{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:55:21Z","timestamp":1789588521995,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T00:00:00Z","timestamp":1639440000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["21H02704"],"award-info":[{"award-number":["21H02704"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["21K06891"],"award-info":[{"award-number":["21K06891"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate the histological diversity of salivary mucoepidermoid carcinoma (MEC), its clinicopathological features, and its associations with <jats:italic>CRTC1<\/jats:italic>\/<jats:italic>3<\/jats:italic>\u2010<jats:italic>MAML2<\/jats:italic> fusions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Salivary MEC cases (<jats:italic>n<\/jats:italic>\u2009=\u2009177) were examined for <jats:italic>CRTC1<\/jats:italic>\/<jats:italic>3<\/jats:italic>\u2010<jats:italic>MAML2<\/jats:italic> fusions, histological variants were classified, and tumours were graded according to four different grading systems. Adverse histological features considered to be unusual in MEC were also investigated. Of the 177 MEC cases, 110 were positive for <jats:italic>CRTC1<\/jats:italic>\/<jats:italic>3\u2010MAML2<\/jats:italic> fusions. The classical variant was the most frequent in the fusion\u2010positive case group, the fusion\u2010negative case group, and the total case group. The clear\/oncocytic variant was the second most frequent in the fusion\u2010positive and total case groups. Oncocytic, Warthin\u2010like and spindle variants were seen in the fusion\u2010positive case group only. Clear cell, sclerosing, mucinous and central variants were seen in both the fusion\u2010positive case group and the fusion\u2010negative case group. No case was classified as a ciliated variant, as a mucoacinar variant, or as a high\u2010grade transformation. As compared with the classical variant, non\u2010classical variants were characterised by frequent <jats:italic>CRTC1<\/jats:italic>\/<jats:italic>3\u2010MAML2<\/jats:italic> fusions and a low clinical stage in all cases. Of the four histological features considered to be unusual in MEC, marked nuclear atypia, frequent mitoses (&gt;10\/10 high\u2010power fields) and extensive necrosis were found independently of the fusion status, and were present in 3\u20135% of all cases. However, none of the cases showed overt keratinisation. On comparison, the Armed Forces Institute of Pathology and modified Healey grading systems downgraded tumours, the Brandwein system upgraded tumours, and the Memorial Sloan Kettering system provided a moderate means of assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Recognition of the histological diversity of MEC, its clinicopathological features and its associations with <jats:italic>CRTC1<\/jats:italic>\/<jats:italic>3<\/jats:italic>\u2010<jats:italic>MAML2<\/jats:italic> fusions is helpful for an accurate diagnosis of this carcinoma.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.14586","type":"journal-article","created":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T03:49:49Z","timestamp":1634615389000},"page":"729-735","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Salivary mucoepidermoid carcinoma: histological variants, grading systems, <i>CRTC1\/3\u2010MAML2<\/i> fusions, and clinicopathological features"],"prefix":"10.1111","volume":"80","author":[{"given":"Satsuki","family":"Nakano","sequence":"first","affiliation":[{"name":"Department of Pathology and Molecular Diagnostics Graduate School of Medical Sciences Nagoya City University Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihide","family":"Okumura","sequence":"additional","affiliation":[{"name":"Department of Pathology and Molecular Diagnostics Graduate School of Medical Sciences Nagoya City University Nagoya Japan"},{"name":"Department of Maxillofacial Surgery School of Dentistry Aichi\u2010Gakuin University Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Murase","sequence":"additional","affiliation":[{"name":"Department of Pathology and Molecular Diagnostics Graduate School of Medical Sciences Nagoya City University Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshitaka","family":"Nagao","sequence":"additional","affiliation":[{"name":"Department of Anatomic Pathology Tokyo Medical University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5315-2540","authenticated-orcid":false,"given":"Kimihide","family":"Kusafuka","sequence":"additional","affiliation":[{"name":"Department of Pathology Shizuoka General Hospital Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Urano","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Fujita Health University School of Medicine Bantane Hospital Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9148-6445","authenticated-orcid":false,"given":"Hidetaka","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Anatomic Pathology Graduate of School of Medical Science Kyushu University Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kano","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Faculty of Medicine and Graduate School of Medicine Hokkaido University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoaki","family":"Tsukahara","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Tokyo Medical University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Okami","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Tokai University School of Medicine Isehara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Kawakita","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Graduate School of Medical Sciences Nagoya City University Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Nagao","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery School of Dentistry Aichi\u2010Gakuin University Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Hanai","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Aichi Cancer Center Hospital Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Iwai","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Kansai Medical University Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Kawata","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Osaka 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