Pulmonary ciliated muconodular papillary tumor: clinical pathologic analysis of two cases and review of literature

doi:10.16150/j.1671-2870.2018.05.018

Abstract

Abstract: Objective: To investigate the clinical manifestation, pathological feature, immunophenotype, differential diagnosis of ciliated muconodular papillary tumor. Methods: Clinical data from two cases of CMPT were collected, analyzed retrospectively, including clinical, pathologic features, imaging findings, immunophenotype. Results: In frozen section examination during operation, one case was diagnosed as minimally invasive mucinous adenocarcinoma, the other was considered as CMPT or minimally invasive mucinous adenocarcinoma. Histologic findings of paraffin embedded tissue sections revealed that the tumor consisted of papillary, glandular architecture, a minimal extent of micropapillary structure, discontinuous lepidic growth. There was abundant extracellular mucin surrounding the tumor, which formed pools of mucin, with chronic inflammatory cell infiltration in the stroma. The epithelial components of the lesion consisted of ciliated columnar cells, mucous cells, basal cells. The basal cells provided a scaffold in the ou-ter layer, the ciliated columnar cells, mucous cells intermingled at the surface of the glandular/papillary structures. All three types of cells showed no nuclear atypia, no mitotic figures. Tissue necrosis was not observed. The basal cells expressed P63, P40, while a subset of basal cells expressed TTF-1. Both ciliated columnar cells, mucous cells expressed CK7, MUC-1, whereas TTF-1, Napsin A, SP-A, P63showed a patchy moderate intensity staining, P40showed no staining. The ciliated columnar cells were focally positive for MUC5AC. All three types of cells showed a low Ki-67index. Conclusions: CMPT of lung is a newly defined, extremely rare tumor with characteristic histological findings, immunophenotype. There is a potential diagnostic pitfalls for CMPT because it is easily misdiagnosed as mucinous adenocarcinoma by imaging findings, in the frozen section examination. The accurate pathologic diagnosis depends on the morphologic characteristics of paraffin-embedded tissue section, immunohistochemical staining

Key words: Pulmonary, ciliated muconodular papillary tumors, Clinicopathology, Immunophenotype

CLC Number:

R734.2

CHEN Xiaoyan, YANG Xiaoqun, YUAN Fei, ZHANG Jing, WANG Chaofu. Pulmonary ciliated muconodular papillary tumor: clinical pathologic analysis of two cases and review of literature[J]. Journal of Diagnostics Concepts & Practice, 2018, 17(05): 575-580.

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