Pulmonary epithelial-myoepithelial carcinoma: a clinicopathologic and immunohistochemical study of 5 cases

Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
Human pathology (Impact Factor: 2.81). 11/2008; 40(3):366-73. DOI: 10.1016/j.humpath.2008.08.009
Source: PubMed

ABSTRACT Pulmonary epithelial-myoepithelial carcinomas are rare low-grade malignant neoplasms with histologic features similar to their salivary gland counterparts. We report a series of 5 cases and describe their clinical, morphological, and immunohistochemical features. The patients included 3 men and 2 women whose ages ranged from 38 to 56 years. All patients had obstructing endobronchial lesions that ranged from 2.5 to 5.0 cm in greatest dimension. The tumors were completely resected by simple lobectomy or pneumonectomy. In one patient, the tumor infiltrated perinodal soft tissue of a peribronchial lymph node with intranodal extension and metastasis within the same lymph node. The follow-up in these patients ranged from 4 to 12 months. The histologic appearance of these tumors varied, but all shared the common feature of a biphasic proliferation of epithelial (strong cytokeratin-positive; actin and S-100-negative) and myoepithelial (strong actin and S-100 and focal weak cytokeratin-positive) cells with formation of bilayered ductlike structures. The focal resemblance to other salivary gland-type tumors may cause diagnostic difficulties, particularly in small endobronchial biopsies. Although little is known about their biologic potential due to limited follow-up data, these tumors when in the lung clearly have the capacity to infiltrate and metastasize and therefore should be designated as epithelial-myoepithelial carcinoma. At present, it appears that treatment by complete surgical resection with negative margins alone is appropriate and adequate.

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    • "Histologically, all lesions share the common features of having duct-like structures within a background of variable proportions of epithelial and myoepithelial cells [6]. The inner layer consists of small darker cuboidal epithelial cells (positive for cytokeratin, negative for S-100 and muscle-specific actin), while the outer layer is formed by clear myoepithelial cells (positive for S-100, muscle-specific actin, and P63 with focal weak positivity for cytokeratin) [3] [4] [6] [11]. As to the malignant potential of pulmonary EMC, samples obtained from the primary and metastatic regions in our case did not show prognostic factors such as mitoses or necrosis. "
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    ABSTRACT: Epithelial-myoepithelial carcinoma (EMC) of the lung is rare and is considered to be low-grade malignancy. Intracranial metastasis of pulmonary EMC has not previously been reported according to our search of the literature. We report a case of skull metastasis as the initial manifestation of pulmonary EMC. An 81-year-old man complained of left leg motor weakness. Neurological examination showed left hemiparesis. Computed tomography and magnetic resonance imaging revealed an osteolytic tumor in the right frontal bone with invasion to the dura and subdural space, attached to the superior sagittal sinus. Subtotal removal of the tumor was performed, and the left hemiparesis showed improvement. Histopathological study revealed the tumor to consist of epithelial and myoepithelial cells. Pulmonary EMC was diagnosed. The MIB-1 index in primary lesion was approximately 10%. The skull and dura are possible sites for metastasis from pulmonary EMC. The MIB-1 index is a predictive marker of malignant potential.
    07/2011; 2011:610383. DOI:10.1155/2011/610383
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    • "This first histological separation is of outmost importance for the patient's prognosis. As pointed out by Nguyen et al. [8] in a recent review of 23 cases of pulmonary epithelial-myoepithelial tumors, these neoplasms are low-grade lesions without recurrences or metastasis described after resection. "
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    ABSTRACT: Primary salivary gland-type tumors of the lung are rare neoplasms. The pulmonary myoepithelial carcinoma belongs to this group. Since it was first described in 1998, we have identified only seven actual cases reported in the literature so far. We describe the case of a non-smoker 60-year-old Caucasian female, who was referred to our institution for the treatment of three peripheral nodules. Her medical history revealed that a wedge resection, for pulmonary myoepithelial carcinoma, was performed in another center 15 months previously. After resection of the current nodules, the histological findings showed three myoepithelial carcinomas of the lung. There was no vascular or lymphatic invasion. The hilar and mediastinal lymph nodes were negatives. The patient is doing well without any sign of recurrence. Herein we shall discuss the case of a primary pulmonary myoepithelial carcinoma in a female and propose a brief review of the literature.
    Interactive Cardiovascular and Thoracic Surgery 05/2011; 13(2):226-8. DOI:10.1510/icvts.2011.270934 · 1.11 Impact Factor
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    ABSTRACT: Die tracheobronchialen Drüsen werden als Pendant der kleinen Speicheldrüsen im Respirationstrakt angesehen und können ähnliche Tumoren (Tumoren vom Speicheldrüsentyp) aufweisen. Innerhalb dieser Tumorgruppe ist das epithelial-myoepitheliale Karzinom im Respirationstrakt sehr selten und häufig schwierig zu diagnostizieren. Wir berichten über den ersten Fall dieses Karzinoms mit Lokalisation in der Trachea und präsentieren eine Übersicht der Literatur über diese Tumoren. Die genaue histologische Zuordnung sowie die Lokalisation und der endoskopische Befund dieser Läsionen sind für die Therapiewahl entscheidend.
    Der Pathologe 02/2012; 34(1). DOI:10.1007/s00292-012-1610-z · 0.64 Impact Factor
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