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Cha, Kim, Cho, Park, Park, Kim, Kwak, Yoo, Cho, and Lee: A Case of Intermediate Grade Bronchial Mucoepidermoid Carcinoma and Review in Korean Cases
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 65(1): 41-48.

Published online: 31 July 2008

DOI: https://doi.org/10.4046/trd.2008.65.1.41

A Case of Intermediate Grade Bronchial Mucoepidermoid Carcinoma and Review in Korean Cases

Sung Chul Cha, M.D.1, Si Woo Kim, M.D.1, Yoo Jin Cho, M.D.1, Sung Kyoon Park, M.D.1, Hyun Keun Park, M.D.1, Jong Sang Kim, M.D.1, Jae Wook Kwak, M.D.1, Moon Bin Yoo, M.D.1, Hye Jae Cho, M.D.2, Jae Jin Lee, M.D.3

1Department of Internal Medicine, Seoul Adventist Hospital, Seoul, Korea.

2Department of Pathology, Seoul Adventist Hospital, Seoul, Korea.

3Department of Thoracic and Cardiovascular Surgery, Seoul Adventist Hospital, Seoul, Korea.

Address for correspondence: Sung Chul Cha, M.D. Division of Pulmonary Medicine, Department of Internal Medicine, Seoul Adventist Hospital, 29-1, Hwikyung 2-dong, Dongdaemun-gu, Seoul 130-092, Korea. Phone: 82-2-2210-3441, Fax: 82-2-2212-2673, anoldlove@naver.com

Received 2 June 2008       Accepted 30 June 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Bronchial mucoepidermoid carcinoma is uncommon, representing 0.2% of all lung tumors. The disease usually presents with symptoms of airway obstruction and recurrent pneumonia. It is commonly classified into two grades in Korea, low and high. We report a case of a bronchial mucoepidermoid carcinoma in a 40-year-old woman who complained of symptoms of an upper respiratory infection. The histological grade after a bronchoscopic biopsy was intermediate. A left upper lobectomy was performed as treatment. The TNM stage of this case was IA (T1N0M0). In addition, 25 cases of bronchial mucoepidermoid carcinoma from 1984 in Korea are also reviewed from the viewpoint of the relationship between the histological grade, TNM stage and clinical course of the tumor.

Keywords: Bronchial mucoepidermoid carcinoma, Intermediate grade, TNM stage, PET

Figures and Tables

Figure 1
Chest X-ray shows hazy opacities in the lingular segment of the left lung, around the left cardiac border.
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Figure 2
Computed tomography scan reveals focal ateletatic change on left lingular segment, but no mass is seen in endobronchial area.
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Figure 3
Flexible bronchoscopy reveals 1.8 cm sized, soft yellowish tumor deriving from the bronchial wall. It has much mucoid like material and is bulging into the ostium of lingular segment of bronchus (arrows).
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Figure 4
Positron Emission Tomography at lower lung level. There was 18F-fluoro deoxyglucose (FDG) uptake in the bronchial area.
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Figure 5
A yellowish solid endobronchical mass was seen, which is 1.8×3.0 cm sized and arising from the bronchial wall.
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Figure 6
Histology of the tumour. The nuclear showed moderate pleomorphism. But tumor cell showed few mitotic figures (less than 5 per 50 HPF). Well differentiated Goblet cell is seen at central portion. Necrosis is absent (H&E stain, ×400).
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Figure 7
Immunohistochemical stain of Cytokeratin 7 (A) was positive and TTF-1 (B) was negative.
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Table 1
Histology, stage and clinical course (n=22)
trd-65-41-i001

BL: bilobectomy; Lo: lobectomy; SR: sleeve resection; Pn: pneumonectomy; Ch: chemotherapy; Ra: radiotherapy.

*case of mucoepidermoid carcinoma with adenocarcinoma, †inoperable case due to location of tumor was upper trachea.

Table 2
Conlan's classification of mucoepidermoid carcinoma of lung
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*nuclear to cytoplasmic ratio.

Table 3
Classification of mucoepidermoid carcinoma of salivary gland
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*high power field.

