Letter to the Editor
Mucoepidermoid Carcinoma in a Bone Marrow Transplant Patient
Tumor mucoepidermoide en paciente trasplantada de médula ósea
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=> "To the Editor:" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "125" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "María del Valle Somiedo Gutiérrez, Rosa Girón Moreno, Ramón Moreno Balsalobre" "autores" => array:3 [ 0 => array:4 [ "nombre" => "María del Valle" "apellidos" => "Somiedo Gutiérrez" "email" => array:1 [ 0 => "v_somiedo@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Rosa" "apellidos" => "Girón Moreno" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Ramón" "apellidos" => "Moreno Balsalobre" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario de La Princesa, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Cirugía Torácica, Hospital Universitario de La Princesa, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tumor mucoepidermoide en paciente trasplantada de médula ósea" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 767 "Ancho" => 976 "Tamanyo" => 88982 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest computed axial tomography slice showing an occupation of the segmental and some subsegmental bronchi by soft tissue in the left lung base, probably related to endobronchial tumor disease.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Mucoepidermoid carcinoma of the lung (MEC) is a very rare tumor of low malignant potential. We present a case that occurred in a patient with bone marrow transplantation.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 38-year-old female ex-smoker was diagnosed with acute leukemia and treated with chemotherapy, radiotherapy and subsequently received allogeneic bone marrow transplantation from an unrelated HLA-identical donor. After the procedure, she developed cutaneous and pulmonary graft-versus-host disease and repeated respiratory infections. She was admitted for hemoptysis of approximately 50<span class="elsevierStyleHsp" style=""></span>cm,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> with no clinical symptoms of infection. She had very mild leukocytosis, mild hypoxemia and increased density in the left lower lobe. Chest CT scan revealed occupation of the segmental bronchi in the left lung base (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Bronchoscopy showed a highly vascularized endobronchial mass with whitish plaques. The biopsies did not reveal malignancy. After endobronchial laser resection, the biopsy was reported to be adenocarcinoma with mucinous areas, of pulmonary origin. Immunohistochemistry was positive for cytokeratin 7 (CK7) and carcinoembryonic antigen. Left lower lobectomy with mediastinal lymphadenectomy was performed by video-assisted thoracoscopy. A brown 3-cm endobronchial polypoid lesion with preserved bronchial epithelium lining was identified. There was involvement of the bronchial wall, but no extension beyond it. There was no infiltration into the lung parenchyma or vascular bundle. The growth pattern was glandular, with abundant mucoid material. No mitosis, nuclear pleomorphism, or necrosis were observed. Neoplastic cellularity was CK7-positive, while thyroid transcription factor-1 and chromogranin were negative, with isolated positivity for p63. The final diagnosis was low-grade endobronchial mucoepidermoid carcinoma, with a free surgical margin and hilar nodes with no neoplastic involvement. The patient continues to be followed up with regular visits, and no tumor recurrence has been detected to date.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">MEC is an epithelial tumor with low malignant potential (5-year survival greater than 95%) composed of squamous, mucinous and intermediate cells. It usually originates in the salivary glands, but can be found in the lacrimal sac, sinonasal tract, larynx, thyroid and bronchi.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> MEC is rare (0.1–0.2% of all lung tumors) and over 50% of cases are detected in patients younger than 30 years.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> It is not related to tobacco smoking. Because of its typical endobronchial location, MEC may cause nonspecific symptoms of obstruction or infection. Peripheral lesions are usually infrequent and asymptomatic. Bronchoscopy is the most useful diagnostic test, although histological type may be difficult to establish. From a histological and immunohistochemistry point of view, MEC is similar to the neoplasm originating in the salivary glands.