Clinical and pathological analysis of primary pulmonary mucoepidermoid carcinoma
Objective To investigate the clinicopathological and molecular features of pulmonary mucoepidermoid carcinoma(PMEC).Methods The clinicopathological data of 11 cases pathologically proven PMEC from January 2005 to December 2021 were analyzed retrospectively.The clinicopathological features were discussed and related literatures were reviewed.Results Among the 11 patients,there were 7 males and 4 females,with a median age of 33 years(range 19-58 years).All the tumors occurred in the segmental and above-segmental bronchi,and the main clinical symptoms were bronchial irritation.CT in chest showed well-defined round nodules in 10 cases,irregular mass in 1 case and shallow lobulation in 5 cases.After contrast-enhanced scanning,the tumors showed mild to moderate inhomogeneous enhancement and calcification in 5 cases.One case was histologically classified as high-grade PMEC and the others were low-grade PMEC.Immunohistochemistry showed that the tumor cells were positive for CK7,p63 and p40,but negative for TTF1,NapsinA,CK20 and SMA.The Ki-67 index was about 4%-28%.Special staining showed that mucous cells were PAS positive.MAML2 was detected in 6 patients,and MAML2 gene rearrangement was positive in 4 patients.All the 11 patients were treated by operation and 3 patients were treated with adjuvant chemotherapy after operation.During the follow-up from 8 months to 144 months,1 case of high-grade PMEC recurred.Conclusion PMEC is an extremely rare pulmonary malignant tumor,and the diagnosis mainly depends on postoperative histopathology.CRTC1/MAML2 translocation is detected by FISH.Surgery is the main method of treatment,and its prognosis is related to pathological grade and clinical stage.
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