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Benign and malignant salivary gland-type mixed tumors of the lung.
Clinicopathologic and immunohistochemical study of eight cases.Cancer.
1994 May 15;73(10):2481-90.
BACKGROUND.
Primary lung tumors showing features of salivary gland-type neoplasms
are extremely rare. METHODS. Eight patients with primary lung
neoplasms showing light microscopic and immunohistochemical features
of salivary gland-type mixed tumors were studied. RESULTS. The
patients were six women and two men, ages 35-69 years (mean, 52.5
years). The tumors ranged from 2 to 16 cm in greatest diameter. In two
patients the lesions presented as polypoid endobronchial lesions
obstructing the lumen; in another two patients the lesions were found
in close proximity or in continuity with a bronchus; in three
patients, the lesions presented as peripheral parenchymatous nodules
unrelated to a bronchus; and in one patient, the relationship to the
bronchus could not be determined. Histologically, the lesions were
biphasic, showing admixtures in varying proportions of epithelial
elements containing a predominant myoepithelial cell population with a
stromal component containing an abundant myxoid or focally chondroid
matrix. Immunohistochemical studies showed strong positivity of the
cells in the epithelial component with low molecular weight keratins
(CAM 5.2), and to a lesser extent with broad spectrum keratin, actin,
and vimentin antibodies. The cells also showed variable reactivity in
the epithelial and nonepithelial elements with S-100 protein and glial
fibrillary acidic protein. Six tumors were grossly and histologically
benign; in two patients, the tumors were larger, locally invasive, and
showed more atypical histologic features. All patients were treated
with surgical excision. On follow-up, of the six patients with
histologically benign-appearing tumors, one was alive and well 6 years
after surgery; another died 4 years after surgery of a second
unrelated malignancy; one died during the immediate postoperative
period of myocardial infarction; and three have been lost to
follow-up. In the two patients with histologically atypical lesions,
the tumors recurred and metastasized after 2 and 3 years,
respectively, with one of them leading to death caused by widespread
metastases and superior vena cava syndrome. CONCLUSIONS. Review of the
literature and the findings in the current series indicate that
salivary gland-type mixed tumors of the lung may present with a
spectrum of histologic features and clinical behavior, ranging from
benign to frankly malignant, similar to that observed for their
salivary gland counterparts. Size of the lesion at the time of
presentation, extent of local infiltration, and degree of mitotic
activity appear to be the most reliable prognostic features of these
tumors.
A case of salivary gland-type mixed tumor of the lung
differentiating toward type II alveolar epithelial cells in glandular
components with a literature review.Virchows
Arch. 2002 Dec;441(6):618-21. Epub 2002
Jun 26.
Salivary
gland-type mixed tumor primarily arising in the lung is extremely
rare. We report here a case of this type of tumor that occurred in the
periphery of S4 of the right middle lobe in a 74-year-old man.
Light-microscopically, this lung tumor, 15x9mm in size, exhibited
almost the same features as those of mixed tumor of the salivary gland
intermingled with chondromyxoid stroma, glandular component, solid
growth pattern of myoepithelial components and well-developed
cartilage formation, exhibiting a sharp margin. Immunohistochemical
study revealed that the glandular components in the tumor was positive
for thyroid transcription factor-1, TTF-1, a marker of epithelial
cells of the thyroid as well as the lung. Furthermore, surface lining
cells of the glandular components and luminal contents were positive
for surfactant apoprotein A, PE-10, used as a marker of type II
alveolar epithelial cells. These findings clearly demonstrate for the
first time that glandular epithelial cells in the present salivary
gland-type mixed tumor exhibited differentiation toward type II
alveolar epithelial cells.
Malignant mixed tumor of bronchus: a biphasic neoplasm of
epithelial and myoepithelial cells.Mod
Pathol. 1993 Jan;6(1):85-8.
This paper
describes an unusual malignant mixed tumor of the bronchus arising in
a 71-yr-old male and provides evidence of an epithelial-myoepithelial
origin based on the findings on light microscopy and
immunohistochemistry. The neoplasm contained elements of recognizable
benign tumor resembling salivary gland-type pleomorphic adenoma,
adenosquamous carcinoma, and a spindle-cell sarcomatous component.
Immunohistochemical stains showed the characteristic relationship
between epithelial and myoepithelial cells in the benign component of
the neoplasm. In addition, the spindle cells stained for myoepithelial
markers (S-100 protein and actin) but were also positive for keratin
(AE1/AE3). The relationship of this neoplasm to classical
carcinosarcoma and the recently described adenosquamous carcinoma with
amyloid-like stroma is discussed.
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