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The degree of malignancy is based on the cellular activity and the presence of mitosis, and prognosis is determined by locoregional and distant invasion. MEC of high-grade malignancy usually occurs in older patients.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The treatment of choice is surgery, and more conservative surgery may be performed in the case of lesions with low malignant potential when respiratory capacity is reduced.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Adjuvant therapy is considered unnecessary, although some authors suggest radiotherapy and/or chemotherapy in the case of lymph node invasion or high-grade tumors.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Follow-up is recommended due to the possibility of metastasis or relapse.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Somiedo Gutiérrez MdV, Girón Moreno R, Moreno Balsalobre R. Tumor mucoepidermoide en paciente trasplantada de médula ósea. Arch Bronconeumol. 2014;50:125.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 767 "Ancho" => 976 "Tamanyo" => 88982 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest computed axial tomography slice showing an occupation of the segmental and some subsegmental bronchi by soft tissue in the left lung base, probably related to endobronchial tumor disease.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mucoepidermoid carcinoma of the lung in a 6-year-old boy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P. 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Adams" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1043/1543-2165(2007)131[1400:MCOTBA]2.0.CO;2" "Revista" => array:6 [ "tituloSerie" => "Arch Pathol Lab Med" "fecha" => "2007" "volumen" => "131" "paginaInicial" => "1400" "paginaFinal" => "1404" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17824797" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mucoepidermoid carcinoma of the lung: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Kitada" 1 => "Y. Matsuda" 2 => "K. Sato" 3 => "S. Hayashi" 4 => "K. Ishibashi" 5 => "N. Miyokawa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1749-8090-6-132" "Revista" => array:5 [ "tituloSerie" => "J Cardiothorac Surg" "fecha" => "2011" "volumen" => "6" "paginaInicial" => "132" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21985459" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Carcinoma mucoepidermoide pulmonar. Grado histológico y comportamiento" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Blanco" 1 => "A. Ginel" 2 => "J. Sánchez" 3 => "M. Torres" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Neumosur" "fecha" => "2000" "volumen" => "12" "paginaInicial" => "131" "paginaFinal" => "134" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005000000003/v1_201403120155/S1579212914000408/v1_201403120155/en/main.assets" "Apartado" => array:4 [ "identificador" => "14576" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005000000003/v1_201403120155/S1579212914000408/v1_201403120155/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212914000408?idApp=UINPBA00003Z" ]
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| 2017 December | 48 | 8 | 56 |
| 2017 November | 28 | 3 | 31 |
| 2017 October | 24 | 7 | 31 |
| 2017 September | 30 | 5 | 35 |
| 2017 August | 46 | 9 | 55 |
| 2017 July | 43 | 9 | 52 |
| 2017 June | 47 | 6 | 53 |
| 2017 May | 32 | 3 | 35 |
| 2017 April | 33 | 6 | 39 |
| 2017 March | 25 | 9 | 34 |
| 2017 February | 12 | 1 | 13 |
| 2017 January | 14 | 4 | 18 |
| 2016 December | 28 | 9 | 37 |
| 2016 November | 42 | 8 | 50 |
| 2016 October | 34 | 10 | 44 |
| 2016 September | 37 | 10 | 47 |
| 2016 August | 41 | 7 | 48 |
| 2016 July | 25 | 7 | 32 |
| 2016 March | 3 | 0 | 3 |
| 2015 December | 3 | 0 | 3 |
| 2015 October | 36 | 2 | 38 |
| 2015 September | 33 | 6 | 39 |
| 2015 August | 33 | 10 | 43 |
| 2015 July | 34 | 2 | 36 |
| 2015 June | 35 | 7 | 42 |
| 2015 May | 40 | 8 | 48 |
| 2015 April | 31 | 7 | 38 |
| 2015 March | 32 | 5 | 37 |
| 2015 February | 17 | 1 | 18 |
| 2015 January | 26 | 3 | 29 |
| 2014 December | 24 | 4 | 28 |
| 2014 November | 22 | 7 | 29 |
| 2014 October | 37 | 7 | 44 |
| 2014 September | 32 | 10 | 42 |
| 2014 August | 34 | 16 | 50 |
| 2014 July | 24 | 7 | 31 |
| 2014 June | 47 | 15 | 62 |
| 2014 May | 2 | 1 | 3 |
| 2014 April | 0 | 1 | 1 |
| 2014 March | 0 | 2 | 2 |
Show all
