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

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

机构地区：[1]Department of Pathology,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China

出　　处：《Chronic Diseases and Translational Medicine》2023年第1期29-38,共10页慢性疾病与转化医学（英文版）

基　　金：Beijing Hope Run Special Fund of Cancer Foundation of China(Grant/Award Number: LC2018A19)

摘　　要：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 Warthinlike 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.

关 键 词：differential diagnosis HISTOLOGY MAML2 rearrangement mucinous feature mucoepidermoid carcinoma 

分 类 号：R73[医药卫生—肿瘤]