Clinicopathological practice in the differential diagnosis of mucoepidermoid carcinoma from neoplasms with mucinous component

Q1 Medicine

Chronic Diseases and Translational Medicine Pub Date : 2023-01-02 DOI:10.1002/cdt3.55

Yuelu Zhu, Yan Li, Lei Guo, Wenbin Li, Jiali Mu, Haifeng Zhang, Xin Li, Jianming Ying, Haizhen Lu

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引用次数: 1

Abstract

Background

The differential diagnosis of mucoepidermoid carcinoma (MEC) from neoplasm undergoing mucinous features brings more pitfalls to pathologists. Combining specific MAML2 gene rearrangement and histological characteristics may be the solution.

Methods

Twenty-five tumors with mucinous components were selected for differential diagnosis of MEC. All the cases were detected for MAML2 gene rearrangement. The cases diagnosed as MEC were classified into four variants: classic, oncocytic, Warthin-like, and nonclassified, and they were graded using the Brandwein system. The histological characteristics of non-MECs were summarized for differential diagnosis. Univariate survival analysis was performed on MECs.

Results

There were 16 MECs; 62.5% were MAML2 rearranged. For the low-, intermediate-, and high-grade MECs, the rate of rearrangement was 83.3%, 100%, and 28.6%, respectively. Both the oncocytic and Warthin-like MECs were MAML2 rearranged. For the classic and nonclassified MECs without MAML2 rearrangement, non-keratinized squamoid cells and distinctive mucinous cells were essential diagnostic criteria. On survival analysis, all the disease progression occurred in high-grade MECs (p = 0.038). Nine cases were diagnosed as non-MECs: pleomorphic adenoma with mucinous metaplasia showed no ex-capsular involvement; metaplastic Warthin tumor appeared with overt keratinization and residual oncocytic bilayered epithelium; mix squamous cell and glandular papilloma showed an endobronchial papillary growing pattern; adenosquamous carcinoma was accompanied by squamous carcinoma in situ of the overlying mucosa. All the non-MECs were negative for MAML2 rearrangement.

Conclusion

The application of combining MAML2 rearrangement and histological characteristics is helpful in the differential diagnosis between MEC and other tumors with mucinous components.

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黏液表皮样癌与黏液成分肿瘤鉴别诊断的临床病理实践

背景粘液表皮样癌(MEC)与具有黏液特征的肿瘤的鉴别诊断给病理学家带来了更多的困难。结合特定的MAML2基因重排和组织学特征可能是解决方案。方法选择25例有黏液成分的MEC肿瘤进行鉴别诊断。所有病例均检测到MAML2基因重排。诊断为MEC的病例分为四种变体:典型型、嗜瘤型、wartin样型和非分类型，并使用Brandwein系统进行分级。总结非mec的组织学特征以鉴别诊断。对mec进行单因素生存分析。结果16例mec;62.5%为MAML2重排。低、中、高等级mec的重排率分别为83.3%、100%和28.6%。嗜瘤细胞和wartin样mec均发生MAML2重排。对于没有MAML2重排的经典和非分类mec，非角化鳞状细胞和独特的粘液细胞是必不可少的诊断标准。在生存分析中，所有的疾病进展都发生在高级别mec中(p = 0.038)。9例诊断为非mec:多形性腺瘤伴粘液化生，未累及包膜前;化生沃氏瘤表现为明显的角化和残留的嗜瘤细胞双层上皮;鳞状细胞和腺状乳头状瘤呈支气管内乳头状生长;腺鳞癌伴上覆粘膜原位鳞状癌。所有非mec细胞的MAML2重排均为阴性。结论结合MAML2重排与组织学特征的应用有助于MEC与其他黏液成分肿瘤的鉴别诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Chronic Diseases and Translational Medicine Medicine-General Medicine

CiteScore

6.70

自引率

0.00%

发文量

195

审稿时长

35 weeks

期刊介绍： This journal aims to promote progress from basic research to clinical practice and to provide a forum for communication among basic, translational, and clinical research practitioners and physicians from all relevant disciplines. Chronic diseases such as cardiovascular diseases, cancer, diabetes, stroke, chronic respiratory diseases (such as asthma and COPD), chronic kidney diseases, and related translational research. Topics of interest for Chronic Diseases and Translational Medicine include Research and commentary on models of chronic diseases with significant implications for disease diagnosis and treatment Investigative studies of human biology with an emphasis on disease Perspectives and reviews on research topics that discuss the implications of findings from the viewpoints of basic science and clinical practic.