PDF(Pubmed)
Abstract：
Warthin-like mucoepidermoid carcinoma (WL-MEC) is a newly reported variant of mucoepidermoid carcinoma. Its histological feature is easy to confused with metaplastic Warthin Tumor, and its relationship with Warthin tumor in histogenesis is controversial. In this study, we presented two cases of WL-MEC, discussing their clinicopathological and molecular features. Notably, one case was initially misdiagnosed during the first onset of the tumor. Case 1 was a 60-year-old female with a mass in the right parotid gland. Case 2 featured a 29-year-old male who developed a lump at the original surgical site 6 months after a \"Warthin tumor\" resection from the submandibular gland. Histologically, both tumor exhibited a prominent lymphoid stroma and cystic pattern, accompanied by various amounts of epithelial nests composed of squamoid cells, intermediate cells and mucinous cells. The characteristic eosinophilic bilayer epithelium of Warthin tumor was not typically presented in either case. Both cases tested positive for MAML2 gene rearrangement. To contextualize our findings, we conducted a comprehensive review of forty-eight WL-MEC cases documented in the English literature, aiming to synthesizing a reliable differential diagnostic approach. WL-MEC is a rare yet clinically relevant variant, posing a diagnostic pitfall for pathologists. Our study underscores the importance of a meticulous evaluation of both clinical and histological features, coupled with the detection of MAML2 rearrangement, as a credible method for distinguishing WL-MEC from other benign and malignant lesions, particularly metaplastic Warthin tumor.
摘要：
Warthin样粘液表皮样癌（WL-MEC）是新近报道的粘液表皮样癌的变体。它的组织学特征容易与化生沃辛肿瘤混淆，其与Warthin肿瘤组织发生的关系存在争议。在这项研究中,我们提出了两例WL-MEC，讨论他们的临床病理和分子特征。值得注意的是,1例最初在肿瘤首次发作期间被误诊。病例1是一名60岁的女性，右侧腮腺有肿块。病例2包括一名29岁的男性，他在下颌下腺切除“Warthin肿瘤”6个月后在原始手术部位出现肿块。组织学上,两个肿瘤都表现出突出的淋巴间质和囊性模式，伴随着由鳞片状细胞组成的各种数量的上皮巢，中间细胞和粘液细胞。两种情况下都没有典型地出现Warthin肿瘤的特征性嗜酸性双层上皮。两个病例的MAML2基因重排检测呈阳性。为了了解我们的发现，我们对英语文献中记录的48例WL-MEC病例进行了全面审查，旨在综合可靠的鉴别诊断方法。WL-MEC是一种罕见但临床相关的变体，给病理学家带来一个诊断陷阱。我们的研究强调了对临床和组织学特征进行细致评估的重要性。再加上MAML2重排的检测，作为区分WL-MEC与其他良性和恶性病变的可靠方法，特别是化生Warthin肿瘤.
