Pulmonary Mucoepidermoid Carcinoma With Prominent Tumor-Associated Lymphoid Proliferation

Department of Pulmonary and Mediastinal Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
American Journal of Surgical Pathology (Impact Factor: 5.15). 04/2005; 29(3):407-11. DOI: 10.1097/01.pas.0000151616.14598.e7
Source: PubMed


We report 6 cases of low-grade pulmonary mucoepidermoid carcinoma displaying a striking lymphoplasmacytic infiltrate. All six tumors had a typical pulmonary mucoepidermoid carcinoma presentation as a polypoid endobronchial mass involving the proximal bronchi. The patients were 3 females and 3 males with a mean age of 33 years (range, 5-61 years). Half of the patients were asymptomatic, while half experienced mild symptoms of pneumonia, asthma-like symptoms, or hemoptysis. No tumor-related deaths were observed, with a mean follow-up of 51 months. The tumor size ranged from 2.1 to 3.4 cm (mean, 2.9 cm). The tumors characteristically displayed an elaborate tubulocystic epithelial component composed of intermediate, epidermoid, and mucus-producing cells, and variable numbers of clear cells, multinucleated giant cells, columnar cells, and oncocytic cells. The tumors' lymphoplasmacytic infiltrate with occasional Russell bodies was sufficiently intense to raise concern of a low-grade lymphoma. All tested tumors were immunoreactive with CK7 while nonreactive with TTF-1 and CK20. Recognition of this histologic variant is important for a correct diagnosis of low-grade pulmonary mucoepidermoid carcinoma. The dense lymphoplasmacytic infiltrate is similar to that previously described in salivary glands as tumor-associated lymphoid proliferation.

11 Reads
  • Source
    • "However, effective treatment measures for high grade tumors have not been established, and these cases reportedly have a poor prognosis [22]. Under such circumstances, there are several reports on the efficacy of the tyrosine kinase inhibitor gefitinib in patients with epidermal growth factor receptor (EGFR) gene mutations [23,24], and this molecularly targeted therapy is likely to improve the prognosis of cases with progressive high grade and recurrent MEC. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Mucoepidermoid carcinoma (MEC) of the lung is a rare malignant neoplasm. We aimed to investigate clinicopathological features, therapies, and prognoses of eight MEC cases. 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. 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. 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.
    World Journal of Surgical Oncology 02/2014; 12(1):33. DOI:10.1186/1477-7819-12-33 · 1.41 Impact Factor
  • Source
    • "Previous studies examined the expression of TTF-1 in a small numbers of mucoepidermoid carcinomas of the lung. They showed that all mucoepidermoid carcinomas of the bronchus in their series were negative for TTF-1 [2,14]. So, it was considered that TTF-1 was useful in differentiating mucoepidermoid carcinoma of the bronchus from primary lung adenosquamous carcinoma [2]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: 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 SlidesThe virtual slide(s) for this article can be found here:
    Diagnostic Pathology 10/2012; 7(1):137. DOI:10.1186/1746-1596-7-137 · 2.60 Impact Factor
  • Source
    • "Mucoepidermoid carcinoma is one of the most common malignant tumors of salivary glands, representing 5%–10% of all salivary gland tumors. However, these tumors are also known to occur in lips, tongue, and buccal mucosa.1 Although known to be metastatic to local lymph nodes, distant metastases are rare (especially, with low and intermediate grade tumors). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Tumors of salivary glands are uncommon and comprise of about 2%-4% of all head and neck tumors. About 75%-80% of these tumors are benign and include pleomorphic adenoma, monomorphic adenoma, oncocytoma, and papillary cystadenoma lymphomatosum. Mucoepidermoid carcinoma is the most common malignant tumor of salivary glands, representing 5-10% of all salivary gland tumors. Although known to be metastatic to local lymph nodes, distant metastases are rare (especially, with low and intermediate grade tumors). Histologic grade and the expression of various mucin glycoproteins are useful prognostic indicators. We present a case of mucoepidermoid carcinoma of parotid gland origin with distant metastases which is an uncommon occurrence with intermediate grade tumors. Also, this is the first reported case of humoral hypercalcemia of malignancy secondary to mucoepidermoid carcinoma.
    Clinical Medicine Insights: Oncology 04/2011; 5:83-7. DOI:10.4137/CMO.S5733
Show more