• 대한세포병리학회지
• /
• 제13권1호
• /
• pp.28-32
• /
• 2002

Malignant myoepithelioma (myoepithelial carcinoma), is a very rare malignant epithelial accounting for less than 1% of all salivary gland tumors and has an intermediate malignant potential. We report a case of malignant myoepithelioma arising in the left parotid giand in a 54-year-old man, which was difficult to differentiate from pleomorphic adenoma and other malignant salivary gland neoplasms. Fine needle aspiration cytology of the parotid gland showed cellular smear, composed of overlapped sheets and clusters or individually scattered tumor cells without any acinic or ductal structures. The tumor cells were rather uniform, with distinct cell borders and moderate amount of cytoplasm. The eccentrically located nuclei were oval to round and pleomorphic and showed prominent nucleoli. A few clear cells were noted in the cellular aggregates Metachromatic matrix was seen between individual tumor cells in a lacelike fashion, resembling pleomorphic adenoma. According to the immunohistochemical staining, we recognized that the component cells are myoeplthelial in nature, showing reactivity for the S-100 protein, vimentin, and actin.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제31권1호
• /
• pp.71-76
• /
• 2009

Benign myoepithelioma (BME) and malignant myoepithelioma (MME) of the salivary gland are very rare and its biologic behavior has not been clarified fully. Although, cases reports for BME and MME were increased in recent, their diagnostic criteria were not completely established. We describe herein a case of BME of the parotid gland and a case of MME of the palatal minor gland, respectively. Histologically, multinodular growth pattern, infiltration to adjacent tissues, and hyalinized and myxoid matrix were observed in MME, that were different histologic features compared with BME. Strong immunoreactivities for the S-100 protein and vimentin were detected in the tumor cells of BME and MME. In specimen of MME, moderately expressed p53 and strongly expressed p63 were detected. However, in specimen of BME, p53 was negatively and p63 was weakly expressed, respectively. In conclusion, the expression patterns of p53 and p63 as well as histologic aggressiveness might be used to diagnose the MME.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제18권1호
• /
• pp.115-119
• /
• 1996

Myoepithelioma is composed exclusively of myoepithelial cells. Myoepithelial cells are ectodermally derived contractile cells that can be routinely identified in many normal tissues having secretory function such as major and minor salivary glands, lacrimal gland and sweat gland. Tumors composed exclusively of myoepithelial cells, so-called myoepitheliomas, are rare-less than 1% of all salivary gland tumors. Grossly, these tumors are well demarcated. The external surface is smooth and may be bosselated. The cut surface is white and homogenous. Microscopically, these tumors are surrounded by a thin fibrous capsule. They are composed of benign-appearing spindle- shaped and/or polygonal cells. Mitoses are rare. Frequently these tumors contain myxomatous stroma which is susceptible to alcial blue stain. Clinically, myoepitheliomas present as slow-glowing, painless masses and can not distinguished from pleomorphic adenomas. Treatment is the same as for pleomorphic adenoma, and the surgical excision should include a margin of normal tissue. Although the majority of myoepitheliomas have behaved in a beingn manner, pleomorphism and mitotic activity have been associated with local aggressiveness.

