title: p63 Expression of clear myoepithelial cells in epithelial-myoepithelial carcinoma of the salivary gland: a useful marker for naked myoepithelial cells in cytology.
abstract: BACKGROUND
  The typical form of epithelial-myoepithelial carcinoma (EMC) is a double-layered ductal structure, but occasionally EMC presents as a predominant solid growth of clear myoepithelial cells. In the current study, the authors analyzed the distribution and visual patterns of p63-positive clear myoepithelial cells in EMC.
  
  
  METHODS
  Six cases of EMC were evaluated with Papanicolaou staining and with p63 and alpha-smooth muscle actin (SMA) immunostaining. Furthermore, the expressions of p63 and SMA were compared.
  
  
  RESULTS
  The cytologic features of EMC were classified into two types-biphasic and clear cell-dominant type. The biphasic type showed myoepithelial cells with moderate or scant cytoplasm or naked nuclei, overlapping a cohesive cluster of ductal cells. This biphasic type was similar to that in fibroadenoma of the breast. The clear cell-dominant type consisted of myoepithelial cells with a large amount of fragile pale cytoplasm or naked nuclei. In this type, there were many clusters of myoepithelial cells without ductal cells. Nuclear immunoreactivity to p63 was expressed clearly in both biphasic and clear cell-dominant types. Cytoplasm immunoreactivity to SMA was expressed in many myoepithelial cells in the clear cell-dominant type, but only in myoepithelial cells with moderate cytoplasm in the biphasic type.
  
  
  CONCLUSIONS
  Clear myoepithelial cells in EMC were distributed in various patterns. The authors concluded that p63 is an especially useful marker of myoepithelial cells with naked nuclei in EMC.
authors.affiliation: Department of Pathology, Kurume University Hospital, Kurume, Japan. akihiko4@med.kurume-u.ac.jp
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kawahara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Harada
authors.forename: Toshiro
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kage
mesh_terms: D000199:Actins / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001707:Biopsy, Needle; D002277:Carcinoma / Q000378:metabolism* / Q000473:pathology; D004268:DNA-Binding Proteins; D003937:Diagnosis, Differential; D016147:Genes, Tumor Suppressor; D006801:Humans; D009130:Muscle, Smooth / Q000378:metabolism; D010750:Phosphoproteins / Q000378:metabolism*; D012468:Salivary Gland Neoplasms / Q000378:metabolism* / Q000473:pathology; D015534:Trans-Activators / Q000378:metabolism*; D014157:Transcription Factors; D025521:Tumor Suppressor Proteins
chemical_list: D000199:Actins; D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; D010750:Phosphoproteins; C115051:TP63 protein, human; D015534:Trans-Activators; D014157:Transcription Factors; D025521:Tumor Suppressor Proteins