Primary epithelial-myoepithelial carcinoma of the lung: A case report demonstrating high-grade transformation-like changes

Tajima,Shogo; Aki,Michihiko; Yajima,Kiyoshige; Takahashi,Tsuyoshi; Neyatani,Hiroshi; Koda,Kenji

doi:10.3892/ol.2015.3169

Primary epithelial-myoepithelial carcinoma of the lung: A case report demonstrating high-grade transformation-like changes

Authors:
- Shogo Tajima
- Michihiko Aki
- Kiyoshige Yajima
- Tsuyoshi Takahashi
- Hiroshi Neyatani
- Kenji Koda
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Affiliations: Department of Pathology, Shizuoka Saiseikai General Hospital, Shizuoka, Shizuoka 422-8021, Japan, Department of Cell Biology and Anatomy, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka 431-3192, Japan, Department of Chest Surgery, Fujieda Municipal General Hospital, Fujieda, Shizuoka 426-0077, Japan, Department of Pathology, Fujieda Municipal General Hospital, Fujieda, Shizuoka 426-0077, Japan
Published online on: April 30, 2015 https://doi.org/10.3892/ol.2015.3169
Pages: 175-181
Copyright: © Tajima et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Primary salivary gland-type tumors of the lung are rare; among them, epithelial‑myoepithelial carcinomas (EMC) represent a minor histological subtype. The present case documents an EMC that occluded the B8 segment of the left lung in a 72‑year‑old woman. Macroscopically, the tumor was well‑demarcated; however, microscopic examination demonstrated that it had infiltrated the lung parenchyma. The majority of the tumor mass was composed of a myoepithelial overgrowth in conjunction with conventional bilayered ductal structures comprising epithelial and myoepithelial cells. At the advancing edge of the tumor, the myoepithelial overgrowth was observed to be gradually transitioning to a higher‑grade component, which demonstrated venous invasion. The Ki‑67 labeling index was reduced compared with high‑grade transformation (HGT) of salivary gland EMC; p53 was sparsely observed on immunostaining. However, cyclin D1, which is reported to be overexpressed in certain subtypes of salivary gland carcinomas with HGT, was overexpressed in the higher‑grade component of the tumor, indicating a potential HGT initiation. The surgical margin was tumor free, and no recurrence has been observed for 4 months. A thorough follow‑up is required considering the HGT‑like changes and venous invasion of the tumor. Additional studies are required to elucidate the characteristics of pulmonary EMC, with an emphasis on detecting HGT or HGT‑like changes.

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