Ciliated muconodular papillary tumor of the lung: The risk of false-positive diagnosis in frozen section

Chu, Hyun Hee; Park, Shin Young; Jung, Eun Jung

doi:10.1016/j.ehpc.2015.08.003

Cited by 25 publications

(45 citation statements)

References 9 publications

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“…Ishikawa suggested a possible malignant potential of CMPT from histopathological observations, which included focal alveolar destruction and mixed features of papillary, micropapillary, and/or skipping lepidic growth. However, all previously reported cases showed no distinctive invasive features or aggressive clinical courses . On the other hand, in the present case, basal tumor cells in typical CMPT‐like structures exhibited more atypical nuclear features, such as nuclear enlargement, hyperchromatic change, and irregular nuclear contours, and focally invaded with spindle cell morphologies.…”

Section: Discussioncontrasting

confidence: 63%

“…In the 2015 World Health Organization Classification of Tumours of the Lung, glandular and mixed glandular and squamous cell papilloma (as synonyms, mixed papilloma and transitional papilloma) have been described, but the term “CMPT” was not included . Some authors have described that CMPT should be discriminated from mixed papilloma composed of glandular and squamous cell features, however the histopathological features of these glandular and mixed papillomas closely mimic those of CMPT . In our review of the literature, the presence of no endobronchial growth and a relatively central tumor location seemed to be the only points differentiating CMPT from these papillomas .…”

Section: Discussionmentioning

confidence: 62%

“…Ciliated muconodular papillary tumor is a rare disease, and since Ishikawa reported the first incidence in 2002, only 22 cases have been reported to date . The reported histopathological features consist of proliferating ciliated columnar cells, mucous cells, and basal cells with minimal atypia, and resemble of the most part of the current pulmonary nodule.…”

Section: Discussionmentioning

confidence: 99%

“…However, cellular atypia of CMPT is usually not prominent, and the distinctive malignant morphology of CMPT has not been reported previously. All reported cases of CMPT have showed benign clinical courses . Recently, we encountered a unique pulmonary nodule, which primarily showed typical features of CMPT but also had atypical spindle cell components that focally invading the fibrous stroma.…”

mentioning

confidence: 98%

“…Ciliated muconodular papillary tumor (CMPT) is a rare neoplasm composed of proliferating ciliated columnar cells, mucous cells, and basal cells in the peripheral lung . CMPT was first described as a “malignant mimicker” because this tumor showed focal stromal distortion and complex architecture including papillary, micropapillary, and focally discontinuous lepidic growth .…”

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confidence: 99%

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Invasive form of ciliated muconodular papillary tumor of the lung: A case report and review of the literature

Miyai

Takeo

Nakayama

et al. 2018

Pathology International

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We report a case of a 67-year-old woman with an invasive ciliated muconodular papillary tumor (CMPT) that developed in her right middle lobe. The current tumor was incidentally detected during a follow-up imaging examination for a large cell carcinoma that was resected 10 years previously. Partial removal of the middle lobe showed a 2 cm-sized, solid and myxoid tumor located in the peripheral region. Histologically, this tumor primarily consisted of ciliated columnar cells, mucous cells, and basal cells, all of which had relatively swollen nuclei and were proliferating in a lepidic or papillary/micropapillary manner. These features were consistent with those of previously reported CMPT. In addition, atypical spindle tumor cells with more swollen nuclei, which were partly continuous to less atypical basal tumor cells, were focally found and invaded fibrous stroma in a reticular fashion. Immunohistochemically, both basal cells and atypical spindle tumor cells were positive for pancytokeratin, cytokeratin 5/6, and p40. Increased p53 positivity was found in these invading spindle cells compared with basal tumor cells. Neither BRAF V600E nor V600K mutation was detected. We concluded that this tumor was an extremely rare invasive case of CMPT, possibly representing malignant transformation of basal tumor cell components of CMPT.

