; Tumor Burden
PubMed: 32810854
DOI: 10.1159/000509142 -
International Journal of Surgical... Feb 2018Mucoepidermoid carcinoma (MEC) shows a wide morphologic spectrum, including epithelium with oncocytic or squamous metaplastic changes overlying a prominent cystic...
Mucoepidermoid carcinoma (MEC) shows a wide morphologic spectrum, including epithelium with oncocytic or squamous metaplastic changes overlying a prominent cystic architecture, as well as tumor-associated lymphoid tissue. We illustrate a case of MEC of the parotid in a 17-year-old female, in which all these features occurred extensively, such that they accounted for almost the entire neoplasm, and closely mimicked Warthin tumor histologically. This highlights the need for diagnostic awareness of this particular morphologic variant of MEC, as patients could potentially be inappropriately discharged from follow-up if diagnosed with a benign neoplasm.
Topics: Adenolymphoma; Adolescent; Carcinoma, Mucoepidermoid; Diagnosis, Differential; Female; Humans; Parotid Neoplasms
PubMed: 28793830
DOI: 10.1177/1066896917724889 -
BMJ Case Reports Oct 2016Necrotising sialometaplasia is a benign, necrotising, self-healing inflammatory condition categorised as idiopathic disease of salivary glands. This condition holds...
Necrotising sialometaplasia is a benign, necrotising, self-healing inflammatory condition categorised as idiopathic disease of salivary glands. This condition holds diagnostic importance because of its clinical and histopathological presentation, which is ambiguous, and can be misdiagnosed as carcinoma particularly squamous cell carcinoma or mucoepidermoid carcinoma. This report describes a case of bilateral necrotising sialometaplasia occurring in a 38-year-old male patient.
Topics: Adult; Carcinoma, Mucoepidermoid; Carcinoma, Squamous Cell; Diagnosis, Differential; Head and Neck Neoplasms; Humans; Male; Mouth Neoplasms; Sialometaplasia, Necrotizing; Squamous Cell Carcinoma of Head and Neck
PubMed: 27789544
DOI: 10.1136/bcr-2015-211348 -
Japanese Journal of Clinical Oncology Mar 2024Salivary gland-type tumors of the lung are thought to originate from the submucosal exocrine glands of the large airways. Due to their rare occurrence, reports of their... (Review)
Review
Salivary gland-type tumors of the lung are thought to originate from the submucosal exocrine glands of the large airways. Due to their rare occurrence, reports of their study are limited to small-scale or case reports. Therefore, daily clinical practices often require a search for previous reports. In the last 20 years, several genetic rearrangements have been identified, such as MYB::NF1B rearrangements in adenoid cystic carcinoma, CRTC1::MAML2 rearrangements in mucoepidermoid carcinoma, EWSR1::ATF1 rearrangements in hyalinizing clear cell carcinoma and rearrangements of the EWSR1 locus or FUS (TLS) locus in myoepithelioma and myoepithelial carcinoma. These molecular alterations have been useful in diagnosing these tumors, although they have not yet been linked to molecularly targeted therapies. The morphologic, immunophenotypic, and molecular characteristics of these tumors are similar to those of their counterparts of extrapulmonary origin, so clinical and radiologic differential diagnosis is required to distinguish between primary and metastatic disease of other primary sites. However, these molecular alterations can be useful in differentiating them from other primary lung cancer histologic types. The management of these tumors requires broad knowledge of the latest diagnostics, surgery, radiotherapy, bronchoscopic interventions, chemotherapy, immunotherapy as well as therapeutic agents in development, including molecularly targeted agents. This review provides a comprehensive overview of the current diagnosis and treatment of pulmonary salivary gland tumors, with a focus on adenoid cystic carcinoma and mucoepidermoid carcinoma, which are the two most common subtypes.
Topics: Humans; Carcinoma, Adenoid Cystic; Carcinoma, Mucoepidermoid; Salivary Gland Neoplasms; Carcinoma; Myoepithelioma; Salivary Glands; Lung Neoplasms
PubMed: 38018262
DOI: 10.1093/jjco/hyad160 -
Journal of Cancer Research and... 2022Mucoepidermoid carcinoma (MEC) is a rare malignant thyroid neoplasm. Cases of MEC with papillary, insular, and anaplastic thyroid carcinoma have been reported. Here, we...
Mucoepidermoid carcinoma (MEC) is a rare malignant thyroid neoplasm. Cases of MEC with papillary, insular, and anaplastic thyroid carcinoma have been reported. Here, we present a case of follicular carcinoma with extensive MEC-like differentiation. A 62-year-old female presented with complaint of thyroid swelling for 10 years. Cytological features were suggestive of follicular neoplasm. Contrast-enhanced computed tomography showed metastasis to lung and vertebrae. Salivary glands and breasts were normal on examination and imaging. Subtotal thyroidectomy with bilateral neck dissection surgery was performed. The specimen was submitted for histopathological examination. Microscopy showed features of follicular carcinoma with capsular and vascular invasion along with an additional MEC-like morphology. Follicular carcinoma with extensive MEC-like differentiation is a rare observation. Since the tumor was sparing salivary glands and breasts, we considered it as mucoepidermoid differentiation over a collision tumor. However, immunohistochemistry and molecular analysis were the limitations.
Topics: Adenocarcinoma, Follicular; Carcinoma, Mucoepidermoid; Female; Humans; Middle Aged; Thyroid Neoplasms; Thyroidectomy
PubMed: 35900576
DOI: 10.4103/jcrt.JCRT_1422_20 -
International Journal of Clinical and... 2015Pulmonary mucoepidermoid carcinoma (PMEC) is a rare malignant neoplasm with remarkable resemblance to mucoepidermoid carcinoma of the salivary glands. It constitutes a...
BACKGROUND
Pulmonary mucoepidermoid carcinoma (PMEC) is a rare malignant neoplasm with remarkable resemblance to mucoepidermoid carcinoma of the salivary glands. It constitutes a unique set of patient population. In this study we briefly discussed the current state of knowledge of PMEC and described the clinical presentation and management of 27 PMEC cases. This study aimed to discuss the utility of surgical treatment in the patients with pulmonary mucoepidermoid carcinoma.
METHODS
We retrospectively studied 27 cases with the diagnosis of PMEC, divided into low grade and high grade based on histopathological characteristics. The clinical symptoms, radiological manifestations, pathological characteristics, treatment strategy and prognosis were systemically analyzed.
RESULTS
The tumor could occur in any lobe of the lungs. The treatment included surgical intervention and/or adjuvant therapies. While the sex-age distribution and initial staging was not different between low- and high- grade PMEC, the disease control rate (95%) and 5 year survival (95%) were much higher in low-grade PMEC than the high-grade cases (57.1% and 42.9%, respectively).
CONCLUSION
The clinical, radiographical and pathological features of PMECs were systemically analyzed and summarized, and the utility of pathological grading system as the independent prognostic factor in addition to clinical staging was confirmed.
Topics: Adult; Aged; Asian People; Carcinoma, Mucoepidermoid; Female; Humans; Lung Neoplasms; Male; Middle Aged; Prognosis; Retrospective Studies; Survival Analysis; Tomography, X-Ray Computed
PubMed: 26045810
DOI: No ID Found