Table 4
Grade and age (n=21)
trd-65-41-i004

References

1. Colby T, Koss M, Travis W. Tumors of the lower respiratory tract. 1995. Washington, DC: Armed Forces Institute of Pathology;3rd series.
2. Heitmiller RF, Mathisen DJ, Ferry JA, Mark EJ, Grillo HC. Mucoepidermoid lung tumors. Ann Thorac Surg. 1989. 47:394–399.
3. Conlan AA, Payne WS, Woolner LB, Sanderson DR. Adenoid cystic carcinoma (cylindroma) and mucoepidermoid carcinoma of the bronchus. Factors affecting survival. J Thorac Cardiovasc Surg. 1978. 76:369–377.
4. Smetana HF, Iverson L, Swan LL. Bronchogenic carcinoma: an analysis of 100 autopsy cases. Mil Surg. 1952. 111:335–351.
5. Liu X, Adams AL. Mucoepidermoid carcinoma of the bronchus. Arch Pathol Lab Med. 2007. 131:1400–1404.
6. Pandya H, Matthews S. Case report: Mucoepidermoid carcinoma in a patient with congenital agenesis of the left upper lobe. Br J Radiol. 2003. 76:339–342.
7. Tonon G, Gehlhaus KS, Yonescu R, Kaye FJ, Kirsch IR. Multiple reciprocal translocations in salivary gland mucoepidermoid carcinomas. Cancer Genet Cytogenet. 2004. 152:15–22.
8. Barrett W, Heaps LS, Diaz S, Sharma P, Arbuckle S, Smith A. Mucoepidermoid carcinoma of the bronchus in a 15-year-old girl with complex cytogenetic rearrangement involving 11q and over-expression of cyclin D1. Med Pediatr Oncol. 2002. 39:49–51.
9. Niggemann B, Gerstner B, Guschmann M, Paul K, Wit J, Mau H, et al. An 11-yr-old male with pneumonia and persistent airway obstruction. Eur Respir J. 2002. 19:582–584.
10. Ishizumi T, Tateishi U, Watanabe S, Maeda T, Arai Y. F-18 FDG PET/CT imaging of low-grade mucoepidermoid carcinoma of the bronchus. Ann Nucl Med. 2007. 21:299–302.
11. Kinoshita H, Shimotake T, Furukawa T, Deguchi E, Iwai N. Mucoepidermal carcinoma of the lung detected by positron emission tomography in a 5-year-old girl. J Pediatr Surg. 2005. 40:E1–E3.
12. Chin CH, Huang CC, Lin MC, Chao TY, Liu SF. Prognostic factors of tracheobronchial mucoepidermoid carcinoma: 15 years experience. Respirology. 2008. 13:275–280.
13. Matsuzaki Y, Shibata K, Yoshioka M, Inoue M, Sekiya R, Onitsuka T, et al. Successful treatment of bronchial mucoepidermoid carcinoma in an 11-year-old boy by bronchoplasty: report of a case. Surg Today. 1996. 26:64–67.
14. Klacsmann PG, Olson JL, Eggleston JC. Mucoepidermoid carcinoma of the bronchus: an electron microscopic study of the low grade and the high grade variants. Cancer. 1979. 43:1720–1733.
15. Carter D, Eggleston JC. Tumors of the lower respiratory tract. 1980. Washington, DC: Atlas of tumour pathology.
16. Brandwein MS, Ivanov K, Wallace DI, Hille JJ, Wang B, Fahmy A, et al. Mucoepidermoid carcinoma: a clinicopathologic study of 80 patients with special reference to histological grading. Am J Surg Pathol. 2001. 25:835–845.
17. Hicks MJ, el-Naggar AK, Flaitz CM, Luna MA, Batsakis JG. Histocytologic grading of mucoepidermoid carcinoma of major salivary glands in prognosis and survival: a clinicopathologic and flow cytometric investigation. Head Neck. 1995. 17:89–95.
