Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Mucoepidermoid carcinoma
- Radiologic Findings
- Fig 1. Chest PA shows mass like consolidation in right middle lung zone
Fig 2-5. On CT images, There is about 2cm sized enhancing nodular lesion in RLL and this lesion make occlusion at RML lateral bronchus subsegmental branch
Fig 6. That nodule show mild hypermetabolism on PET CT
- Brief Review
- Pulmonary mucoepidermoid carcinoma (PMEC) is an uncommon neoplasm of the lung and the most common salivary gland malignancy. PMEC is usually located in the lobar or segmental bronchi, usually accompanied by distal bronchial dilatation with mucoid impaction. Although it is most commonly identified in the head and neck, it can occur in many sites of the body, including the breasts, lungs, skin, and thymus.
Clinically, PMEC occurs over a broad age range of 3–78 years with a peak age of diagnosis in the third and fourth decades. Although some studies have reported a male predominance, most reports fail to demonstrate a clear predilection regarding PMEC occurrence based on gender.
Symptoms primarily include bronchial irritation and obstruction, including cough, wheezing, hemoptysis, and postobstructive pneumonia.
Patchy areas of low density are usually observed in PMEC cases and the solid part of PMEC usually shows moderate or severe enhancement. Furthermore, on CT images, the central type of PMEC was characterized by limited nodules, and tumors' appearances included a circumferential or elevated soft tissue nodule with either a smooth, lobulated, or polypoid margin. Meanwhile, the hilar type usually manifested with nodules inside the lobar or segmental lumen, often accompanied by distal bronchial dilatation with mucoid impaction. Finally, the peripheral type was the least found type both in PMEC, and its lesions were all masses, originating from small bronchi.
PMEC is a low-grade malignancy, and therefore is mainly treated by surgical resection. The utility of chemotherapy and radiotherapy in these cases remains controversial. When complete resection is not possible, adjuvant therapy should be administered.
- Please refer to
Case 34, Case 100, Case 363, Case 483, Case 498, Case 645, Case 816, Case 928, Case 1133, -
KSTR imaging conference 2017 Summer Case 9
,
KSTR Imaging Conference 2004 Summer Case 3
,
KSTR Imaging Conference 2003 Summer Case 7,
- References
- 1. Zhen H, Huanwen W, Ji L, Shanqing L, Shafei W, Yuanyuan L, Yufeng L, Jinling C, Xuan Z, Zhiyong L, Primary Pulmonary Mucoepidermoid Carcinoma: Histo-pathological and Moleculargenetic Studies of 26 Cases, PLoS One. 2015; 10(11): e0143169.
2. Xian Li1, Wei Yi2, Qingsi Zeng, CT features and differential diagnosis of primary pulmonary mucoepidermoid carcinoma and pulmonary adenoid cystic carcinoma, J Thorac Dis. 2018 Dec; 10(12): 6501–6508
- Keywords
- Airway, Malignant neoplasm, Mucoepidermoid carcinoma,