{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T06:21:05Z","timestamp":1792995665824,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T00:00:00Z","timestamp":1666915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>Mucoepidermoid carcinoma (MEC) is historically defined by a mix of squamoid, intermediate, and mucous cells, but we have recently encountered several cases lacking immunoreactivity for squamous markers p40, p63, and CK5\/6 despite <jats:italic>MAML2<\/jats:italic> fusions. This study will characterise these unique tumours. Ten MEC were collected arising from the parotid gland (<jats:italic>n<\/jats:italic>\u00a0=\u00a04), submandibular gland (<jats:italic>n<\/jats:italic>\u00a0=\u00a02), nasopharynx (<jats:italic>n<\/jats:italic>\u00a0=\u00a01), base of tongue (<jats:italic>n<\/jats:italic>\u00a0=\u00a01), bronchus (<jats:italic>n<\/jats:italic>\u00a0=\u00a01), and trachea (<jats:italic>n<\/jats:italic>\u00a0=\u00a01). Six tumours were low\u2010grade, two intermediate\u2010grade, one high\u2010grade, and one demonstrated low\u2010grade areas with high\u2010grade transformation. Four cases were oncocytic, four had clear\u2010cell features, two had spindle cell features, and one high\u2010grade MEC had prominent solid, cord\u2010like, and micropapillary features. The tumours were negative for p40 (10\/10), p63 (10\/10), and CK5\/6 (9\/9). Targeted RNA sequencing demonstrated <jats:italic>CRTC1::MAML2<\/jats:italic> in five cases, <jats:italic>CRTC3::MAML2<\/jats:italic> in two, and a novel <jats:italic>MAML2::CEP126<\/jats:italic> in the unusual high\u2010grade case. In two cases with insufficient RNA, <jats:italic>MAML2<\/jats:italic> fluorescence <jats:italic>in\u00a0situ<\/jats:italic> hybridisation (FISH) showed rearrangement. Genetically\u2010confirmed MEC may lack overt squamous differentiation by histology and immunohistochemistry. While most cases harboured canonical fusions and fit within the spectra of MEC variants with oncocytic, clear cell, and\/or spindle cell features, one had a novel <jats:italic>MAML2::CEP126<\/jats:italic> fusion and unusual morphology. In MEC without squamoid cells, the use of immunohistochemistry may hinder, rather than aid, the correct diagnosis. In such cases, <jats:italic>MAML2<\/jats:italic> analysis is most useful. The historical definition of MEC as a carcinoma with squamoid, intermediate and mucous cells should be revisited.<\/jats:p>","DOI":"10.1111\/his.14817","type":"journal-article","created":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T08:05:17Z","timestamp":1665216317000},"page":"305-313","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Mucoepidermoid carcinoma may be devoid of squamoid cells by immunohistochemistry: expanding the histologic and immunohistochemical spectrum of <i>MAML2<\/i>\u2010 rearranged salivary gland tumours"],"prefix":"10.1111","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0412-6810","authenticated-orcid":false,"given":"Justin A","family":"Bishop","sequence":"first","affiliation":[{"name":"Department of Pathology UT Southwestern Medical Center  Dallas TX 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University School of Medicine  St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca D","family":"Chernock","sequence":"additional","affiliation":[{"name":"Department of Pathology and Immunology Washington University School of Medicine  St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5636-9753","authenticated-orcid":false,"given":"Lisa M","family":"Rooper","sequence":"additional","affiliation":[{"name":"Department of Pathology The Johns Hopkins Hospital  Baltimore MD 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