18. Shilo K, Foss RD, Franks TJ, DePeralta-Venturina M, Travis WD. Pulmonary mucoepidermoid carcinoma with prominent tumor-associated lymphoid proliferation. Am J Surg Pathol. 2005. 29:407–411.
19. Han SW, Kim HP, Jeon YK, Oh DY, Lee SH, Kim DW, et al. Mucoepidermoid carcinoma of lung: potential target of EGFR-directed treatment. Lung Cancer. 2008. 61:30–34.
20. Molina JR, Aubry MC, Lewis JE, Wampfler JA, Williams BA, Midthun DE, et al. Primary salivary gland-type lung cancer: spectrum of clinical presentation, histopathologic and prognostic factors. Cancer. 2007. 110:2253–2259.
21. Song IS, Cho KH, Lee HG. Mucoepidemoid tumor of the bronchus. Korean J Thorac Cardiovasc Surg. 1984. 17:740–746.
22. Ann B, Cha HD, Kwon YM, Kang JM. Childhood bronchial mucoepidermoid tumor: a case report and review of the literature. Korean J Pediatr. 1985. 28:102–106.
23. Byun HS, Oh BS, Lee DJ. Bronchial mucoepidermoid carcinoma: 1 case report. Korean J Thorac Cardiovasc Surg. 1988. 21:941–947.
24. Kim JH, Kim YB, Kim CS, Kim DS, Kim RH, Kim CH, et al. A report of two cases of mucoepidermoid carcinoma. Tuberc Respir Dis. 1993. 40:58–66.
25. Jeong JM, Song JY, Hong JR, Kim YJ, Kim MS. A case of mucoepidermoid carcinoma in pulmonary tuberculosis patient. Tuberc Respir Dis. 1994. 41:429–434.
26. Yim JY, Son HY, Park KR, Lee KH, Shin MS, Chang JH, et al. A case of bronchial mucoepidermoid carcinoma. Tuberc Respir Dis. 1997. 44:1132–1139.
27. Kim CM, Sohn JW, Yang SC, Yoon HJ, Shin DH, Park SS, et al. A case of bronchial mucoepidermoid carcinoma associated with adenocarcinoma. Tuberc Respir Dis. 1997. 44:677–683.
28. Kim YJ, Park JY, Shin MC, Bae MS, Kim JS, Chae SC, et al. A clinical review of mucoepidermoid carcinoma of the lung in Korea. Tuberc Respir Dis. 1992. 45:311–321.
29. Choi YH, Kim TS, Shin JS, Hwang JJ, Sohn YS, Kim HJ, et al. Low grade mucoepidermoid carcinomas of the lung. Korean J Bronchoesophagol. 1998. 4:225–230.
30. Son JA, Koo HH, Lee SI, Kim JG. Mucoepidermoid carcinoma of the bronchus in a 9-year-old-child. J Korean Pediatr Soc. 1998. 41:837–840.
31. Lee SY, Lim MR, Koo SE, Kim Jh, Hong SJ. A case of mucoepidermoid carcinoma of bronchus. Pediatr Allergy Respir Dis. 2002. 12:160–165.
32. Yun SW, Kim DK, Park CR, Park SI. Mucoepidermoid carcinoma of the bronchus in a 10-year-old child. Korean J Thorac Cardiovasc Surg. 2002. 35:760–763.
33. Yoon KC, Park YT. Mucoepidermoid carcinoma of the lung. Korean J Thorac Cardiovasc Surg. 2004. 37:92–94.
34. Ryoo JY, Kim YS, Kim WS, Chang WI, Joo M. Mucoepidermoid carcinoma of the right lower lobe bronchus: a case report. Korean J Thorac Cardiovasc Surg. 2004. 37:955–958.
35. Lee SJ, Cho SM, Koo KM. A case of bronchial mucopeidermoid carcinoma in a 11-year-old Child. Dongguk J Med. 2004. 11:389–394.
36. Park YH, Kang JW, Kim KW, Kim ES, Jee HM, Sohn MH, et al. Mucoepidermoid carcinoma in a 12-year-old boy. Pediatr Allergy Respir Dis. 2007. 17:420–424.
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