• 대한골관절종양학회지
• /
• 제20권2호
• /
• pp.54-59
• /
• 2014

목적: 사지에 발생한 연부 조직 악성 근상피종의 진단, 치료 및 예후에 대하여 알아보고자 하였다. 대상 및 방법: 2008년 1월부터 2014년 10월까지 연부 조직 악성 근상피종으로 진단받고 본원에서 치료받은 6명의 환자를 대상으로 하였다. 2명의 환자는 타원에서 조직 검사 없이 무계획 절제술(unplanned excision)을 시행받은 이후 본원으로 전원되었으며, 나머지 4명의 환자는 모두 본원에서 조직 검사 및 광범위 절제술을 시행받았다. 결과: 평균 연령은 41세(33-54)였고, 남자가 3예, 여자가 3예였으며 평균 추시 기간은 28개월(9-45)이었다. 1명의 환자에서만 술 후 항암요법을 시행하였다. 연구 대상 환자 중 4명만이 악성 연부 조직 종양 의심하에 조직 검사 후 광범위 절제술을 시행하였다. 본원에서 광범위 절제술을 시행한 환자 4명은 모두 절제연에 종양 세포가 관찰되지 않았다. 무계획 절제술 이후 전원된 환자 2명 모두 본원에서 재절제술 시행받았으며, 이중 한명은 재절제술 병리 조직에서 잔존하는 종양 세포는 관찰되지 않았다. 6명의 환자 모두에게서 수술 후 평균 6개월(3-29)에 국소 재발 소견이 관찰되었고 4명의 환자에서는 수술 후 평균 7개월(3-14)에 원격 전이도 관찰되었다. 원격 전이가 발생한 4명의 환자는 모두 질병으로 인하여 사망하였고, 국소 재발만 발생한 2명의 환자중 1명은 환자는 재발하여 추시 관찰 중이며 나머지 1명의 환자는 재수술후 2년간 재발이나 전이 없이 경과 관찰 중이다. 결론: 연부 조직 악성 근상피종은 극히 드물게 발병하는 질환으로 재발과 전이를 잘 하는 공격적인 악성 연부 조직 종양으로 적절한 치료법으로는 광범위 절제술이 권장되며, 국소 재발을 줄이기 위해서는 악성 연부 조직 종양일 가능성을 염두에 두고 반드시 술 전 조직 검사를 하여 악성임을 확인하고 이후 계획된 광범위 절제술을 시행하는 것이 중요하다고 생각된다.

• Imaging Science in Dentistry
• /
• 제50권1호
• /
• pp.73-79
• /
• 2020

Computed tomography (CT) and magnetic resonance imaging (MRI) can be useful for the evaluation of palatal lesions, and strain elastography (performed together with intraoral ultrasonography) is a relatively new sonographic imaging modality. This report describes 2 clinical cases in which strain elastography was used to assess palatal tumors in conjunction with intraoral ultrasonography, CT, and MRI. In the first case, diagnosed as a myoepithelioma, the strain was determined to be 0.000% (strain of normal tissue, 0.556%). In the second case, diagnosed as an adenoid cystic carcinoma, the determined strain was 0.000% (strain of normal tissue, 1.077%). Therefore, we conclude that intraoral strain elastography can be useful for evaluating palatal lesions.

• Archives of Plastic Surgery
• /
• 제39권2호
• /
• pp.158-161
• /
• 2012

Myopericytoma is a benign tumor that is composed of myoid-appearing oval to spindle-shaped cells with a concentric perivascular pattern of growth. The tumor is morphologically heterogeneous and can exhibit a broad histologic spectrum. We describe a case of multiple myopericytoma occurring in the head and neck skin region with involvement of the parotid gland where it is known to occur very rarely. A 40-year-old woman noticed multiple enlarging, painless, round-shaped masses on her left cheek. The patient had experienced a similar lesion of the same area 8 years earlier which was completely excised and the pathological diagnosis was spindle cell type myoepithelioma. On a computed tomographic image, one mass involved the superficial parotid gland and was well encapsulated. Excision of the facial masses and superficial parotidectomy with facial nerve preservation were performed. A diagnosis of myopericytoma was established in light of the immunohistochemical pattern with the histopathological findings. Over the 4-year follow-up period, there was no evidence of recurrence. As many perivascular myoid neoplasms share common morphologic features with myopericytoma, we should consider the differential diagnosis, and confirm the histological findings with appropriate immunohistochemical staining. After identifying myopericytoma, it should be treated with wide surgical excision to prevent local recurrence.

