Difference between revisions of "Epithelial-myoepithelial carcinoma"

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#redirect [[Salivary_glands#Epithelial-myoepithelial_carcinoma]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Epithelial-myoepithelial carcinoma - very high mag.jpg
| Width      =
| Caption    = Epithelial-myoepithelial carcinoma. [[H&E stain]].
| Micro      = biphasic tumour with (1) epithelial layer, and (2) myoepithelial layer; variable architecture (solid, cystic, tubular, papillary); +/- spindle cells
| Subtypes  =
| LMDDx      = [[adenoid cystic carcinoma]] (tubular variant), [[pleomorphic adenoma]], tubular variant.
| Stains    =
| IHC        = CAM5.2 +ve (epithelial comp.), p63 +ve (myoepithelial comp.)
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[salivary gland]] - usually parotid gland
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      = salivary gland mass
| Symptoms  =
| Prevalence = very rare
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    = other [[salivary gland]] masses
}}
Epithelial-myoepithelial carcinoma, abbreviated '''EMCa''', is a rare malignant [[salivary gland]] tumour.
 
Should '''not''' be confused with ''[[myoepithelial carcinoma]]''.
 
==General==
*Rare ~1% of salivary gland tumours.<ref  name=pmid9568184>{{Cite journal  | last1 = Tralongo | first1 = V. | last2 = Daniele | first2 = E. | title = Epithelial-myoepithelial carcinoma of the salivary glands: a review of literature. | journal = Anticancer Res | volume = 18 | issue = 1B | pages = 603-8 | month =  | year =  | doi =  | PMID = 9568184 }}</ref>
*Female:male = 1.5:1.<ref name=pmid17197918>{{Cite journal  | last1 = Seethala | first1 = RR. | last2 = Barnes | first2 = EL. | last3 = Hunt | first3 = JL. | title = Epithelial-myoepithelial carcinoma: a review of the clinicopathologic spectrum and immunophenotypic characteristics in 61 tumors of the salivary glands and upper aerodigestive tract. | journal = Am J Surg Pathol | volume = 31 | issue = 1 | pages = 44-57 | month = Jan | year = 2007 | doi = 10.1097/01.pas.0000213314.74423.d8 | PMID = 17197918 }}</ref>
*Usually older people - 50s or 60s.
*Usually parotid gland ~ 60% of cases.<ref name=pmid17197918/>
*Prognosis: usually good; 5-year and 10-year survival over 90% and 80% respectively.<ref name=pmid17197918/>
 
Notes:
*Most common malignant component in ''[[carcinoma ex pleomorphic adenoma]]''.
*May be the same tumour as ''[[adenomyoepithelioma]] of the breast''.<ref name=pmid9769134>{{Cite journal  | last1 = Seifert | first1 = G. | title = Are adenomyoepithelioma of the breast and epithelial-myoepithelial carcinoma of the salivary glands identical tumours? | journal = Virchows Arch | volume = 433 | issue = 3 | pages = 285-8 | month = Sep | year = 1998 | doi =  | PMID = 9769134 }}</ref>
*An analogous [[lung tumour]] exists - see ''[[epithelial-myoepithelial carcinoma of lung]].<ref>{{Cite journal  | last1 = Nakashima | first1 = Y. | last2 = Morita | first2 = R. | last3 = Ui | first3 = A. | last4 = Iihara | first4 = K. | last5 = Yazawa | first5 = T. | title = Epithelial-myoepithelial carcinoma of the lung: a case report. | journal = Surg Case Rep | volume = 4 | issue = 1 | pages = 74 | month = Jul | year = 2018 | doi = 10.1186/s40792-018-0482-8 | PMID = 29987577 }}</ref>
 
==Microscopic==
Features:
*Biphasic tumour:<ref name=pmid17197918/>
*#Epithelial layer.
*#Myoepithelial layer - '''key feature'''.
*Architecture: variable (solid, cystic, tubular, papillary).
*+/-Spindle cells.
*Basement membrane-like material; may mimic adenoid cystic carcinoma.
 
Notes:
*Usually few mitoses.
 
DDx:
*[[Adenoid cystic carcinoma]] (tubular variant).
*[[Pleomorphic adenoma]], tubular variant.
**Has focal epithelial-myoepithelial carcinoma-like areas.
 
