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Epithelial-myoepithelial tumour of the lung a case report referring to its molecular histogenesis.doc

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Epithelial-myoepithelial tumour of the lung a case report referring to its molecular histogenesis

Mu?ozetal.DiagnosticPathology2011,6:71 /content/6/1/71 CASE REPORT OpenAccess Epithelial-myoepithelialtumourofthelung:a casereportreferringtoitsmolecularhistogenesis GuillermoMu?oz*,FrancescFelipo,IsabelMarquinaandCeliaDelAgua Abstract Tracheobronchialsubmucousglandscanbeconsideredthepulmonaryequivalentofminorsalivaryglandsand thereforetheycandevelopmostofthetumoursoriginatedinthese.Nevertheless,inspiteofthewidedistribution ofthiskindofglandsalongthetracheobronchialtree,pulmonarysalivarygland-likeneoplasmsarenotvery frequent.Amongthem,themostfrequentaremucoepidermoidandadenoidcysticcarcinomas.Onthecontrary, pulmonaryneoplasmsshowingamixtureofepithelialandmyoepithelialelementsareextraordinaryinfrequent, withonly11casescollectedfromliterature. Wepresentthecaseofa76year-oldwomanwithnointerestingpathologicalhistory,towhomapulmonary noduleisdetectedduringastudyofunknownoriginneutropenia.Anupperrightlobectomyisperformed. Aftermacroandmicroscopicstudy,thediagnosisofpulmonaryepithelial-myoepithelialtumourismade.Itisalow malignantpotentialtumourwithcapacitytolocallyrecurandlessfrequentlytometastasize.Ourcasehasthe peculiarityofnotbeingconnectedneithertovisceralpleuranortobronchialtree;wehavenotfoundthis characteristicinanyliteraturereviewedcase. Thesetumourshavebeennamedinalotofdifferentways,includingadenomyoepithelioma,epithelial- myoepithelialtumour,epithelial-myoepithelialcarcinomaorepithelial-myoepithelialtumourofuncertainmalignant potential. Thep27/kip-1proteinplaysafundamentalroleinthedevelopmentoftheseneoplasms.Aswehaveverifiedinour case,itsaberrantcytoplasmiclocation,besidesitsprovedoncogenicfunction,wouldfavourtheproliferationof stemcells,whichwouldexplainbothdualphenotypewithpresenceofmyoepithelialcellswithoutconnection withthebronchialtree,andTTF-1immunostaininginepithelialcells. Introduction would provoke loss oftheir growth-inhibition function Epithelial-myoepithelialtumoursarerareneoplasmsthat andwouldcontribute totumorigenesis throughlackor occur more f