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KNOW YOUR FIELD |
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| Year : 2012 | Volume
: 16
| Issue : 3 | Page : 473-474 |
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Epithelial myoepithelial carcinoma
Nagarajan Lavanya, Elizabeth Joshua, Kannan Ranganathan
Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India
| Date of Web Publication | 16-Oct-2012 |
Correspondence Address:
Nagarajan Lavanya
Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0973-029X.102526
How to cite this article:
Lavanya N, Joshua E, Ranganathan K. Epithelial myoepithelial carcinoma. J Oral Maxillofac Pathol 2012;16:473-4 |
 Case History | |  |
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 | | |
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 | | |
- 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 | | |
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.
| Diagnosis | | |
Epithelial myoepithelial carcinoma.
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
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