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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists


 
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Year : 2012  |  Volume : 16  |  Issue : 3  |  Page : 473-474
 

Epithelial myoepithelial carcinoma


Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India

Date of Web Publication16-Oct-2012

Correspondence Address:
Nagarajan Lavanya
Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-029X.102526

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How to cite this article:
Lavanya N, Joshua E, Ranganathan K. Epithelial myoepithelial carcinoma. J Oral Maxillofac Pathol 2012;16:473-4

How to cite this URL:
Lavanya N, Joshua E, Ranganathan K. Epithelial myoepithelial carcinoma. J Oral Maxillofac Pathol [serial online] 2012 [cited 2019 Aug 23];16:473-4. Available from: http://www.jomfp.in/text.asp?2012/16/3/473/102526



   Case History Top


A 78-year-old male complained of postextraction pain in right lower jaw; 46, 47, 48 had been extracted 4 days as they were mobile and painful for the past 6 months. Extra orally, there was a 3 × 4 cm sized firm, nontender swelling in the right submandibular region. A single submandibular node was palpable and fixed. Intra orally, there was a tender ulcer in the floor of the mouth in the right lingual vestibule with central yellow slough.


   Histopathology Top


Ulcerated nonkeratinising surface epithelium in association with an inflamed fibrovascular connective tissue exhibiting infiltrating islands and nests of neoplastic epithelial cells [[Figure 1] surface epithelium not seen in the picture].
Figure 1: Infiltrating Islands and nests of neoplastic epithelial cells in a fibrous connective tissue (Original magnification, 4×)

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Variably sized duct like structures and microcystic areas were seen within the islands and nests [Figure 1] and [Figure 2].
Figure 2: Duct like structures and microcystic areas lined by two layers of cells (Original magnification, 10×)

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Duct like structures were lined with two layers of cells; luminal cuboidal cells and abluminal (basal) of layer of clear cells [Figure 2], [Figure 3], [Figure 4].
Figure 3: Higher magnification showing luminal intercalated Duct like cells and abluminal clear cells. (Original magnification, 40×)

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Figure 4: A nother area Showing luminal cuboidal cells and abluminal clear cells and dense hyalinised basement membrane (Original magnification, 40×)

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The inner layer of cuboidal cells were similar to epithelium of normal intercalated ducts, with eosinophilic cytoplasm and nucleus exhibiting fine chromatin. This was surrounded by an abluminal (basa) l layer of larger cells with clear cytoplasm and basophilic round to oval nuclei [Figure 2], [Figure 3], [Figure 4].

Dense hyalinized basement membrane of variable thickness surrounding the islands of neoplastic epithelial cells [Figure 4].


   Differential Diagnosis Top


  • Epithelial Myoepithelial carcinoma.
  • Clear cell variant of - Mucoepidermoid carcinoma, oncocytic lesions, mixed tumor.
  • Polymorphous low-grade adeno carcinoma.
  • Clear cell carcinoma not otherwise specified/hyalinising clear cell carcinoma.
  • Sebaeceous adenoma/carcinoma.
  • Metastatic renal cell carcinoma.



   Immunohistochemistry Top


Basal cells were positive for both S-100 and p63. However, p63 staining was more uniform and confined to the basal layer. [[Figure 5] and [Figure 6]; S-100, p63, respectively] confirming basal cells as myoepithelial cells.
Figure 5: S - 100 immunohistochemistry

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Figure 6: p63 immunohistochemistry

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   Diagnosis Top


Epithelial myoepithelial carcinoma.


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]



 

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   Case History
   Histopathology
    Differential Dia...
   Immunohistochemistry
   Diagnosis
    Article Figures

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