Ciliated muconodular papillary tumor of the lung: a newly defined peripheral pulmonary tumor with conspicuous mucin pool mimicking colloid adenocarcinoma: a case report and review of literature

Pathol Int. 2014 Jul;64(7):352-7. doi: 10.1111/pin.12179.

Abstract

We report the case of a 68-year-old man with a newly defined rare entity of a peripheral pulmonary tumor, consisting of a nodular papillary lesion with papillary structures containing ciliated columnar and goblet cells, as well as floating tumor cells in the mucin pool. The conspicuous mucin pool was observed to be mimicking colloid adenocarcinoma in a low-power view, particularly in a frozen section slide. We originally reported it as an adenocarcinoma during intraoperative consultation. Immunohistochemically, the tumor cells exhibited a similar immunophenotype to pulmonary adenocarcinoma, except for the presence of focal ciliated and basaloid cells, which we found using CK5/6 and P63 immunostaining. No KRAS or EGFR mutation was found. We revised the diagnosis to that of a ciliated muconodular papillary tumor (CMPT). Four years after a wedge resection, the patient remained free of tumors. Although the malignant potential of CMPT cannot be ignored, a wedge resection with a safe margin might be a treatment option for CMPT patients.

Keywords: ciliated muconodular papillary tumor; colloid adenocarcinoma; glandular papilloma; wedge resection.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / genetics
  • Adenocarcinoma / pathology*
  • Adenocarcinoma of Lung
  • Adenocarcinoma, Mucinous / diagnosis
  • Adenocarcinoma, Mucinous / genetics
  • Adenocarcinoma, Mucinous / pathology
  • Aged
  • Carcinoma, Papillary / genetics
  • Carcinoma, Papillary / pathology*
  • Diagnosis, Differential*
  • Epithelial Cells / metabolism
  • Goblet Cells / pathology
  • Humans
  • Immunohistochemistry / methods
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / genetics
  • Lung Neoplasms / pathology*
  • Male
  • Mucins
  • Mutation / genetics

Substances

  • Mucins