Mucoepidermoid Carcinoma of the Pleura



Mucoepidermoid Carcinoma of the Pleura







Key Facts


Terminology



  • MEC


Clinical Issues



  • Symptoms



    • Chest pain


    • Shortness of breath


Image Findings



  • Pleural-based mass


  • Diffuse involvement of pleura has not been recorded for these tumors


Microscopic Pathology



  • Epidermoid component without keratinization


  • Mucus-secreting cells admixed with epidermoid component


  • Mild cellular atypia


  • Low mitotic activity


  • Possible sclerotic stroma


Top Differential Diagnoses



  • Adenocarcinoma



    • MEC lacks the presence of malignant glandular component


  • Squamous cell carcinoma



    • Presence of keratinization unusual in MEC


    • Mucus-producing cells (mucocytes) admixed with epidermoid component in MEC


  • Synovial sarcoma



    • Spindle cell component in synovial sarcoma is malignant


    • Sclerotic component in MEC is fibroblastic benign






Pleural MEC shows invasion of the tumor into the adipose tissue image. Similar features may also be seen in mesotheliomas. However, note the presence of cystic structures containing mucin image.






MEC shows gland-like structures of different sizes with mucoid material image. The neoplastic cellular proliferation is rather homogeneous.


TERMINOLOGY


Abbreviations



  • Pleural mucoepidermoid carcinoma (MEC)


Definitions



  • Primary salivary gland-type tumor of pleura


ETIOLOGY/PATHOGENESIS


Etiology



  • Although etiology of this tumor in pleura is unknown, it is possible that it may arise from entrapped glands in pleura


CLINICAL ISSUES


Epidemiology



  • Incidence



    • Exceedingly rare tumor in pleura


  • Age



    • Has been described only in adults


  • Gender



    • No gender predilection


Presentation



  • Chest pain


  • Shortness of breath


Treatment



  • Surgical approaches



    • Complete resection of tumor



      • Lobectomy


      • Decortication


      • Simple resection of pleural tumor


  • Adjuvant therapy



    • Possible chemotherapy


Prognosis



  • May be good depending on histological grade of tumor


  • Difficult to assess due to the few cases reported


IMAGE FINDINGS


General Features



  • Pleural-based mass


  • Diffuse involvement of pleura has not been recorded for these tumors


MACROSCOPIC FEATURES


General Features



  • Tumor mass well circumscribed and attached to pleura


Size



  • May vary from 2 cm to > 5 cm


MICROSCOPIC PATHOLOGY


Histologic Features

Tags:
Jul 9, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Mucoepidermoid Carcinoma of the Pleura

Full access? Get Clinical Tree
Get Clinical Tree app for offline access