Difference between revisions of "Nasopharyngeal carcinoma"

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#redirect [[Head_and_neck_pathology#Nasopharyngeal_carcinoma]]
'''Nasopharyngeal carcinoma''', abbreviated '''NPC''', is malignant epithelial tumour of the [[Head and neck pathology|head and neck]] closely related to [[squamous cell carcinoma]].


==General==
*"Nasopharyngeal carcinoma" is the name of an entity - it is not a descriptive term.
*Strong association with [[Epstein-Barr virus]] (EBV).
Note:
*A morphologically identical tumour elsewhere is called ''[[lymphoepithelioma-like carcinoma]]''.
==Gross==
*Nasopharynx - as the name would suggest.
==Microscopic==
Features:<ref name=Ref_Klatt145>{{Ref Klatt|145}}</ref>
*Prominent lymphoid component - '''key feature'''.
*Features of squamous cell carcinoma:
**Cohesive cells with:
***Abundant dense eosinophilic cytoplasm.
***Central nuclei +/- small/indistinct nucleoli.
===Images===
<gallery>
Image:Lymphoepithelioma_met_to_LN_4.jpg | Nasopharyngeal carcinoma - in a LN - low mag. (WC)
Image:Lymphoepithelioma_met_to_LN_6.jpg | Nasopharyngeal carcinoma - in a LN - intermed. mag. (WC)
Image:Lymphoepithelioma_met_to_LN_2.jpg | Nasopharyngeal carcinoma - in a LN - high mag. (WC)
</gallery>
===Histologic subclassification===
World Health Classification (2005) for NPC:<ref name=Ref_WMSP39>{{Ref WMSP|39}}</ref>
{| class="wikitable"
! Type
! Histology
! Description
! EBV
! Prevalence
! Prognosis
|-
| 1
| keratinizing SCC
| graded poorly-well-diff.
| -ve
| ?
| bad
|-
| 2a
| nonkeratinizing carcinoma, differentiated
| well def. cell borders & tumour nest borders, mimics appearance of [[UCC]]
| +ve
| ?
| good
|-
| 2b
| nonkeratinizing carcinoma, undifferentiated
| sheets/syncytial, vescicular nuclei, prominent nucleoli, pink cytoplasm
| ?
| most common
| ?
|-
| 3
| basaloid SCC
| mimics BCC - see [[basaloid SCC]]
| ?
| least common
| ?
|}
How to remember ''KNUB'':
*'''K'''eratinizing, '''N'''on-keratinizing diff., non-keratinizing '''U'''ndiff., '''B'''asaloid SCC.
==IHC==
*EBER +ve.
*p16 -ve.<ref name=pmid9546345>{{cite journal |author=Gulley ML, Nicholls JM, Schneider BG, Amin MB, Ro JY, Geradts J |title=Nasopharyngeal carcinomas frequently lack the p16/MTS1 tumor suppressor protein but consistently express the retinoblastoma gene product |journal=Am. J. Pathol. |volume=152 |issue=4 |pages=865–9 |year=1998 |month=April |pmid=9546345 |pmc=1858242 |doi= |url=}}</ref>
Notes:
*[[HPV-associated head and neck squamous cell carcinoma]]s are p16 +ve.<ref name=pmid21484924>{{Cite journal  | last1 = Singhi | first1 = AD. | last2 = Califano | first2 = J. | last3 = Westra | first3 = WH. | title = High-risk human papillomavirus in nasopharyngeal carcinoma. | journal = Head Neck | volume = 34 | issue = 2 | pages = 213-8 | month = Feb | year = 2012 | doi = 10.1002/hed.21714 | PMID = 21484924 }}</ref>
==See also==
*[[Head and neck pathology]].
==References==
{{Reflist|2}}
[[Category:Head and neck pathology]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]

Revision as of 15:33, 23 February 2014

Nasopharyngeal carcinoma, abbreviated NPC, is malignant epithelial tumour of the head and neck closely related to squamous cell carcinoma.

General

  • "Nasopharyngeal carcinoma" is the name of an entity - it is not a descriptive term.
  • Strong association with Epstein-Barr virus (EBV).

Note:

Gross

  • Nasopharynx - as the name would suggest.

Microscopic

Features:[1]

  • Prominent lymphoid component - key feature.
  • Features of squamous cell carcinoma:
    • Cohesive cells with:
      • Abundant dense eosinophilic cytoplasm.
      • Central nuclei +/- small/indistinct nucleoli.

Images

  • Nasopharyngeal carcinoma - in a LN - low mag. (WC)

  • Nasopharyngeal carcinoma - in a LN - intermed. mag. (WC)

  • Nasopharyngeal carcinoma - in a LN - high mag. (WC)

Histologic subclassification

World Health Classification (2005) for NPC:[2]

Type Histology Description EBV Prevalence Prognosis
1 keratinizing SCC graded poorly-well-diff. -ve ? bad
2a nonkeratinizing carcinoma, differentiated well def. cell borders & tumour nest borders, mimics appearance of UCC +ve ? good
2b nonkeratinizing carcinoma, undifferentiated sheets/syncytial, vescicular nuclei, prominent nucleoli, pink cytoplasm ? most common ?
3 basaloid SCC mimics BCC - see basaloid SCC ? least common ?

How to remember KNUB:

  • Keratinizing, Non-keratinizing diff., non-keratinizing Undiff., Basaloid SCC.

IHC

  • EBER +ve.
  • p16 -ve.[3]

Notes:

See also

References

  1. ↑ Klatt, Edward C. (2006). Robbins and Cotran Atlas of Pathology (1st ed.). Saunders. pp. 145. ISBN 978-1416002741.
  2. ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 39. ISBN 978-0781765275.
  3. ↑ Gulley ML, Nicholls JM, Schneider BG, Amin MB, Ro JY, Geradts J (April 1998). "Nasopharyngeal carcinomas frequently lack the p16/MTS1 tumor suppressor protein but consistently express the retinoblastoma gene product". Am. J. Pathol. 152 (4): 865–9. PMC 1858242. PMID 9546345. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1858242/.
  4. ↑ Singhi, AD.; Califano, J.; Westra, WH. (Feb 2012). "High-risk human papillomavirus in nasopharyngeal carcinoma.". Head Neck 34 (2): 213-8. doi:10.1002/hed.21714. PMID 21484924.
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