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Kumagai E, Matsumura M, Kato I, Arai H, Suzuki T, Sugiyama M, Sekiya M, Mitsui H, Kataoka T, Iwashita H, Okudela K. A case of lung carcinoma with a unique biphasic feature: Implications for histogenesis of "fake mucoepidermoid carcinoma" developing in the peripheral lung. Pathol Int 2023; 73:463-468. [PMID: 37606200 DOI: 10.1111/pin.13368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/31/2023] [Indexed: 08/23/2023]
Abstract
We present a case of lung carcinoma with a unique biphasic feature. The patient was a 67-year-old male smoker with idiopathic pulmonary fibrosis (IPF). A subpleural tumor in the left lower lobe, embedded in fibrotic tissue, was resected. Histologically, the tumor consisted of major and minor components of mucoepidermoid carcinoma (MEC) and surrounding conventional lepidic adenocarcinoma, respectively. Both components had the same TP53 somatic mutation (p.V157F) but not Mastermind-like 2 (MAML2) gene rearrangement. The two components may have developed from an identical origin. The tumor could be trans-differentiating from lepidic adenocarcinoma to MEC, possibly promoted by IPF-induced tissue damage. The final diagnosis was "adenosquamous carcinoma with mucoepidermoid-like features (that may originate from lepidic adenocarcinoma)." This case has implications for the potential histogenesis of peripheral lung MEC. Over time, the MEC would expand and outgrow the lepidic adenocarcinoma, making it impossible to distinguish between fake and true MEC. The present case suggests that peripheral MEC could differ from proximal MEC in its histogenesis and molecular genetics. Thus, careful examination is necessary to diagnose peripheral lung MEC, particularly in patients with interstitial lung diseases.
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Affiliation(s)
- Eita Kumagai
- Department of Pathology, Yokohama City University Medical Center, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Mai Matsumura
- Department of Pathology, Yokohama City University Medical Center, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Ikuma Kato
- Department of Molecular Pathology, Yokohama City University, School of Medicine, Yokohama-shi, Japan
| | - Hiromasa Arai
- Division of Surgery, Kanagawa Prefectural Cardiovascular and Respiratory Center Hospital, Yokohama-shi, Japan
| | - Takehisa Suzuki
- Department of Pathology, Yokohama City University Medical Center, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Misaki Sugiyama
- Division of Pathology, Kanagawa Prefectural Cardiovascular and Respiratory Center Hospital, Yokohama-shi, Japan
| | - Motoki Sekiya
- Division of Pathology, Kanagawa Prefectural Cardiovascular and Respiratory Center Hospital, Yokohama-shi, Japan
| | - Hideaki Mitsui
- Department of Pathology, Yokohama City University Medical Center, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Toshiaki Kataoka
- Department of Pathology, Yokohama City University Medical Center, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Hiromichi Iwashita
- Department of Pathology, Yokohama City University Medical Center, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Koji Okudela
- Department of Pathology, Yokohama City University Medical Center, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
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