Abstract
BACKGROUND
All aspects of mucoepidermoid carcinoma (MEC) of the lung including histologic grading, clinical behavior and its differentiation from adenosquamous cell carcinoma are still not fully understood.
METHODS
We reviewed the hematoxylin-eosin stained slides and medical records of 31 cases of MEC of the lungs. The cases were classified as low and high grade according to the quantitative grading system formulated for MEC. High grade tumors were tested for an epidermal growth factor receptor (EGFR) mutation.
RESULTS
Twenty eight cases were classified as low grade and 3 cases as high grade. Histologically, lower glandular component, cellular atypia, necrosis, mitoses >4/10 high power fields, and endolymphatic tumor emboli were typical characteristics of a high grade tumor. Although some tumors showed histologic features mimicking high grade tumors, they were classified as low grade tumors according to this quantitative grading system. Low grade tumors showed no recurrence or metastasis. However, among three patients with a high grade tumor, two had distant metastases and one died of disease. Additionally, an EGFR mutation was not detected.
CONCLUSIONS
A high grade MEC was consistently different from a low grade tumor with regard to malignant histologic features and poor prognosis. Therefore, correct histologic grading is important in predicting the prognosis to avoid unnecessary treatment.
Citations
Citations to this article as recorded by
- A rare case of endobronchial mucoepidermoid carcinoma of the lung presenting as non-resolving pneumonia
Toolsie Omesh, Ranjan Gupta, Anjali Saqi, Joshua Burack, Misbahuddin Khaja
Respiratory Medicine Case Reports.2018; 25: 154. CrossRef - Cutaneous Involvement by Nasal Mucoepidermoid Carcinoma: The Tip of the Iceberg Phenomenon
Ge Zhao, Oliver Chang, John Streidl, Amit Bhrany, Kyle Garton, Timothy H. McCalmont, Paul E. Swanson, Zsolt Argenyi, Michi M. Shinohara
Journal of Cutaneous Pathology.2017; 44(2): 113. CrossRef - Surgical outcomes of pulmonary mucoepidermoid carcinoma: A review of 41 cases
Chih-Cheng Hsieh, Yung-Han Sun, Shih-Wei Lin, Yi-Chen Yeh, Mei-Lin Chan, Pei-Yi Chu
PLOS ONE.2017; 12(5): e0176918. CrossRef - Clinicopathologic characteristics of EGFR, KRAS, and ALK alterations in 6,595 lung cancers
Boram Lee, Taebum Lee, Se-Hoon Lee, Yoon-La Choi, Joungho Han
Oncotarget.2016; 7(17): 23874. CrossRef - Metastatic Pulmonary Mucoepidermoid Carcinoma with Fulminant Clinical Course
Yong Won Park, Seon Bin Yoon, Mi Ju Cheon, Young Min Koh, Hyeon Sik Oh, Se Joong Kim, Seung Hyeun Lee
The Ewha Medical Journal.2015; 38(2): 85. CrossRef - Lung cancer in never-smoker Asian females is driven by oncogenic mutations, most often involving EGFR
Sang Yun Ha, So-Jung Choi, Jong Ho Cho, Hye Joo Choi, Jinseon Lee, Kyungsoo Jung, Darry Irwin, Xiao Liu, Maruja E. Lira, Mao Mao, Hong Kwan Kim, Yong Soo Choi, Young Mog Shim, Woong Yang Park, Yoon-La Choi, Jhingook Kim
Oncotarget.2015; 6(7): 5465. CrossRef - Bronchoscopic Resection of an Exophytic Endoluminal Tracheal Mass
Russell J. Miller, Septimiu D. Murgu
Annals of the American Thoracic Society.2013; 10(6): 697. CrossRef - EGFR mutations and mucoepidermoid carcinoma: Putative significance in differing populations
Iain D. O’Neill
Lung Cancer.2012; 78(1): 125. CrossRef