Epithelial-myoepthelial carcinoma of the tracheobronchial tree: the prognostic role of myoepithelial cells.
OBJECTIVE
Epithelial myoepithelial carcinoma (EMC) of the lung is a very rare tumor that is characterized by biphasic differentiation of epithelial and myoepithelial cells. Current discussion about this entity focuses on the malignant potential of the tumor and the role of myoepithelial cells in diagnosis and patient prognosis. This study reports five EMC cases in the lung and discusses issues related to EMC prognosis.


METHODS
The five EMC cases were diagnosed and collected at the Samsung Medical Center (Seoul, Korea) from 1998 to 2012. Four patients with EMC were received a lobectomy and one patient was given a bronchoscopy to excise the tumor. All cases were evaluated with hematoxylin and eosin and immunohistochemical staining, which included S-100 protein, smooth muscle actin, TTF-1, cytokeratin, vimentin, and p27 analysis.


CONCLUSIONS
All cases revealed biphasic differentiation of epithelial and myoepithelial tumor cells with various stromal patterns. One of the cases contained predominantly myoepithelial and focal epithelial differentiation, and the tumor showed recurrence and metastasized to the chest wall. This was the first case of metastatic pulmonary EMC. Therefore, we suggest that EMC of the lung has a malignant potential, and that myoepithelial tumor cells may be associated with a pulmonary EMC prognosis.
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Dae Hyun
DH
Song
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
In Ho
IH
Choi
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Sang Yun
SY
Ha
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Kang Min
KM
Han
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address: hanjho@skku.edu.
Joungho
J
Han
Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Tae-Sung
TS
Kim
Thoracic Surgery and Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Jhingook
J
Kim
Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Hojoong
H
Kim
D000199:Actins / Q000378:metabolism; D000368:Aged; D001984:Bronchial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology; D002454:Cell Differentiation; D050760:Cyclin-Dependent Kinase Inhibitor p27 / Q000378:metabolism; D004268:DNA-Binding Proteins / Q000378:metabolism; D004847:Epithelial Cells / Q000502:physiology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009208:Myoepithelioma / Q000175:diagnosis* / Q000473:pathology; D011379:Prognosis; D009418:S100 Proteins / Q000378:metabolism; D014134:Tracheal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014157:Transcription Factors; D016896:Treatment Outcome; D014746:Vimentin / Q000378:metabolism
D000199:Actins; D004268:DNA-Binding Proteins; D009418:S100 Proteins; C504003:TTF1 protein, human; D014157:Transcription Factors; D014746:Vimentin; D050760:Cyclin-Dependent Kinase Inhibitor p27; D007633:Keratins
Bronchus; Epithelial–myoepithelial carcinoma; Lung; Prognostic factor; Trachea