• 대한세포병리학회지
• /
• 제4권2호
• /
• pp.111-120
• /
• 1993

Fine needle aspiration cytology has become a frequently used technique for the diagnosis of lesions in the head and neck. Fine needle aspiration cytology of the salivary glands were performed on 66 patients. In 59 patients with satisfactory samples, cytologic diagnoses were as follows; there were 47 benign lesions, including pleomorphic adenoma(20), Warthin's tumor(3), benign cystic lesion(4), Inflammatory lesion(4), lymphoid lesion(3), myoepithelioma(1), unspecified benign neoplasm (5), and unclassified benign lesion(7). There were 6 cases of undetermined malignancy and 6 malignant lesions including mucoepidermoid carcinoma(3), adenoid cystic carcinoma(1), carcinoma ex pleomorphic adenoma(1), and metastatic carcinoma(1) in cytologic diagnosis. In 25 patients, the cytologic diagnosis was correlated with histologic findings. The sensitivity of the benign lesion was 96% and the specificity was 82%. There was no false-positive diagnosis. The sensitivity and the specificity of pleomorphic adenoma were 75% and 95%, respectively. Some of Warthin's tumors were confused with benign cystic lesion due to frequent cystic change of the tumor. The sensitivity and specificity of the malignant lesions were 56% and 88%, respectively. There were three false negative diagnoses. Two mucoepidermoid carcinomas were correctly diagnosed by cytology. Two of three adenoid cystic carcinomas were misdiagnosed as benign tumors.

• 대한두경부종양학회지
• /
• 제18권1호
• /
• pp.56-59
• /
• 2002

Background and Objective: Even though major salivary gland tumor is a rare disease, the diversity of histopathologic characteristics makes treatment decisions difficult. The aim of this study is to analysis the clinical experience of our major salivary gland tumor and to suggest a guideline of treatment. Materials and Method: Sixty-eight major salivary gland tumors and tumor-like glandular enlargements treated at Sanggye Paik Hospital during the past seven years between June, 1995 and January, 2002 are analyzed for histopathologic diagnosis, treatment modality, clinical manifestation, local control, and treatment-related morbidity, recurrence rate, retrospectively. Results: In twenty-eight patients the swellings were diagnosed as non-tumorous condition. The clinical features, diagnostic and surgical management of fourty salivary neoplasms involving the parotid and submandibular glands are correlated with their histological features. Conclusion: We have concluded that salivary gland neoplasms are needed multimodal treatment, because of their highly variable biologic behavior in each tumor type. Thirty-four cases were benign and six cases were malignant. Most of benign cases were pleomorphic adenoma and they showed wide age-distribution. In six malignant cases, there were acinic cell carcinoma, adenocarcinoma, carcinoma ex-plemorphic adenoma, myoepithelioma, and adenoid cystic carcinoma.

• 대한수의학회지
• /
• 제15권1호
• /
• pp.27-38
• /
• 1975

개에 자연발생(自然發生)한 다음과 같은 종양(腫瘍)을 수집(蒐集)하여, 그 육안적(肉眼的) 및 조직학적(組織學的) 소견(所見)을 검토(檢討)하고, 이에 관(關)한 간단한 고찰(考察)을 가(加)했다. 피부(皮膚) 및 피하직(皮下織)의 종양(腫瘍) : 섬유종(纖維腫), 지방종(脂肪腫), 표피성(表皮性) 낭종(囊腫), 흑색육종(黑色肉腫), 한선종(汗腺腫), 비만세포종(肥滿細胞腫)(2예(例)), 비만세포육종(肥滿細胞肉腫), 피지선암종(皮脂腺癌腫). 비장(脾臟) 및 임파절(淋巴節)의 종양(腫瘍) : 비피막(脾被膜)의 섬유육종(纖維肉腫), 비(脾)의 평활근육종(平滑筋肉腫), 임파절(淋巴節)의 임파육종(淋巴肉腫)(2예(例)). 폐장(肺臟)의 종양(腫瘍) : 기관지성암종(氣管枝性癌腫)(3예(例)), 각각(各各) 선암종형(腺癌腫型), 편평세포암종형(扁平細胞癌腫型) 및 미분화세포(未分化細胞)(원형(圓形))암종형(癌腫型). 소화관(消化管) 및 간장(肝臟)의 종양(腫瘍) : 위(胃)의 섬유종(纖維腫), 간(肝)의 혈관종(血管腫), 담관암종(膽管癌腫), 간세포암종(肝細胞癌腫), 간(肝)에 출현(出現)한 골수성백혈세포세포(骨髓性白血細胞細胞). 복막(腹膜)의 종양(腫瘍) : 섬유육종(纖維肉腫). 비뇨생식계(泌尿生殖系)의 종양(腫瘍) : 자궁(子宮)의 섬유종(纖維腫), 난소(卵巢)의 난포낭종(卵胞囊腫), 질(膣)의 전염성(傳染性) 성기종(性器腫)(6예(例)), 신암종(腎癌腫), 섭호선종(攝護腺腫)(2예(例)), 포피(包皮)의 섬유종(纖維腫), 고환(睾丸)의 정충종(精蟲腫). 유선(乳腺)의 종양(腫瘍) : 혼합종(混合腫)(2예(例)), 근상피종(筋上皮腫). 신경계(神經系)의 종양(腫瘍) : 대퇴부(大腿部)의 신경섬유육종(神經纖維肉腫).