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Section: Discussioncontrasting

confidence: 63%

Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 98%

mentioning

confidence: 99%

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Invasive form of ciliated muconodular papillary tumor of the lung: A case report and review of the literature

Miyai

Takeo

Nakayama

et al. 2018

Pathology International

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Ciliated muconodular papillary tumors of the lung: Cytologic features and diagnostic pitfalls in intraoperative examinations

Mikubo

Maruyama

Kakinuma

et al. 2019

Diagnostic Cytopathology

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Ciliated muconodular papillary tumors (CMPTs) of the lung are rare, likely benign neoplastic lesions. Here we describe a case of a CMPT, focusing on its cytologic features, which to our knowledge have not been reported previously. Owing to dull back pain, a 69‐year‐old male non‐smoker underwent CT, which revealed a 1.3 × 1.3‐cm solid nodule in the peripheral field of the left lower lung lobe. A wedge resection of the nodule was performed, with the provisional diagnosis being primary lung cancer. Macroscopic examination of a resected specimen showed a 1.2‐cm grayish nodule. Touch imprint smear cytology revealed ciliated columnar cells and mucous cells, as well as abundant extracellular mucin on inflammatory background of lymphocytes and histiocytes. Histologic examination revealed a nodular papillary tumor composed of ciliated columnar cells, mucous cells, and basal cells surrounded by a mucin pool. No nuclear atypia or mitotic figures were identified. The final diagnosis was CMPT. The postoperative course was uneventful, with no recurrence at 8 months after surgery. Although a CMPT is a rare lung tumor, it should be considered when cytological or histological examination of a solitary peripheral lung nodule shows non‐atypical ciliated cells and mucous cells surrounded by mucin.

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Bronchiolar Adenoma/Pulmonary Ciliated Muconodular Papillary Tumor

Shirsat¹,

Zhou²,

Chang

et al. 2020

American Journal of Clinical Pathology

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Objectives To describe the histologic features that are helpful in the diagnosis of the rare bronchiolar adenomas/ciliated muconodular papillary tumors (BAs/CMPTs) during intraoperative consultation. Methods Multi-institutional retrospective review of frozen sections of 18 BAs/CMPTs. Results In 14 of 18 cases, BA/CMPT was the primary reason for sublobar lung resection, and in 4 cases, BA/CMPT was an incidental finding intraoperatively for resections performed for carcinoma in other lobes. There were 11 proximal-type/classic BAs/CMPTs and 7 distal-type/nonclassic BAs/CMPTs. Only 3 (16.7%) of 18 were correctly diagnosed at the time of frozen section, all of which were proximal type/classic. The remainder were diagnosed as adenocarcinoma (n = 7); invasive mucinous adenocarcinoma (n = 1); non–small cell lung carcinoma (n = 1); cystic mucinous neoplasm, favor adenocarcinoma (either mucinous or colloid type) (n = 1); favor adenocarcinoma, cannot exclude CMPT (n = 1); atypical proliferation (n = 2); mucinous epithelial proliferation (n = 1); and mucous gland adenoma (n = 1). Conclusions BA/CMPT can potentially be misdiagnosed as carcinoma during intraoperative consultation. On retrospective review of the frozen sections, the presence of the following may help to avoid misdiagnosis: a mixture of bland ciliated columnar cells, mucinous cells, and, most important, a basal cell layer, as well as a lack of necrosis, significant atypia, and mitoses.

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Ciliated muconodular papillary tumor of the lung: The risk of false-positive diagnosis in frozen section

Cited by 25 publications

References 9 publications

Invasive form of ciliated muconodular papillary tumor of the lung: A case report and review of the literature

Invasive form of ciliated muconodular papillary tumor of the lung: A case report and review of the literature

Ciliated muconodular papillary tumors of the lung: Cytologic features and diagnostic pitfalls in intraoperative examinations

Bronchiolar Adenoma/Pulmonary Ciliated Muconodular Papillary Tumor

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