Comparative Study

. 2022 Mar;80(4):729-735.

doi: 10.1111/his.14586. Epub 2021 Dec 14.

Salivary mucoepidermoid carcinoma: histological variants, grading systems, CRTC1/3-MAML2 fusions, and clinicopathological features

Satsuki Nakano¹, Yoshihide Okumura^{1

2}, Takayuki Murase¹, Toshitaka Nagao³, Kimihide Kusafuka⁴, Makoto Urano⁵, Hidetaka Yamamoto⁶, Satoshi Kano⁷, Kiyoaki Tsukahara⁸, Kenji Okami⁹, Daisuke Kawakita¹⁰, Toru Nagao², Nobuhiro Hanai¹¹, Hiroshi Iwai¹², Ryo Kawata¹³, Yuichiro Tada¹⁴, Ken-Ichi Nibu¹⁵, Hiroshi Inagaki¹

Affiliations

¹ Department of Pathology and Molecular Diagnostics, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
² Department of Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan.
³ Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan.
⁴ Department of Pathology, Shizuoka General Hospital, Shizuoka, Japan.
⁵ Department of Diagnostic Pathology, Fujita Health University, School of Medicine, Bantane Hospital, Nagoya, Japan.
⁶ Department of Anatomic Pathology, Graduate of School of Medical Science, Kyushu University, Fukuoka, Japan.
⁷ Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
⁸ Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan.
⁹ Department of Otolaryngology-Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan.
¹⁰ Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
¹¹ Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
¹² Department of Otolaryngology, Head and Neck Surgery, Kansai Medical University, Hirakata, Japan.
¹³ Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.
¹⁴ Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
¹⁵ Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

PMID: 34657306
DOI: 10.1111/his.14586

Comparative Study

Salivary mucoepidermoid carcinoma: histological variants, grading systems, CRTC1/3-MAML2 fusions, and clinicopathological features

Satsuki Nakano et al. Histopathology. 2022 Mar.

. 2022 Mar;80(4):729-735.

doi: 10.1111/his.14586. Epub 2021 Dec 14.

Authors

Affiliations

¹ Department of Pathology and Molecular Diagnostics, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
² Department of Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan.
³ Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan.
⁴ Department of Pathology, Shizuoka General Hospital, Shizuoka, Japan.
⁵ Department of Diagnostic Pathology, Fujita Health University, School of Medicine, Bantane Hospital, Nagoya, Japan.
⁶ Department of Anatomic Pathology, Graduate of School of Medical Science, Kyushu University, Fukuoka, Japan.
⁷ Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
⁸ Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan.
⁹ Department of Otolaryngology-Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan.
¹⁰ Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
¹¹ Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
¹² Department of Otolaryngology, Head and Neck Surgery, Kansai Medical University, Hirakata, Japan.
¹³ Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.
¹⁴ Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
¹⁵ Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

PMID: 34657306
DOI: 10.1111/his.14586

Abstract

Aims: To investigate the histological diversity of salivary mucoepidermoid carcinoma (MEC), its clinicopathological features, and its associations with CRTC1/3-MAML2 fusions.

Methods and results: Salivary MEC cases (n = 177) were examined for CRTC1/3-MAML2 fusions, histological variants were classified, and tumours were graded according to four different grading systems. Adverse histological features considered to be unusual in MEC were also investigated. Of the 177 MEC cases, 110 were positive for CRTC1/3-MAML2 fusions. The classical variant was the most frequent in the fusion-positive case group, the fusion-negative case group, and the total case group. The clear/oncocytic variant was the second most frequent in the fusion-positive and total case groups. Oncocytic, Warthin-like and spindle variants were seen in the fusion-positive case group only. Clear cell, sclerosing, mucinous and central variants were seen in both the fusion-positive case group and the fusion-negative case group. No case was classified as a ciliated variant, as a mucoacinar variant, or as a high-grade transformation. As compared with the classical variant, non-classical variants were characterised by frequent CRTC1/3-MAML2 fusions and a low clinical stage in all cases. Of the four histological features considered to be unusual in MEC, marked nuclear atypia, frequent mitoses (>10/10 high-power fields) and extensive necrosis were found independently of the fusion status, and were present in 3-5% of all cases. However, none of the cases showed overt keratinisation. On comparison, the Armed Forces Institute of Pathology and modified Healey grading systems downgraded tumours, the Brandwein system upgraded tumours, and the Memorial Sloan Kettering system provided a moderate means of assessment.

Conclusion: Recognition of the histological diversity of MEC, its clinicopathological features and its associations with CRTC1/3-MAML2 fusions is helpful for an accurate diagnosis of this carcinoma.

Keywords: CRTC1/3-MAML2 fusions; clinicopathological correlations; histological variants; mucoepidermoid carcinoma.

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Salivary mucoepidermoid carcinoma: histological variants, grading systems, CRTC1/3-MAML2 fusions, and clinicopathological features

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Salivary mucoepidermoid carcinoma: histological variants, grading systems, CRTC1/3-MAML2 fusions, and clinicopathological features

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