Limits...
Tracheal epithelial-myoepithelial carcinoma associated with sarcoid-like reaction: A case report.

Dong H, Tatsuno BK, Betancourt J, Oh SS - Respir Med Case Rep (2014)

Bottom Line: Imaging revealed diffuse intra-thoracic and intra-abdominal lymphadenopathy.Lymph node biopsy demonstrated non-caseating granulomas consistent with sarcoidosis.Repeat CT imaging demonstrated complete resolution of lymphadenopathy.

View Article: PubMed Central - PubMed

Affiliation: Cedars-Sinai Medical Center, 8700 Beverly Boulevard, B112, Los Angeles, CA 90048, USA.

ABSTRACT
Epithelial-myoepithelial carcinomas are rare tumors that primarily originate in the salivary glands but have also been found in the tracheobronchial tree. We report the first case of epithelial-myoepithelial carcinoma associated with sarcoidosis. A 61 year old Hispanic man presented with altered mental status and hypercalcemia. Imaging revealed diffuse intra-thoracic and intra-abdominal lymphadenopathy. A diagnostic bronchoscopy was performed where an incidental tracheal nodule was discovered and biopsied. Pathology was consistent with epithelial-myoepithelial carcinoma. Lymph node biopsy demonstrated non-caseating granulomas consistent with sarcoidosis. Patient underwent tracheal resection of the primary tumor with primary tracheal reconstruction. Hypercalcemia subsequently normalized with clinical improvement. Repeat CT imaging demonstrated complete resolution of lymphadenopathy. Our findings are suggestive of a possible paraneoplastic sarcoid-like reaction to the epithelial-myoepithelial carcinoma with associated lymphadenopathy and symptomatic hypercalcemia.

No MeSH data available.


Related in: MedlinePlus

Small tracheal lesion seen on computer tomography imaging of the chest.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4356052&req=5

fig1: Small tracheal lesion seen on computer tomography imaging of the chest.

Mentions: Imaging findings prompted diagnostic bronchoscopy, which was unremarkable except for an incidental 0.7 cm tracheal nodule (Fig. 1). The nodule was sampled and pathology demonstrated a tumor composed of glands with a double layer of lining cells (Fig. 2). The inner layer was composed of eosinophilic cells, immunoreactive to cytokeratin-7. The outer layer was composed of clear cells, immunoreactive to smooth muscle actin and p63 (Fig. 3). The tumor was classified as an epithelial-myoepithelial carcinoma. Mediastinal lymph nodes were also sampled. Non-caseating granulomas were identified consistent with stage I sarcoidosis. There was no evidence of infection or other malignancy. Three-ring tracheal resection with primary tracheal reconstruction was performed with a normal calcium level at one-month follow up. Serial imaging demonstrated complete resolution of lymphadenopathy with no evidence of recurrence at 1 year.


Tracheal epithelial-myoepithelial carcinoma associated with sarcoid-like reaction: A case report.

Dong H, Tatsuno BK, Betancourt J, Oh SS - Respir Med Case Rep (2014)

Small tracheal lesion seen on computer tomography imaging of the chest.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356052&req=5

fig1: Small tracheal lesion seen on computer tomography imaging of the chest.
Mentions: Imaging findings prompted diagnostic bronchoscopy, which was unremarkable except for an incidental 0.7 cm tracheal nodule (Fig. 1). The nodule was sampled and pathology demonstrated a tumor composed of glands with a double layer of lining cells (Fig. 2). The inner layer was composed of eosinophilic cells, immunoreactive to cytokeratin-7. The outer layer was composed of clear cells, immunoreactive to smooth muscle actin and p63 (Fig. 3). The tumor was classified as an epithelial-myoepithelial carcinoma. Mediastinal lymph nodes were also sampled. Non-caseating granulomas were identified consistent with stage I sarcoidosis. There was no evidence of infection or other malignancy. Three-ring tracheal resection with primary tracheal reconstruction was performed with a normal calcium level at one-month follow up. Serial imaging demonstrated complete resolution of lymphadenopathy with no evidence of recurrence at 1 year.

Bottom Line: Imaging revealed diffuse intra-thoracic and intra-abdominal lymphadenopathy.Lymph node biopsy demonstrated non-caseating granulomas consistent with sarcoidosis.Repeat CT imaging demonstrated complete resolution of lymphadenopathy.

View Article: PubMed Central - PubMed

Affiliation: Cedars-Sinai Medical Center, 8700 Beverly Boulevard, B112, Los Angeles, CA 90048, USA.

ABSTRACT
Epithelial-myoepithelial carcinomas are rare tumors that primarily originate in the salivary glands but have also been found in the tracheobronchial tree. We report the first case of epithelial-myoepithelial carcinoma associated with sarcoidosis. A 61 year old Hispanic man presented with altered mental status and hypercalcemia. Imaging revealed diffuse intra-thoracic and intra-abdominal lymphadenopathy. A diagnostic bronchoscopy was performed where an incidental tracheal nodule was discovered and biopsied. Pathology was consistent with epithelial-myoepithelial carcinoma. Lymph node biopsy demonstrated non-caseating granulomas consistent with sarcoidosis. Patient underwent tracheal resection of the primary tumor with primary tracheal reconstruction. Hypercalcemia subsequently normalized with clinical improvement. Repeat CT imaging demonstrated complete resolution of lymphadenopathy. Our findings are suggestive of a possible paraneoplastic sarcoid-like reaction to the epithelial-myoepithelial carcinoma with associated lymphadenopathy and symptomatic hypercalcemia.

No MeSH data available.


Related in: MedlinePlus