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Two-week history of yellow sputum and fever with recurrent lower respiratory tract infections. Right endobronchial mass present. Biopsy showed squamous papilloma. This is a repeat biopsy.
Pulmonary mucoepidermoid carcinoma (MEC) is a rare malignant neoplasm representing 0.1 to 0.2% of all primary lung carcinomas. It is a rare primary carcinoma that arises from the minor salivary gland-type epithelium of the large central airways (tracheal bronchial tree). It can occur in children as young as 6-7 years old. Median age is 50 years. MEC can exhibit cellular heterogeneity including epidermoid, intermediate and mucin secreting cells. IHC is p40+ve CK+ve p63+ that overlaps with squamous cell carcinoma. Similar to the MEC of major salivary glands, fusion oncogene MECT1-MAML2 can be detected by RT-PCR; FISH; t(11;19) fusion is associated with lower histological grade and improved survival. To date, histological grade is the most significant prognostic factor. Treatment is surgical excision.