• 치위생과학회지
• /
• 제8권3호
• /
• pp.207-214
• /
• 2008

본 연구는 구강내 발생하는 소타액선 종양의 발생 빈도와 조직병리학적 특성에 대한 후향적 연구로서 한국인에서 나타나는 소타액선 종양의 특성을 연구하고자 1990년부터 2006년 8월까지 연세대학교 치과대학 부속병원 구강악안면외과, 연세대학교 의과대학 부속 영동 세브란스병원, 순천향대학교 부속 부천병원에 내원한 200명의 소타액선 종양 환자를 대상으로 치과 및 의과 임상 기록지 검토와 H/E 슬라이드를 재검토하여 다음과 같은 결론을 얻었다. 1. 200명의 환자 중 양성 종양은 123예(61.5%), 악성종양은 77예(38.5%)였으며 남성에서는 87예, 여성에서는 113예였다. 2. 가장 흔하게 발생한 소타액선 종양은 다형성 선종이며 선양 낭성 암종, 점액표피암종, 와틴씨 종양, 선암종과 다형성 선종에서 발생한 악성 종양, 림프관종 등의 순이었다. 3. 호발 부위는 경구개(42.5%), 연구개(9%), 협점막(6%), 입술(3.5%) 부위였다. 4. 발생 연령은 4세부터 70세까지 다양하게 분포하였으며 50대에서 가장 많았다. 양성 종양의 발생 평균 연령은 46.2세였으며 악성 종양의 발생 평균 연령이 56.1세였다. 5. 다형성 선종은 가장 호발한 소타액선 종양으로서 모두 104예였으며 남성 38명, 여성 66명에서 발생하였다. 평균 발생 연령은 46.7세였으며 구개 부위에서 가장 많이 발생하였다. 조직학적 소견은 관 구조 형성, 별 모양, 다각형, 방추형, 형질세포양(plasmacytoid), 연골양, 점액양 구조를 보였으며 불완전한 피막과 종양 피막을 뚫고 다발성으로 발생하는 소견이 관찰되었다. 6. 선양 낭성 암종은 가장 호발한 악성 타액선 종양으로 모두 32예였으며 남성 16명, 여성 16명에서 발생하였다. 평균 발생 연령은 57.4세였으며 경구개 부위에서 가장 많이 발생하였다. 조직학적 소견은 cribriform pattern, 관상 구조, 판상 구조 형성, 종양 세포의 신경 주위 침습 등을 보였다. 7. 점액표피암종은 모두 25예였으며 남성 10명, 여성 15명에서 발생하였다. 평균 발생 연령은 50.0세였으며 경구개 부위에서 가장 많이 발생하였다. 조직학적 소견은 점액 세포, epidermoid-type 세포, intermediate cell의 분포가 대부분 저등급을 보였다. 이외에도 와틴씨 종양, 선암종과 다형성 선종에서 발생한 악성종양, 림프관종 등이 발생하였다. 8. 한국인의 소타액선 종양의 발생 빈도는 양성 종양이 높으며 특히 다형성 선종이 많았고 여성 발생, 구개 부위 발생이 많았으며 다형성 저등급 선암종 등 특정 소타액선 종양의 발생이 극히 적었다.