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Difference between revisions of "Nasopharyngeal carcinoma"
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = | | Image = Nasopharyngeal carcinoma - alt -- high mag.jpg | ||
| Width = | | Width = | ||
| Caption = Nasopharyngeal carcinoma. [[H&E stain]]. | | Caption = Nasopharyngeal carcinoma. [[H&E stain]]. | ||
| Synonyms = | | Synonyms = nasopharyngeal-type undifferentiated carcinoma, non-keratining nasopharyngeal carcinoma undifferentiated type | ||
| Micro = Cohesive typical (squamoid) cells (abundant dense eosinophilic cytoplasm, central nuclei +/- small/indistinct nucleoli), prominent lymphoid component | | Micro = Cohesive typical (squamoid) cells (abundant dense eosinophilic cytoplasm, central nuclei +/- small/indistinct nucleoli), prominent lymphoid component | ||
| Subtypes = keratinizing SCC; nonkeratinizing carcinoma, differentiated; nonkeratinizing carcinoma, undifferentiated; basaloid SCC | | Subtypes = keratinizing SCC; nonkeratinizing carcinoma, differentiated; nonkeratinizing carcinoma, undifferentiated; basaloid SCC | ||
| LMDDx = [[HPV-associated head and neck squamous cell carcinoma]], [[squamous cell carcinoma of the head and neck]] | | LMDDx = [[HPV-associated head and neck squamous cell carcinoma]], [[squamous cell carcinoma of the head and neck]], [[sinonasal undifferentiated carcinoma]] (SNUC) | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = p16 -ve, LMP-1 -ve/+ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = [[EBER]] +ve | ||
| IF = | | IF = | ||
| Gross = | | Gross = | ||
| Line 55: | Line 55: | ||
***Abundant dense eosinophilic cytoplasm. | ***Abundant dense eosinophilic cytoplasm. | ||
***Central nuclei +/- small/indistinct nucleoli. | ***Central nuclei +/- small/indistinct nucleoli. | ||
Note: | |||
*May be keratinizing or nonkeratinizing<ref name=pmid10594290>{{Cite journal | last1 = Wenig | first1 = BM. | title = Nasopharyngeal carcinoma. | journal = Ann Diagn Pathol | volume = 3 | issue = 6 | pages = 374-85 | month = Dec | year = 1999 | doi = 10.1053/ADPA00300374 | PMID = 10594290 }}</ref> and the distinction is important - see classification below. | |||
DDx: | DDx: | ||
*[[HPV-associated head and neck squamous cell carcinoma]]. | *[[HPV-associated head and neck squamous cell carcinoma]]. | ||
*[[Squamous cell carcinoma of the head and neck]]. | *[[Squamous cell carcinoma of the head and neck]]. | ||
*[[Sinonasal undifferentiated carcinoma]] (SNUC). | |||
===Images=== | ===Images=== | ||
====Case 1==== | |||
<gallery> | |||
Image: Nasopharyngeal carcinoma -- extremely low mag.jpg | NPC - very low mag. (WC) | |||
Image: Nasopharyngeal carcinoma -- very low mag.jpg | NPC - very low mag. (WC) | |||
Image: Nasopharyngeal carcinoma -- low mag.jpg | NPC - low mag. (WC) | |||
Image: Nasopharyngeal carcinoma -- intermed mag.jpg | NPC - intermed. mag. (WC) | |||
Image: Nasopharyngeal carcinoma -- high mag.jpg | NPC - high mag. (WC) | |||
Image: Nasopharyngeal carcinoma - alt -- high mag.jpg | NPC - high mag. (WC) | |||
Image: Nasopharyngeal carcinoma -- very high mag.jpg | NPC - very high mag. (WC) | |||
</gallery> | |||
====Case 2==== | |||
<gallery> | <gallery> | ||
Image:Lymphoepithelioma_met_to_LN_6.jpg | Nasopharyngeal carcinoma - in a LN - intermed. mag. (WC) | Image:Lymphoepithelioma_met_to_LN_6.jpg | Nasopharyngeal carcinoma - in a LN - intermed. mag. (WC) | ||
</gallery> | </gallery> | ||
www | ====www==== | ||
*[http://en.wikipedia.org/wiki/File:Lymphoepithelioma_met_to_LN_4.jpg Nasopharyngeal carcinoma - in a LN - low mag. (WP)]. | *[http://en.wikipedia.org/wiki/File:Lymphoepithelioma_met_to_LN_4.jpg Nasopharyngeal carcinoma - in a LN - low mag. (WP)]. | ||
*[http://en.wikipedia.org/wiki/File:Lymphoepithelioma_met_to_LN_2.jpg Nasopharyngeal carcinoma - in a LN - high mag. (WP)]. | *[http://en.wikipedia.org/wiki/File:Lymphoepithelioma_met_to_LN_2.jpg Nasopharyngeal carcinoma - in a LN - high mag. (WP)]. | ||
| Line 111: | Line 127: | ||
==IHC== | ==IHC== | ||
*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> | *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> | ||
*LMP-1 (EBV-LMP) +ve/-ve. | |||
**''Not'' [[Sensitivity|sensitive]]; only positive in 40-45% of cases in a series of 30 cases.<ref name=pmid11913680>{{Cite journal | last1 = Plaza | first1 = G. | last2 = Manzanal | first2 = AI. | last3 = Fogué | first3 = L. | last4 = Santón | first4 = A. | last5 = Martínez-Montero | first5 = JC. | last6 = Bellas | first6 = C. | title = Association of Epstein-Barr virus and nasopharyngeal carcinoma in Caucasian patients. | journal = Ann Otol Rhinol Laryngol | volume = 111 | issue = 3 Pt 1 | pages = 210-6 | month = Mar | year = 2002 | doi = 10.1177/000348940211100304 | PMID = 11913680 }}</ref> | |||
Notes: | 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> | *[[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> | ||
==Molecular== | |||
*[[EBER]] +ve.<ref name=pmid11913680/> | |||
===Images=== | |||
<gallery> | |||
Image: Nasopharyngeal carcinoma - EBER -- very low mag.jpg | NPC - EBER - very low mag. (WC) | |||
Image: Nasopharyngeal carcinoma - EBER -- low mag.jpg | NPC - EBER - low mag. (WC) | |||
Image: Nasopharyngeal carcinoma - EBER -- high mag.jpg | NPC - EBER - high mag. (WC) | |||
</gallery> | |||
==See also== | ==See also== | ||