===Images===
<gallery>
Image:Epithelial-myoepithelial_carcinoma_-_intermed_mag.jpg | EMCa - intermed. mag. (WC/Nephron)
Image:Epithelial-myoepithelial_carcinoma_-_high_mag.jpg | EMCa - high mag. (WC/Nephron)
Image:Epithelial-myoepithelial carcinoma - very high mag.jpg | EMCa - very high mag. (WC/Nephron)
</gallery>
www:
*[http://www.pathologyimagesinc.com/sgt-cytopath/epith-myoepith-ca/cytopathology/images-features/emc-rev-cyto1-18.jpg EMCa  (pathologyimagesinc.com)].<ref>{{cite web |url=http://www.pathologyimagesinc.com/sgt-cytopath/epith-myoepith-ca/cytopathology/fs-emc-cytopath-feat.html |title=Cytopathologic Features of
Epithelial-myoepithelial Carcinoma |last1= |first1= |last2= |first2= |date= |work= |publisher= |accessdate=January 18, 2011}}</ref>
*[http://www.headandneckoncology.org/content/2/1/4 EMCa (headandneckoncology.org)].
 
==IHC==
*CAM5.2 +ve -- epithelial component.
*p63 +ve -- myoepithelial component.
 
==See also==
*[[Salivary glands]].
 
==References==
{{Reflist|2}}
 
[[Category:Diagnosis]]
[[Category:Salivary gland]]
[[Category:Head and neck pathology]]

Latest revision as of 02:13, 19 March 2019

Epithelial-myoepithelial carcinoma
Diagnosis in short

Epithelial-myoepithelial carcinoma. H&E stain.
LM biphasic tumour with (1) epithelial layer, and (2) myoepithelial layer; variable architecture (solid, cystic, tubular, papillary); +/- spindle cells
LM DDx adenoid cystic carcinoma (tubular variant), pleomorphic adenoma, tubular variant.
IHC CAM5.2 +ve (epithelial comp.), p63 +ve (myoepithelial comp.)
Site salivary gland - usually parotid gland
Signs salivary gland mass
Prevalence very rare
Clin. DDx other salivary gland masses

Epithelial-myoepithelial carcinoma, abbreviated EMCa, is a rare malignant salivary gland tumour.

Should not be confused with myoepithelial carcinoma.

General

  • Rare ~1% of salivary gland tumours.[1]
  • Female:male = 1.5:1.[2]
  • Usually older people - 50s or 60s.
  • Usually parotid gland ~ 60% of cases.[2]
  • Prognosis: usually good; 5-year and 10-year survival over 90% and 80% respectively.[2]

Notes:

Microscopic

Features:

  • Biphasic tumour:[2]
    1. Epithelial layer.
    2. Myoepithelial layer - key feature.
  • Architecture: variable (solid, cystic, tubular, papillary).
  • +/-Spindle cells.
  • Basement membrane-like material; may mimic adenoid cystic carcinoma.

Notes:

  • Usually few mitoses.

DDx:

Images

  • EMCa - intermed. mag. (WC/Nephron)

  • EMCa - high mag. (WC/Nephron)

  • EMCa - very high mag. (WC/Nephron)

www:

IHC

  • CAM5.2 +ve -- epithelial component.
  • p63 +ve -- myoepithelial component.

See also

References

  1. ↑ Tralongo, V.; Daniele, E.. "Epithelial-myoepithelial carcinoma of the salivary glands: a review of literature.". Anticancer Res 18 (1B): 603-8. PMID 9568184.
  2. ↑ 2.0 2.1 2.2 2.3 Seethala, RR.; Barnes, EL.; Hunt, JL. (Jan 2007). "Epithelial-myoepithelial carcinoma: a review of the clinicopathologic spectrum and immunophenotypic characteristics in 61 tumors of the salivary glands and upper aerodigestive tract.". Am J Surg Pathol 31 (1): 44-57. doi:10.1097/01.pas.0000213314.74423.d8. PMID 17197918.
  3. ↑ Seifert, G. (Sep 1998). "Are adenomyoepithelioma of the breast and epithelial-myoepithelial carcinoma of the salivary glands identical tumours?". Virchows Arch 433 (3): 285-8. PMID 9769134.
  4. ↑ Nakashima, Y.; Morita, R.; Ui, A.; Iihara, K.; Yazawa, T. (Jul 2018). "Epithelial-myoepithelial carcinoma of the lung: a case report.". Surg Case Rep 4 (1): 74. doi:10.1186/s40792-018-0482-8. PMID 29987577.
  5. ↑ [http://www.pathologyimagesinc.com/sgt-cytopath/epith-myoepith-ca/cytopathology/fs-emc-cytopath-feat.html "Cytopathologic Features of Epithelial-myoepithelial Carcinoma"]. http://www.pathologyimagesinc.com/sgt-cytopath/epith-myoepith-ca/cytopathology/fs-emc-cytopath-feat.html. Retrieved January 18, 2011.
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