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T. Tanaka



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    P1.02 - Biology/Pathology (ID 614)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Biology/Pathology
    • Presentations: 1
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      P1.02-025 - A Case of Primary Peripheral Epithelial–Myoepithelial Carcinoma of the Lung (ID 8384)

      09:30 - 16:00  |  Author(s): T. Tanaka

      • Abstract
      • Slides

      Background:
      Primary epithelial-myoepithelial carcinoma (EMC) of the lung is extremely rare carcinoma of salivary type lung cancer. Only 16 cases were reported for peripheral pulmonary EMC in literatures in the world, at present.

      Method:
      We report a resected case of primary peripheral EMC of the lung existed in right S2 with considerations of literature.

      Result:
      The patient was 63-year old male, received medical check-up at nearby clinic and an abnormal shadow was pointed out on chest X-ray film. He was referred to our hospital for more detailed examinations and therapy. He had no past history, symptoms nor abnormal physical findings. Chest CT scan showed a 56 x 24 mm mass in right S2. Transbronchial lung biopsy (TBLB) was performed and the tumor was diagnosed as adenoid cystic carcinoma. There was no metastasis to other organs in detailed examinations. Right upper lobectomy and lymph node dissection (ND2a-2) was performed. He was discharged our hospital at 8 post operative days with no post-operative complications. Macroscopically the tumor was 32x30x22 mm in size, white-colored, homogeneous, and well-defined surrounding pulmonary substance. Microscopically the tumor was composed of double tubular layers. Inner tubular layer showed epithelial cell characteristics, whereas the outer layer showed myoepithelial cell characteristics. Immunohistochemical examinations revealed positive for cytokeratin AE1/3 at inner tubular layer, and positive for SMA, p63, and calponin at outer tubular layer. Finally, the diagnosis of the tumor was determined as peripheral pulmonary EMC. There were no metastases in dissected lymph nodes. Epidermal growth factor receptor (EGFR) was wild type and anaplastic lymphoma kinase (ALK) was negative. Pathological stage was IB because of T2aN0M0. He was followed up with no adjuvant therapy, and disease free for 2 years after operation.

      Conclusion:
      Primary salivary gland type tumors of the lung are rare. Among them, primary peripheral EMC is extremely rare. Differential diagnoses of pulmonary EMC include mucoepidermoid carcinoma, adenoid cystic carcinoma, pleomorphic adenoma and so on. There is a possibility of misdiagnosis in small specimens. EMC of the lung is regarded as a low-grade malignant neoplasm. For diagnosis of EMC, it is necessary to obtain large specimen and/or resect by operation. In this paper, we report a completely resected case of primary peripheral EMC. It is thought that a biological characteristic of EMC will be elucidated by the further accumulation of EMC case.

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