Tuberc Respir Dis.  2015 Oct;78(4):428-431. 10.4046/trd.2015.78.4.428.

A Rare Case of Bronchial Epithelial-Myoepithelial Carcinoma with Solid Lobular Growth in a 53-Year-Old Woman

• Cha YJ
• Han J
• Lee MJ
• Lee KS
• Kim H
• Zo J

• KMID: 2320721
• DOI: http://doi.org/10.4046/trd.2015.78.4.428

Abstract

Epithelial-myoepithelial carcinoma (EMC) of lung is a minor subset of salivary type carcinoma of lung of known low grade malignancy. Histologically, two-cell components forming duct-like structure with inner epithelial cell layer and outer myoepithelial cell layer are characteristics of EMC. In salivary gland, dedifferentiation of conventional low grade malignancy has been reported and is thought to be related with poor prognosis. However, precise histomorphology and prognostic factors of pulmonary EMC have not been clarified due to its rarity. Herein, we reported a rare case of EMC presented as endobronchial mass in a 53-year old woman, which showed predominant solid lobular growth pattern and lymph node metastases.

Keyword

Bronchial Neoplasms; Carcinoma; Lung

MeSH Terms

Bronchial Neoplasms
Epithelial Cells
Female
Humans
Lung
Lymph Nodes
Middle Aged*
Neoplasm Metastasis
Prognosis
Salivary Glands

Figure

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  Figure 1 (A) Chest computed tomography reveals endobronchial mass in right bronchus intermedius (arrowheads). (B) Bronchoscopy shows lobulated endobronchial mass. (C) Multifocal fluorodeoxyglucose uptake in right bronchus intermedius (arrow) and right paratracheal area (arrowhead) on preoperative positron emission tomography-computed tomography.

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  Figure 2 (A) Infiltrating atypical nests are identified on histologic examination of biopsy specimen (H&E stain, ×200). (B) Grossly, endobronchial yellow-tan solid mass focally interrupts the bronchial cartilage. (C) Tumor cells of solid lobular area demonstrate moderate cytologic atypia and discohesive pattern with accompanied multifocal central necrosis (H&E stain, ×100). (D) Toward the periphery of mass transition from duct-like two-cell layered area to the solid lobules is present (H&E stain, ×100). (E) Cytokeratin (CK) (AE1/AE3) is strong positive in tumor cells of inner layer of duct-like area. Outer layer of duct-like structure and solid area show variable intensity of CK (AE1/AE3) positivity (CK [AE1/AE3], ×100). (F) Smooth muscle actin (SMA) highlights the outer myoepithelial layer of duct-like area, which is only focally expressed in solid lobular area (SMA, ×100). (G) S-100 protein is positive in the outer myoepithelial layer of duct-forming area and variably expressed in solid lobular area (S-100 protein, ×100). (H) Ki-67 proliferative index is notably higher in periphery of solid lobular area, as compared to the center of solid lobules and adjacent duct-like structure (Ki-67, ×100).

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